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高强度运动训练对慢性阻塞性肺疾病患者的益处:一项对照研究。

Benefits of High-Intensity Exercise Training to Patients with Chronic Obstructive Pulmonary Disease: A Controlled Study.

作者信息

Boeselt Tobias, Nell Christoph, Lütteken Lea, Kehr Katharina, Koepke Janine, Apelt Sandra, Veith Martina, Beutel Björn, Spielmanns Marc, Greulich Timm, Vogelmeier Claus F, Kenn Klaus, Janciauskiene Sabina, Alter Peter, Koczulla A Rembert

机构信息

Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany.

出版信息

Respiration. 2017;93(5):301-310. doi: 10.1159/000464139. Epub 2017 Mar 23.

Abstract

BACKGROUND

Various exercise training programs are used for patients with chronic obstructive pulmonary disease (COPD) of different severity.

OBJECTIVES

To investigate the impact of individualized high-intensity training on exercise capacity with COPD.

METHODS

A total of 49 patients agreed to participate. Of these, 31 were assigned to the training group and 18 served as controls. The training group exercised twice a week for 90 min with consecutively increasing loads. At the time of enrollment (T0), as well as after 3 (T1) and 6 (T2) months, a 6-min walk test (6-MWT) was performed and data on health-related quality of life, femoral muscle thickness, and various serum markers were obtained.

RESULTS

The training group improved in their 6-MWT results (T0 = 407 ± 152 m vs. T1 = 459 ± 127 m, p = 0.002, vs. T2 = 483.2 ± 130.1 m, p = 0.004), in their cross-sectional area of the musculus rectus femoris (T0 = 6.2 ± 1.2 cm2 vs. T1 = 6.9 ± 1.2 cm2, p = 0.003, vs. 7.5 ± 1.6 cm2, p = 0.002), and in their St. George's Respiratory Questionnaire (SGRQ) score (T0 = 43.3 ± 18.0 vs. T1 = 36.0 ± 18.4, p = 0.001, vs. T2 = 34.7 ± 18. 0, p = 0.004). Serum levels of myostatin, irisin, resistin, and α-Klotho did not change significantly within the training period. Of note, the exercise group showed an inverse relationship between serum levels of resistin and those of α-Klotho after 6 months (r = -0.608, p = 0.021).

CONCLUSIONS

COPD patients undergoing an individualized, structured, high-intensity training program improved their exercise capacity, gained muscle mass, and improved their quality of life.

摘要

背景

各种运动训练方案被用于不同严重程度的慢性阻塞性肺疾病(COPD)患者。

目的

研究个体化高强度训练对COPD患者运动能力的影响。

方法

共有49名患者同意参与。其中,31名被分配到训练组,18名作为对照组。训练组每周锻炼两次,每次90分钟,负荷逐渐增加。在入组时(T0)以及3个月(T1)和6个月(T2)后,进行6分钟步行试验(6-MWT),并获取与健康相关的生活质量、股四头肌厚度和各种血清标志物的数据。

结果

训练组的6-MWT结果有所改善(T0 = 407 ± 152米 vs. T1 = 459 ± 127米,p = 0.002,vs. T2 = 483.2 ± 130.1米,p = 0.004),股直肌横截面积有所增加(T0 = 6.2 ± 1.2平方厘米 vs. T1 = 6.9 ± 1.2平方厘米,p = 0.003,vs. 7.5 ± 1.6平方厘米,p = 0.002),圣乔治呼吸问卷(SGRQ)评分有所改善(T0 = 43.3 ± 18.0 vs. T1 = 36.0 ± 18.4,p = 0.001,vs. T2 = 34.7 ± 18.0,p = 0.004)。在训练期间,血清中肌生长抑制素、鸢尾素、抵抗素和α-klotho水平没有显著变化。值得注意的是,6个月后,运动组血清抵抗素水平与α-klotho水平呈负相关(r = -0.608,p = 0.021)。

结论

接受个体化、结构化、高强度训练方案的COPD患者提高了运动能力,增加了肌肉量,并改善了生活质量。

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