家庭为基础的肺康复是否能改善支气管扩张症患者的功能能力、外周肌肉力量和生活质量，与标准治疗相比？

Does home-based pulmonary rehabilitation improve functional capacity, peripheral muscle strength and quality of life in patients with bronchiectasis compared to standard care?

机构信息

Universidade Nove de Julho (UNINOVE), Programa de Pós Graduaçaão em Ciências da Reabilitação, São Paulo, SP, Brazil.

La Trobe University, Institute for Breathing and Sleep, Melbourne, Australia.

出版信息

Braz J Phys Ther. 2017 Nov-Dec;21(6):473-480. doi: 10.1016/j.bjpt.2017.06.021. Epub 2017 Aug 19.

BACKGROUND

Home-based pulmonary rehabilitation is a promising intervention that may help patients to overcome the barriers to undergoing pulmonary rehabilitation. However, home-based pulmonary rehabilitation has not yet been investigated in patients with bronchiectasis.

OBJECTIVES

To investigate the effects of home-based pulmonary rehabilitation in patients with bronchiectasis.

METHODS

An open-label, randomized controlled trial with 48 adult patients with bronchiectasis will be conducted.

INTERVENTIONS

The program will consist of three sessions weekly over a period of 8 weeks. Aerobic exercise will consist of stepping on a platform for 20min (intensity: 60-80% of the maximum stepping rate in incremental step test). Resistance training will be carried out using an elastic band for the following muscles: quadriceps, hamstrings, deltoids, and biceps brachii (load: 70% of maximum voluntary isometric contraction).

CONTROL

The patients will receive an educational manual and a recommendation to walk three times a week for 30min. All patients will receive a weekly phone call to answer questions and to guide the practice of physical activity. The home-based pulmonary rehabilitation group also will receive a home visit every 15 days.

MAIN OUTCOME MEASURES

incremental shuttle walk test, quality of life, peripheral muscle strength, endurance shuttle walk test, incremental step test, dyspnea, and physical activity in daily life. The assessments will be undertaken at baseline, after the intervention, and 8 months after randomization.

DISCUSSION

The findings of this study will determine the clinical benefits of home-based pulmonary rehabilitation and will contribute to future guidelines for patients with bronchiectasis.

TRIAL REGISTRATION

www.ClinicalTrials.gov (NCT02731482). https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00060X6&selectaction=Edit&uid=U00028HR&ts=2&cx=1jbszg.

背景

家庭为基础的肺康复是一种很有前途的干预措施，可能有助于患者克服进行肺康复的障碍。然而，支气管扩张症患者尚未进行家庭为基础的肺康复研究。

目的

调查家庭为基础的肺康复对支气管扩张症患者的影响。

方法

将对 48 名成年支气管扩张症患者进行一项开放标签、随机对照试验。

干预措施

该方案将每周进行 3 次，共 8 周。有氧运动包括在平台上踏步 20 分钟（强度：递增台阶试验中最大踏步率的 60-80%）。使用弹性带进行阻力训练，针对以下肌肉：股四头肌、腘绳肌、三角肌和肱二头肌（负荷：最大自主等长收缩的 70%）。

对照组

患者将获得教育手册，并建议每周步行 3 次，每次 30 分钟。所有患者将每周接受一次电话，以解答问题并指导体育活动的实践。家庭为基础的肺康复组还将每 15 天接受一次家访。

主要观察指标

递增穿梭步行试验、生活质量、外周肌肉力量、耐力穿梭步行试验、递增台阶试验、呼吸困难和日常生活中的体力活动。评估将在基线、干预后和随机分组后 8 个月进行。

讨论

本研究的结果将确定家庭为基础的肺康复的临床益处，并为未来支气管扩张症患者的指南提供依据。

试验注册

www.ClinicalTrials.gov（NCT02731482）。https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00060X6&selectaction=Edit&uid=U00028HR&ts=2&cx=1jbszg。