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上肢康复对比肺移植受者无上肢康复的效果:一项随机对照试验。

Effect of Upper Limb Rehabilitation Compared to No Upper Limb Rehabilitation in Lung Transplant Recipients: A Randomized Controlled Trial.

机构信息

Physiotherapy Department, The Alfred Hospital, Melbourne, Victoria, Australia; Respiratory Department, The Alfred Hospital, Melbourne, Victoria, Australia; La Trobe University, Bundoora, Victoria, Australia.

Physiotherapy Department, The University of Melbourne, Carlton, Victoria, Australia.

出版信息

Arch Phys Med Rehabil. 2018 Jul;99(7):1257-1264.e2. doi: 10.1016/j.apmr.2017.09.115. Epub 2017 Oct 16.

Abstract

OBJECTIVE

To investigate the effect of a supervised upper limb (UL) program (SULP) compared to no supervised UL program (NULP) after lung transplantation (LTx).

DESIGN

Randomized controlled trial.

SETTING

Physiotherapy gym.

PARTICIPANTS

Participants (N=80; mean age, 56±11y; 37 [46%] men) were recruited after LTx.

INTERVENTIONS

All participants underwent lower limb strength thrice weekly and endurance training. Participants randomized to SULP completed progressive UL strength training program using handheld weights and adjustable pulley equipment.

MAIN OUTCOME MEASURES

Overall bodily pain was rated on the visual analog scale. Shoulder flexion and abduction muscle strength were measured on a hand held dynamometer. Health related quality of life was measured with Medical Outcomes Study 36-item Short Form health Survey and the Quick Dash. Measurements were made at baseline, 6 weeks, 12 weeks, and 6 months by blinded assessors.

RESULTS

After 6 weeks of training, participants in the SULP (n=41) had less overall bodily pain on the visual analog scale than did participants in the NULP (n=36) (mean VAS bodily pain score, 2.1±1.3cm vs 3.8±1.7cm; P<.001) as well as greater UL strength than did participants in the NULP (mean peak force, 8.4±4.0Nm vs 6.7±2.8Nm; P=.037). At 12 weeks, participants in the SULP better quality of life related to bodily pain (76±17 vs 66±26; P=.05), but at 6 months there were no differences between the groups in any outcome measures. No serious adverse events were reported.

CONCLUSIONS

UL rehabilitation results in short-term improvements in pain and muscle strength after LTx, but no longer-term effects were evident.

摘要

目的

研究与无监督上肢(UL)方案(NULP)相比,监督上肢(SULP)方案对肺移植(LTx)后的影响。

设计

随机对照试验。

地点

物理治疗健身房。

参与者

参与者(N=80;平均年龄 56±11 岁;37 [46%]名男性)在 LTx 后被招募。

干预措施

所有参与者每周接受三次下肢力量和耐力训练。随机分配至 SULP 的参与者使用手持重物和可调节滑轮设备完成渐进式 UL 力量训练计划。

主要观察指标

整体身体疼痛通过视觉模拟量表评定。用手持测力计测量肩屈和外展肌力。使用医疗结局研究 36 项简明健康调查和快速短跑量表测量健康相关生活质量。通过盲法评估员在基线、6 周、12 周和 6 个月时进行测量。

结果

经过 6 周的训练,SULP 组(n=41)的参与者在视觉模拟量表上的整体身体疼痛评分低于 NULP 组(n=36)(平均 VAS 身体疼痛评分,2.1±1.3cm 比 3.8±1.7cm;P<.001),且 UL 力量也强于 NULP 组(平均峰值力,8.4±4.0Nm 比 6.7±2.8Nm;P=.037)。在 12 周时,SULP 组与身体疼痛相关的生活质量更好(76±17 比 66±26;P=.05),但在 6 个月时,两组在任何结果测量中均无差异。没有严重不良事件报告。

结论

LTx 后,UL 康复可在短期内改善疼痛和肌肉力量,但无长期效果。

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