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家庭下肢抗阻训练对稳定期慢性阻塞性肺疾病患者肌肉力量和功能状态的影响。

Effects of home-based lower limb resistance training on muscle strength and functional status in stable Chronic obstructive pulmonary disease patients.

机构信息

Department of Emergency and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

出版信息

J Clin Nurs. 2018 Mar;27(5-6):e1022-e1037. doi: 10.1111/jocn.14131. Epub 2018 Feb 6.

Abstract

AIMS AND OBJECTIVES

This study aimed to determine the effect of home-based lower limb resistance training (LLRT) in patients with stable COPD.

BACKGROUND

Pulmonary rehabilitation (PR) in COPD patients has been substantially investigated, but the rehabilitation components differ among studies. Few works have focused on home-based LLRT. Furthermore, few studies have assessed muscle strength and functional status by isokinetic/isometric extensor muscle peak torque (PT) and five-repetition sit-to-stand test (FTSST), respectively.

DESIGN

A randomised controlled design was adopted.

METHODS

(i) The home-based LLRT consisted of six sets of lower limb training cycles by self-gravity resistance and Thera-band resistance at 8-12RM, 20-30 min/session and 3 sessions/week for 12 weeks. (ii) The intervention group (n = 25) received routine PR guidance and home-based LLRT, whereas the control group (n = 22) received routine PR guidance only. The muscle strengths, FTSST durations, 6-min walking distances (6MWDs) and COPD assessment test results at enrolment and week 12 were compared.

RESULTS

Relative to the baseline findings, all the indexes of muscle strength (isometric extensor muscle PT, isometric extensor muscle PT to body weight ratio [PT/BW], isokinetic extensor muscle PT and isokinetic extensor muscle PT/BW) did not significantly change in the intervention group. Meanwhile, no significant intragroup difference was noted among the indexes of muscle strength (except for isometric extensor muscle PT) in the control group. The FTSST decrease was significant between and within groups. By contrast, the 6MWD significantly increased within both groups, but not between the groups. The COPD assessment tool score decreased significantly within the intervention group.

CONCLUSIONS

Compared with routine PR guidance, home-based LLRT can improve not only the muscle strength and exercise endurance but also the lower limb functional status.

RELEVANCE TO CLINICAL PRACTICE

Our developed home-based LLRT intervention is simple, safe and feasible in stable COPD patients and could hence be promoted in clinical practice.

摘要

目的

本研究旨在探讨家庭下肢抗阻训练(LLRT)对稳定期 COPD 患者的影响。

背景

COPD 患者的肺康复(PR)已得到广泛研究,但研究中的康复内容有所不同。很少有工作关注家庭下肢抗阻训练。此外,很少有研究分别通过等速/等长伸肌峰值扭矩(PT)和 5 次重复坐站测试(FTSST)评估肌肉力量和功能状态。

设计

采用随机对照设计。

方法

(i)家庭下肢抗阻训练包括 6 组下肢训练循环,采用自身体重阻力和Thera-band 阻力,每组 8-12RM,20-30min/session,每周 3 次,持续 12 周。(ii)干预组(n=25)接受常规 PR 指导和家庭下肢抗阻训练,对照组(n=22)仅接受常规 PR 指导。比较两组患者在入组时和第 12 周的肌肉力量、FTSST 持续时间、6 分钟步行距离(6MWD)和 COPD 评估测试结果。

结果

与基线相比,干预组的所有肌肉力量指标(等长伸肌 PT、等长伸肌 PT 与体重比[PT/BW]、等速伸肌 PT 和等速伸肌 PT/BW)均无显著变化。同时,对照组的肌肉力量指标(除等长伸肌 PT 外)也无显著组内差异。FTSST 减少在组间和组内均有显著差异。相比之下,两组的 6MWD 均显著增加,但组间无差异。COPD 评估工具评分在干预组内显著下降。

结论

与常规 PR 指导相比,家庭下肢抗阻训练不仅能改善肌肉力量和运动耐力,还能改善下肢功能状态。

临床意义

我们开发的家庭下肢抗阻训练干预措施简单、安全、可行,适用于稳定期 COPD 患者,可在临床实践中推广。

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