Department of Pneumology, Faculty of Health, University of Witten/Herdecke, Witten, Germany (Dr Spielmanns); Zürcher RehaZentren, Wald, Switzerland (Dr Spielmanns); Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany (Drs Boeselt, Nell, Eckhoff, Koczulla, and Magnet); Department of Pneumology, Cologne Merheim Hospital GmbH, Cologne, Germany (Drs Magnet, Storre, and Windisch); Department of Pneumology, University Hospital, Freiburg, Germany (Drs Storre and Windisch); and Institute of Physiology and Anatomy, German Sports University, Cologne, Germany (Dr Baum).
J Cardiopulm Rehabil Prev. 2018 Jul;38(4):264-268. doi: 10.1097/HCR.0000000000000285.
Purpose of this study was to analyze the impact of a pulmonary rehabilitation (PR) program on the measured inspiratory capacity (IC) in patients with chronic obstructive pulmonary disease (COPD) while performing a 6-min walk test (6MWT).
Before and after PR, IC was measured by spirometry both at the beginning and at the end of the 6MWT for 15 patients with COPD in the PR group (PRG) and compared with a similar calisthenics training group (CTG; n = 15). In addition, the COPD Assessment Test (CAT), St George's Respiratory Questionnaire (SGRQ), and other lung function tests were recorded and compared.
Both groups were not significantly different at baseline. Compared with the CTG, the PRG achieved a significant increase in the delta of IC measured during the 6MWT (0.5 ± 0.2 L [PRG] vs -0.2 + 0.2 L [CTG], P = .001). Significant differences were found for the 6MWT walking distance (PRG: 99 ± 36 m vs CTG: 5 ± 25 m, P = .001). No significant increase in dyspnea while performing the 6MWT was found in either group. The differences in the CAT score and the SGRQ Global score were significant only for the PRG in intragroup comparisons, whereas the intergroup comparison showed no significant differences. Except for residual volume, no significant changes in all parameters of the static lung function tests were observed in either group.
Participation in a PR may lead to a significant and clinically relevant increase in IC and the walking distance. Additional research is necessary to define the effects of this increase in IC on exercise capacity.
本研究的目的是分析肺康复(PR)计划对慢性阻塞性肺疾病(COPD)患者在进行 6 分钟步行测试(6MWT)时测量的吸气容量(IC)的影响。
在 PR 前后,15 例 PR 组(PRG)和 15 例类似的健身训练组(CTG)的 COPD 患者在 6MWT 开始和结束时通过肺活量计测量 IC,并进行比较。此外,还记录并比较了 COPD 评估测试(CAT)、圣乔治呼吸问卷(SGRQ)和其他肺功能测试。
两组在基线时无显著差异。与 CTG 相比,PRG 在 6MWT 期间测量的 IC 差值明显增加(0.5 ± 0.2 L [PRG] vs -0.2 ± 0.2 L [CTG],P =.001)。6MWT 步行距离也存在显著差异(PRG:99 ± 36 m vs CTG:5 ± 25 m,P =.001)。两组在进行 6MWT 时呼吸困难均无明显增加。只有 PRG 在组内比较时,CAT 评分和 SGRQ 全球评分的差异才有统计学意义,而组间比较则无显著差异。除残气量外,两组静态肺功能测试的所有参数均无明显变化。
参加 PR 可能会导致 IC 和步行距离的显著且具有临床意义的增加。需要进一步研究以确定这种 IC 增加对运动能力的影响。