Tarigan Amira Permatasari, Ananda Fannie Rizki, Pandia Pandiaman, Sinaga Bintang Ym, Maryaningsih Maryaningsih, Anggriani Anggriani
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Open Access Maced J Med Sci. 2019 Feb 25;7(4):567-572. doi: 10.3889/oamjms.2019.113. eCollection 2019 Feb 28.
Exercise tolerance is one of the main impacts of COPD. COPD patients often experience dyspnea and fatigue after doing daily activities using their limb parts, even in simple thing such as lifting or grooming. Nowadays, many pulmonologists concerned in pulmonary rehabilitation to modify some limb training with breathing manoeuvre to get positive impact in stable COPD patient.
The purpose of this study is to examine the impact of this modified upper limb training in lung function, functional capacity, dyspnea scale, and quality of life in patients with stable COPD.
This was a quasi-experimental study held in 2017 on 22 stable COPD patients (based on GOLD 2018 criteria). Patients were given modified upper limb training with breathing manoeuvre that leads and monitored by a physiotherapist and physician in 10-20 minutes twice a week for 8 weeks. Before and after completed all sessions of training, we measured pulmonary functions test include FEV1 and FVC, functional capacity by 6 MWT, dyspnea scale by mMRC, and quality of life by CAT assessment. Statistical analysis was performed by Wilcoxon and paired t-test.
There was an improvement of lung function, both FEV1 (40.7 ± 13.8 to 47.3 ± 14.2; p-value 0.001) and FVC (50.7 ± 14.1 to 54.1 ± 14.7; p-value: 0.207) after training. There was a significant change of functional capacity in 6 MWT mean (277.3 ± 80.8 to 319.1 ± 78.3; p-value: 0.001). There was an improved quality of life after training, measured by decreasing in CAT score (23.9 ± 5.5 to 18.3 ± 5.2; p-value: 0.000). There was no significant change in the mMRC scale (p-value: 0.429).
There was an improvement of lung function, functional capacity, and quality of life in stable COPD after upper limb training with breathing manoeuvre in stable COPD patients.
运动耐力是慢性阻塞性肺疾病(COPD)的主要影响因素之一。COPD患者在使用肢体进行日常活动后,即使是诸如抬手或洗漱等简单动作,也常常会出现呼吸困难和疲劳。如今,许多肺科医生关注肺康复治疗,通过结合呼吸动作来调整一些肢体训练,以期对稳定期COPD患者产生积极影响。
本研究旨在探讨这种改良的上肢训练对稳定期COPD患者肺功能、功能能力、呼吸困难量表评分及生活质量的影响。
这是一项于2017年开展的半实验性研究,研究对象为22例稳定期COPD患者(依据2018年慢性阻塞性肺疾病全球倡议(GOLD)标准)。患者接受由物理治疗师和医生指导并监测的、结合呼吸动作的改良上肢训练,每周两次,每次10 - 20分钟,共进行8周。在完成所有训练课程前后,我们测量了肺功能测试指标,包括第1秒用力呼气容积(FEV1)和用力肺活量(FVC);通过6分钟步行试验(6 MWT)评估功能能力;采用改良英国医学研究委员会(mMRC)呼吸困难量表评估呼吸困难程度;通过慢性阻塞性肺疾病评估测试(CAT)评估生活质量。采用Wilcoxon检验和配对t检验进行统计分析。
训练后肺功能有所改善,FEV1从(40.7 ± 13.8)提升至(47.3 ± 14.2);p值为0.001),FVC从(50.7 ± 14.1)提升至(54.1 ± 14.7);p值为0.207)。6分钟步行试验的功能能力均值有显著变化(从277.3 ± 80.8提升至319.1 ± 78.3;p值为0.001)。训练后生活质量得到改善,通过CAT评分降低得以体现(从23.9 ± 5.5降至18.3 ± 5.2;p值为0.000)。mMRC量表评分无显著变化(p值为0.429)。
稳定期COPD患者进行结合呼吸动作的上肢训练后,肺功能、功能能力和生活质量均得到改善。