Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan.
Physical Therapy Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan.
J Formos Med Assoc. 2020 Dec;119(12):1781-1790. doi: 10.1016/j.jfma.2020.01.011. Epub 2020 Feb 7.
Critically compromised by upper airway anatomical impaired properties, obstructive sleep apnea (OSA) can be categorized into different phenotypic traits, mainly including oropharyngeal muscle dysfunction. The upper airway muscle strength training was targeted on oropharyngeal muscle dysfunction by re-educating the oropharyngeal muscles to maintain the upper airway patency. OSA was characterized with multilevel collapsibility of the upper airway; however, the programs are still inconsistent and the effects are unknown. Therefore, the purpose of this study was to investigate the effects of a comprehensive physical therapy on OSA.
Fifteen subjects with newly diagnosed moderate or severe OSA (AHI ≥ 15) were randomized into intervention and control groups. The intervention group underwent a 12-week-intervention of hospital based physical therapy, while the control group was kept on waiting for 12 weeks. Polysomnography (PSG) data, oropharyngeal and respiratory muscle performance were measured before and after intervention.
In intervention group (n = 8), AHI was significantly improved (from 46.96 ± 19.45 to 32.78 ± 10.78 events/h, p = 0.017); in control group (n = 7), AHI was significantly increased (from 35.77 ± 17.49 to 42.96 ± 17.32 events/h, p = 0.043). While the control group remained no change between pre- and post- intervention, the intervention group demonstrated that other PSG outcomes significantly improved, including arousal index (46.04 ± 18.9 versus 32.98 ± 8.35/h), mean SpO (92.88 ± 2.1 versus 94.13 ± 1.46%), and oxygen desaturation index (ODI) (31.13 ± 19.48 versus 20.57 ± 7.83/h).
This comprehensive physical therapy can be prescribed for the significant clinical improvement on sleep apnea for the patients with moderate and severe OSA.
由于上呼吸道解剖结构受损，严重阻塞性睡眠呼吸暂停（OSA）可分为不同的表型特征，主要包括口咽肌肉功能障碍。上气道肌肉力量训练通过重新训练口咽肌肉来维持上气道通畅，针对的是口咽肌肉功能障碍。OSA 以上气道多水平塌陷为特征；然而，目前的治疗方案仍不一致，疗效尚不清楚。因此，本研究旨在探讨综合物理治疗对 OSA 的疗效。
将 15 例新诊断为中重度 OSA（AHI≥15）的患者随机分为干预组和对照组。干预组接受 12 周的医院基础物理治疗，对照组则等待 12 周。治疗前后分别测量多导睡眠图（PSG）数据、口咽和呼吸肌功能。
干预组（n=8）的 AHI 显著降低（从 46.96±19.45 降至 32.78±10.78 事件/小时，p=0.017）；对照组（n=7）的 AHI 显著增加（从 35.77±17.49 增加到 42.96±17.32 事件/小时，p=0.043）。对照组在治疗前后没有变化，而干预组则显示其他 PSG 结果显著改善，包括觉醒指数（46.04±18.9 与 32.98±8.35/小时）、平均 SpO₂（92.88±2.1 与 94.13±1.46%）和氧减饱和度指数（ODI）（31.13±19.48 与 20.57±7.83/小时）。
综合物理疗法可用于治疗中重度 OSA 患者的睡眠呼吸暂停，显著改善临床症状。
