Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Research Institute of the McGill University Health Centre, McGill University, Montréal, Québec, Canada.
Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Research Institute of the McGill University Health Centre, McGill University, Montréal, Québec, Canada; Department of Physical Therapy, University of Fortaleza, Fortaleza, Brazil; Department of Physical Therapy, Federal University of Ceara, Fortaleza, Brazil.
Respir Physiol Neurobiol. 2020 May;276:103414. doi: 10.1016/j.resp.2020.103414. Epub 2020 Feb 9.
To compare eccentric (ECC) and conventional concentric (CON) cycle training on quadriceps muscle strength in advanced COPD. Secondary objective was to assess functional capacity.
A parallel-group, assessor-blind, randomized trial was conducted. Severe COPD patients were randomized to either an ECC (n = 13) or CON (n = 11) cycling program for 30-min, 3 times/week for 10 weeks. ECC group trained at ∼4-fold higher power than the CON group at similar relative heart rate intensity.
Isometric and isokinetic quadriceps peak torque improved after ECC but not CON; between group difference was significant for isometric peak muscle force (p < 0.05). Peak cycling power and endurance time increased in both groups (p < 0.05). Dyspnea at peak cycling power improved only after ECC training (p < 0.05). Sensory intensity ratings of dyspnea and leg fatigue were significantly lower (p < 0.05) during ECC compared with CON at equivalent relative heart rate intensities.
ECC could be an effective alternative and/or adjunct modality to pulmonary rehabilitation in severely ventilatory limited COPD patients.
比较离心（ECC）和传统向心（CON）循环训练对晚期 COPD 患者股四头肌力量的影响。次要目的是评估功能能力。
进行了一项平行组、评估者盲、随机试验。将严重 COPD 患者随机分为 ECC（n=13）或 CON（n=11）组，进行 30 分钟、每周 3 次、持续 10 周的循环训练。ECC 组以比 CON 组高约 4 倍的功率进行训练，相对心率强度相似。
ECC 后等长和等速股四头肌峰值扭矩增加，但 CON 后无变化；等长峰值肌肉力量的组间差异具有统计学意义（p<0.05）。两组的峰值踏车功率和耐力时间均增加（p<0.05）。仅在 ECC 训练后，峰值踏车功率时的呼吸困难得到改善（p<0.05）。在相同的相对心率强度下，ECC 时呼吸困难和腿部疲劳的感觉强度评分明显低于 CON（p<0.05）。
ECC 可能是严重通气受限 COPD 患者肺康复的有效替代和/或辅助治疗方法。
