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一项关于肺动脉高压吸气肌训练的随机对照试验:对呼吸功能、功能运动能力、身体活动和生活质量的影响。

A randomized controlled trial on inspiratory muscle training in pulmonary hypertension: Effects on respiratory functions, functional exercise capacity, physical activity, and quality of life.

机构信息

Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Bakırköy, Istanbul, Turkey.

Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey.

出版信息

Heart Lung. 2020 Jul-Aug;49(4):381-387. doi: 10.1016/j.hrtlng.2020.01.014. Epub 2020 Mar 4.

Abstract

BACKGROUND

Impaired respiratory muscle function may be one of the causes of increased dyspnea, reduced exercise capacity, and physical activity (PA), and poor quality of life in pulmonary hypertension (PH).

OBJECTIVE

To investigate the effects of threshold inspiratory muscle training (TIMT) on respiratory functions, functional exercise capacity, PA, and QoL in patients with PH.

METHODS

Thirty patients with PH were randomly allocated to a TIMT (n = 15) and sham group (n = 15). Three patients in the sham group could not participate in the program. The TIMT group (n = 15) trained at 30% of the maximal inspiratory pressure (MIP), and the sham group (n = 12) performed at lowest pressure without change in threshold pressure. In both groups, patients performed TIMT at home for 15 min, twice per day, with the MIP load determined by the trainer, and were supervised once weekly at the hospital for eight weeks. The primary outcomes were MIP and maximal expiratory pressure (MEP). The secondary outcome measures included spirometric measurements, six-minute walking distance (6MWD), PA (SenseWear armband and International Physical Activity Questionnaire-Short Form-IPAQ-Short Form), and QoL (Minnesota Living with Heart Failure-MLHF).

RESULTS

After the training, changes in MIP (p = 0.023) were higher in the intervention group compared with the sham group. Differences in MEP, FEV1 (%), FVC (%), FEV1/FVC (%), 6MWD, %6MWD, IPAQ-SF, MLHFQ, and armband parameters were not significantly different between the groups (p > 0.05).

CONCLUSIONS

The results of the study demonstrated that TIMT could increase MIP and did not improve other parameters of respiratory functions, functional exercise capacity, PA, and QoL in patients with PH.

摘要

背景

呼吸肌功能障碍可能是肺动脉高压(PH)患者呼吸困难加重、运动能力下降、体力活动(PA)减少和生活质量下降的原因之一。

目的

探讨阈吸气肌训练(TIMT)对 PH 患者呼吸功能、运动耐力、PA 和生活质量的影响。

方法

将 30 例 PH 患者随机分为 TIMT 组(n=15)和假训练组(n=15)。假训练组有 3 例患者无法参与该计划。TIMT 组(n=15)以最大吸气压力(MIP)的 30%进行训练,假训练组(n=12)以最低压力进行训练,但阈压不变。两组患者均在家中使用 MIP 负荷器进行 15 分钟、2 次/天的 TIMT,并在医院每周接受一次监督,共 8 周。主要结局指标为 MIP 和最大呼气压力(MEP)。次要结局指标包括肺量计测量、6 分钟步行距离(6MWD)、PA(SenseWear 臂带和国际体力活动问卷-短表-IPAQ-短表)和生活质量(明尼苏达州心力衰竭生活质量量表-MLHF)。

结果

训练后,干预组 MIP 的变化(p=0.023)明显高于假训练组。两组间 MEP、FEV1(%)、FVC(%)、FEV1/FVC(%)、6MWD、%6MWD、IPAQ-SF、MLHFQ 和臂带参数的差异均无统计学意义(p>0.05)。

结论

研究结果表明,TIMT 可增加 MIP,但不能改善 PH 患者的呼吸功能、运动耐力、PA 和生活质量的其他参数。

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