Belman M J, Shadmehr R
Division of Pulmonary Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
J Appl Physiol (1985). 1988 Dec;65(6):2726-35. doi: 10.1152/jappl.1988.65.6.2726.
To overcome the problem of altered breathing strategy during resistive ventilatory muscle training (VMT), we used a single-orifice inspiratory resistance together with a target feedback device (TFD) in patients with chronic obstructive pulmonary disease (COPD). In a preliminary study (study A), we showed that the resistance plus TFD was effective in controlling breathing strategy. We subsequently used the resistor plus TFD in a 5-wk study (study B) of VMT in 17 COPD patients who were randomized into high-intensity (HI) and low-intensity (LI) training groups. Compared with the LI group, the HI group showed significant increases in static maximal inspiratory pressure (21.3 vs. 5.0 cmH2O), maximal sustained ventilatory capacity (MSVC, 3.2 vs -0.1 l/min, sustained maximal mouth pressure (12.1 vs. 0.6 cmH2O), mean mouth pressure (6.9 vs. 3.9 cmH2O), peak inspiratory flow rate (12.3 vs. 4.0 l/min), and maximal sustained work rate (12.2 vs. 4.2 cmH2O.l-1.min-1). We conclude that targeted VMT with control of breathing strategy improves both ventilatory muscle strength and endurance.
为克服阻力性通气肌肉训练（VMT）期间呼吸策略改变的问题，我们在慢性阻塞性肺疾病（COPD）患者中使用了单孔吸气阻力器和目标反馈装置（TFD）。在一项初步研究（研究A）中，我们表明阻力器加TFD在控制呼吸策略方面是有效的。随后，我们在一项为期5周的研究（研究B）中，将17名COPD患者随机分为高强度（HI）和低强度（LI）训练组，对他们使用电阻器加TFD进行VMT。与LI组相比，HI组的静态最大吸气压力（21.3 vs. 5.0 cmH₂O）、最大持续通气能力（MSVC，3.2 vs -0.1 l/min）、持续最大口腔压力（12.1 vs. 0.6 cmH₂O）、平均口腔压力（6.9 vs. 3.9 cmH₂O）、吸气峰值流速（12.3 vs. 4.0 l/min）和最大持续工作率（12.2 vs. 4.2 cmH₂O·l⁻¹·min⁻¹）均有显著增加。我们得出结论，通过控制呼吸策略进行有针对性的VMT可改善通气肌肉力量和耐力。
