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烧伤瑜伽:呼吸功法对全周胸部烧伤患者肺功能、呼吸肌活动和运动耐量的作用。

Yoga in Burn: Role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full-thickness circumferential burns of the chest.

机构信息

Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.

Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt.

出版信息

Burns. 2021 Feb;47(1):206-214. doi: 10.1016/j.burns.2020.06.033. Epub 2020 Jul 11.

Abstract

BACKGROUND

Circumferential burn of chest (CBC) is a significant type of burn and considers as a major cause of restrictive lung disease (RLD). Patient who has CBC with RLD leads to respiratory symptoms such as breathing difficulty, airway obstruction, reduced exercise capacity and altered pulmonary functions. However, studies examining the role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burn of chest are lacking.

OBJECTIVE

To find the short term effects of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burns of chest.

METHODS

Through simple random sampling method thirty subjects (N = 30) with RLD following CBC were allocated to pranayama breathing exercise group (PBE-G; n = 15) and conventional breathing exercise group (CBE-G; n = 15). They received pranayama breathing exercise and conventional breathing exercise for 4 weeks respectively. All the subjects received chest mobility exercise as common treatment. Primary (Numeric Pain Rating Scale - NPRS, forced expiratory volume (FEV1), forced vital capacity (FVC) and maximum voluntary ventilation (MVV) and secondary (Electromyogram of sternocleidomastoid, scalene, external intercostal and diaphragm muscle, 6 min walk test & Global Rating of Change - GRC) outcome measures were measured at baseline, after four weeks and after three months follow up.

RESULTS

Baseline demographic and clinical variables show homogenous distribution between the groups (p > 0.05). Four weeks following different breathing exercises, PBE-G group shows more significant changes in pain intensity, pulmonary function, respiratory muscle activity, exercise tolerance and global rating of change than CBE-G group (p ≤ 0.05) at four weeks and three months follow up.

CONCLUSION

Both groups showed improvement over time. However, differences between the groups were noticed small. Still physiotherapy management, which included pranayama breathing exercises with chest mobilization program, had an effective strategy in the treatment of restrictive lung disease following circumferential burn of chest.

摘要

背景

胸部环形烧伤(CBC)是一种重要的烧伤类型,被认为是限制性肺病(RLD)的主要原因。患有 CBC 和 RLD 的患者会出现呼吸症状,如呼吸困难、气道阻塞、运动能力下降和肺功能改变。然而,目前缺乏关于普拉那亚姆呼吸练习对全厚度胸部环形烧伤患者肺功能、呼吸肌活动和运动耐量影响的研究。

目的

探讨普拉那亚姆呼吸练习对全厚度胸部环形烧伤患者肺功能、呼吸肌活动和运动耐量的短期影响。

方法

通过简单随机抽样法,将 30 例(N=30)RLD 后 CBC 的患者分为普拉那亚姆呼吸练习组(PBE-G;n=15)和常规呼吸练习组(CBE-G;n=15)。两组分别接受 4 周的普拉那亚姆呼吸练习和常规呼吸练习。所有患者均接受胸部运动练习作为常规治疗。主要(数字疼痛评分量表-NPRS、用力呼气量(FEV1)、用力肺活量(FVC)和最大自主通气量(MVV)和次要(胸锁乳突肌、斜角肌、肋间外肌和膈肌肌的肌电图、6 分钟步行试验和整体变化评级-GRC)结局指标在基线、4 周后和 3 个月随访时进行测量。

结果

两组在基线时的人口统计学和临床变量均显示出同质分布(p>0.05)。在接受不同呼吸练习 4 周后,PBE-G 组在疼痛强度、肺功能、呼吸肌活动、运动耐量和整体变化评级方面的变化均明显优于 CBE-G 组(p≤0.05),在 4 周和 3 个月随访时也如此。

结论

两组均随时间改善,但组间差异较小。尽管如此,包括普拉那亚姆呼吸练习和胸部运动方案在内的物理治疗管理,仍然是治疗 CBC 后 RLD 的有效策略。

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