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慢性阻塞性肺疾病中呼吸肌耐力的可持续吸气压力和递增阈值负荷:一项初步研究。

Sustainable inspiratory pressure and incremental threshold loading for respiratory muscle endurance in chronic obstructive pulmonary disease: A pilot study.

作者信息

Gokcen Selda, Inal-Ince Deniz, Saglam Melda, Vardar-Yagli Naciye, Calik-Kutukcu Ebru, Arikan Hulya, Coplu Lutfi

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kutahya Health Sciences University, Kutahya, Turkey.

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

出版信息

Clin Respir J. 2021 Jan;15(1):19-25. doi: 10.1111/crj.13264. Epub 2020 Sep 7.

Abstract

INTRODUCTION

A prolonged mismatch between the demand for respiratory muscle work and the capacity to meet that demand in chronic obstructive pulmonary disease (COPD) can result in symptoms of dyspnea and the development of muscle fatigue.

OBJECTIVES

The purpose of this study was to compare two different respiratory muscle endurance assessment methods of sustainable inspiratory pressure (SIP) and incremental threshold loading (ITL) in COPD.

METHODS

Thirty-four patients diagnosed with COPD were included in the study. Physical and demographic characteristics of the subjects were recorded. Pulmonary function testing (PFT), modified Medical Research Council (MMRC) dyspnea scale, COPD assessment test, inspiratory and expiratory muscle strength (MIP and MEP, respectively) measurement and six-minute walk test (6MWT) were used to assess subjects. Two different respiratory muscle endurance tests (SIP and ITL) were performed within 48 hours apart, and each test was repeated two times on the same day.

RESULTS

There was no correlation between the SIP and ITL tests (r = 0.069, P = .699). According to the test-retest reliability analysis, both tests were reproducible (ICC = 0.843; P < .001 for SIP, ICC = 0.905; P < .001 for ITL). Finding no differences between repeated tests showed that tests are not affected by learning effect.

CONCLUSION

The SIP and ITL tests are used for the same purpose but have different characteristics. Regarding the relationship between the other parameters and tests, the ITL is well tolerated and reflects the differences in respiratory muscle endurance better.

摘要

引言

在慢性阻塞性肺疾病(COPD)中,呼吸肌工作需求与满足该需求的能力之间长期不匹配可导致呼吸困难症状和肌肉疲劳的发展。

目的

本研究的目的是比较慢性阻塞性肺疾病中两种不同的呼吸肌耐力评估方法,即持续吸气压力(SIP)和递增阈值负荷(ITL)。

方法

34例被诊断为慢性阻塞性肺疾病的患者纳入本研究。记录受试者的身体和人口统计学特征。采用肺功能测试(PFT)、改良医学研究委员会(MMRC)呼吸困难量表、慢性阻塞性肺疾病评估测试、吸气和呼气肌力量(分别为MIP和MEP)测量以及六分钟步行测试(6MWT)对受试者进行评估。两种不同的呼吸肌耐力测试(SIP和ITL)在48小时内间隔进行,且每项测试在同一天重复两次。

结果

SIP和ITL测试之间无相关性(r = 0.069,P = 0.699)。根据重测信度分析,两种测试均具有可重复性(ICC = 0.843;SIP的P < 0.001,ICC = 0.905;ITL的P < 0.001)。重复测试之间未发现差异表明测试不受学习效应影响。

结论

SIP和ITL测试用于相同目的,但具有不同特点。就其他参数与测试之间的关系而言,ITL耐受性良好,能更好地反映呼吸肌耐力的差异。

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