Carter R, Nicotra B, Clark L, Zinkgraf S, Williams J, Peavler M, Fields S, Berry J
Department of Medicine, University of Texas Health Center at Tyler 75710.
Arch Phys Med Rehabil. 1988 Feb;69(2):118-22.
Fifty-nine patients with severe chronic obstructive pulmonary disease (COPD) performed pulmonary function and exercise tests before and after participation in a 12-day pulmonary rehabilitation inpatient program. Postdischarge follow-ups were performed at three months. Training consisted of twice daily aerobic exercise of 30 to 40 minutes' duration. Intensity of training was determined after exercise testing and approached the maximal limits of ventilation. In general, the program failed to demonstrate significant changes in pulmonary function. Exceptions were mid-expiratory flow rate (FEF25-75) (p less than .02) and peak flow rate (p less than .05). Evaluation of exercise capacity via maximal exercise testing yielded significant increases in caloric expenditure (p less than .001), peak exercise oxygen consumption (p less than .001), and work output (p less than .0001). Peak exercise ventilation increased significantly (p less than .005) due to an increase in tidal volume (p less than .002). Work efficiency improved with training, but the change was not statistically significant. Resting oxygen consumption and carbon dioxide production were decreased (p less than .05); tidal volume was increased (p less than .005). However, the significant increase noted in tidal volume did not alter minute ventilation. In general, the changes noted at 12 days were maintained at three months postdischarge. These data support the hypothesis that a short-term, in-hospital program of general exercise conditioning can improve work output, gas exchange, and mechanical efficiency without significantly affecting spirometric indices. These changes may translate into improved performance of activities of daily living and a sense of general well-being.
59例重度慢性阻塞性肺疾病（COPD）患者在参加为期12天的住院肺康复项目前后进行了肺功能和运动测试。出院后3个月进行随访。训练包括每天两次、每次持续30至40分钟的有氧运动。训练强度在运动测试后确定，接近通气的最大极限。总体而言，该项目未能显示出肺功能有显著变化。例外情况是呼气中期流速（FEF25 - 75）（p < .02）和峰值流速（p < .05）。通过最大运动测试评估运动能力，结果显示热量消耗（p < .001）、运动峰值耗氧量（p < .001）和功输出（p < .0001）均显著增加。由于潮气量增加（p < .002），运动峰值通气量显著增加（p < .005）。训练后工作效率有所提高，但变化无统计学意义。静息耗氧量和二氧化碳产生量降低（p < .05）；潮气量增加（p < .005）。然而，潮气量的显著增加并未改变分钟通气量。总体而言，12天时观察到的变化在出院后3个月时得以维持。这些数据支持这样一种假设，即短期的住院全身运动调节项目可以提高功输出、气体交换和机械效率，而不会显著影响肺量计指标。这些变化可能转化为日常生活活动能力的改善和总体幸福感的提升。
