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行走和正念改善慢性阻塞性肺疾病患者的运动能力:一项随机对照试验。

Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial.

机构信息

Department of Nursing, National Taiwan University Hospital, Taipei City.

Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, Taipei City.

出版信息

Clin Rehabil. 2021 Aug;35(8):1117-1125. doi: 10.1177/0269215521992917. Epub 2021 Mar 11.

Abstract

OBJECTIVE

To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD).

DESIGN

A randomised controlled trial with four repeated measurements.

SETTING

Outpatient departments of a medical centre in northern Taiwan.

PARTICIPANTS

Patients with mild to severe COPD.

INTERVENTION

The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice.

OUTCOME MEASURES

The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors.

RESULTS

Compared with the control group ( = 40), the mindful walking group ( = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m;  = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 ( = 0.01), Week 8 ( = 0.002) and Week 12 ( = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D (  0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance ( = 0.02).

CONCLUSION

The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.

摘要

目的

评估正念行走练习对慢性阻塞性肺疾病(COPD)患者运动能力的影响。

设计

一项具有 4 次重复测量的随机对照试验。

地点

台湾北部一家医疗中心的门诊部门。

参与者

轻度至重度 COPD 患者。

干预措施

对照组接受常规护理,而正念行走组在接受常规护理的基础上进行正念行走练习。

主要结局

主要结局是 6 分钟步行距离。慢性阻塞性肺疾病全球倡议分类、呼吸困难、心率变异性和内感受意识是控制因素。

结果

与对照组(n=40)相比,正念行走组(n=38)的 6 分钟步行距离显著延长(延长 45.57m;P=0.04)。第 4 周(P=0.01)、第 8 周(P=0.002)和第 12 周(P=0.02)的 6 分钟步行距离的交互效应显著增加。慢性阻塞性肺疾病全球倡议分类为 A 的患者的 6 分钟步行距离明显优于分类为 D 的患者(P<0.001)。此外,内感受意识的情绪意识量表评分与 6 分钟步行距离显著相关(P=0.02)。

结论

八周的正念行走练习改善了 COPD 患者的运动能力,并且这种效果在练习结束后至少持续了四周。本研究表明,这种练习改善了 COPD 症状,降低了 COPD 风险,增加了该人群的内感受意识。

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