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COPD 患者中有和无衰弱症患者的日常生活活动、运动能力、认知和平衡。

Daily living activities, exercise capacity, cognition, and balance in COPD patients with and without frailty.

机构信息

Haseki Research and Training Hospital, Istanbul, Turkey.

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

出版信息

Ir J Med Sci. 2022 Apr;191(2):817-824. doi: 10.1007/s11845-021-02654-8. Epub 2021 May 24.

Abstract

BACKGROUND

Information on the interaction between frailty and chronic obstructive pulmonary disease (COPD) is limited.

AIMS

This study aimed to compare activities of daily living (ADL), exercise capacity, balance, and cognition in COPD patients with and without frailty.

METHODS

Twenty frail and 28 non-frail COPD patients aged 55 years and over were included. Frailty was determined according to Fried et al. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale. Respiratory and peripheral muscle strength were measured. Functional capacity was assessed using a 6-min walk test (6MWT); ADL performance was evaluated using the Glittre ADL test. The balance was evaluated using the functional reach test (FRT). Cognitive function was assessed using the Montreal Cognitive Evaluation (MoCA) Test. Quality of life was measured using the COPD Assessment Test (CAT).

RESULTS

The mMRC and CAT scores were higher in the frail patients as compared with the non-frail patients (p < 0.05). The maximal inspiratory pressure, handgrip strength, 6MWT distance, and FRT score were lower in the frail patients as compared with the non-frail patients (p < 0.05). The duration for the Glittre ADL test was longer in the frail patients than the non-frail patients (p < 0.05). There was no significant difference between MoCA scores between groups (p > 0.05).

CONCLUSIONS

Frail COPD patients have increased dyspnea perception, impaired muscle strength, and functional capacity, ADL performance, balance, and quality of life. Whether pulmonary rehabilitation programs for patients with frail COPD need to be adapted with new rehabilitation strategies, including components of frailty, needs further investigation.

摘要

背景

关于衰弱和慢性阻塞性肺疾病(COPD)之间相互作用的信息有限。

目的

本研究旨在比较有和无衰弱的 COPD 患者的日常生活活动(ADL)、运动能力、平衡和认知能力。

方法

纳入了 20 名衰弱和 28 名非衰弱的 55 岁及以上 COPD 患者。根据 Fried 等人的标准确定衰弱。呼吸困难采用改良的医学研究委员会(mMRC)呼吸困难量表进行评估。测量呼吸和外周肌肉力量。使用 6 分钟步行测试(6MWT)评估功能能力;使用 Glittre ADL 测试评估 ADL 表现。使用功能性伸展测试(FRT)评估平衡。使用蒙特利尔认知评估(MoCA)测试评估认知功能。使用 COPD 评估测试(CAT)测量生活质量。

结果

与非衰弱患者相比,衰弱患者的 mMRC 和 CAT 评分更高(p < 0.05)。与非衰弱患者相比,衰弱患者的最大吸气压力、手握力、6MWT 距离和 FRT 评分较低(p < 0.05)。Glittre ADL 测试的持续时间在衰弱患者中长于非衰弱患者(p < 0.05)。两组之间的 MoCA 评分没有显著差异(p > 0.05)。

结论

衰弱的 COPD 患者呼吸困难感知增加、肌肉力量和功能能力、ADL 表现、平衡和生活质量受损。是否需要为衰弱的 COPD 患者制定的肺康复计划采用新的康复策略,包括衰弱的组成部分,需要进一步研究。

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