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支气管扩张症患者的居家肺康复:一项随机对照试验。

Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial.

作者信息

José Anderson, Holland Anne E, Selman Jessyca P R, de Camargo Cristiane Oliveira, Fonseca Diogo Simões, Athanazio Rodrigo A, Rached Samia Z, Cukier Alberto, Stelmach Rafael, Dal Corso Simone

机构信息

Postgraduate Program in Rehabilitation Sciences and Physical Functional Performance, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.

Physiotherapy, Alfred Health, Melbourne, Australia.

出版信息

ERJ Open Res. 2021 May 31;7(2). doi: 10.1183/23120541.00021-2021. eCollection 2021 Apr.

Abstract

AIM

To investigate the short- and long-term effects of home-based pulmonary rehabilitation (HBPR) on functional capacity, quality of life, peripheral muscle strength, dyspnoea and daily physical activity in people with bronchiectasis.

METHODS

Randomised controlled trial with 63 participants with bronchiectasis. The HBPR group performed three sessions per week for 8 weeks (aerobic exercise: step training for 20 min; resistance training: exercises for quadriceps, hamstrings, deltoids and biceps brachii using elastic bands). The control group received a recommendation to walk at moderate intensity, three times per week. A weekly phone call was conducted for all participants, and the HBPR group received a home visit every 15 days. The primary outcome was distance in the incremental shuttle walk test (ISWT). Secondary outcomes were time in the endurance shuttle walk test (ESWT), number of steps in the incremental step test, quality of life, quadriceps muscle strength and daily physical activity. Measures were taken before and after intervention and 6 months later.

RESULTS

After the intervention, the HBPR group had increased ISWT distance compared with the control group with between-group difference 87.9 m (95% CI 32.4-143.5 m). In addition, between-group differences were found in the ESWT, incremental step test, quality of life and quadriceps muscle strength, favouring the HBPR group. After 6 months, no differences were observed between the groups.

CONCLUSION

HBPR is an effective alternative offering of pulmonary rehabilitation for people with bronchiectasis. However, the programme was not effective in maintaining the benefits after 6 months of follow-up.

摘要

目的

探讨居家肺康复(HBPR)对支气管扩张症患者功能能力、生活质量、外周肌肉力量、呼吸困难及日常身体活动的短期和长期影响。

方法

对63名支气管扩张症患者进行随机对照试验。HBPR组每周进行3次训练,共8周(有氧运动:20分钟的台阶训练;阻力训练:使用弹力带对股四头肌、腘绳肌、三角肌和肱二头肌进行锻炼)。对照组接受每周三次中等强度步行的建议。对所有参与者每周进行一次电话随访,HBPR组每15天进行一次家访。主要结局是递增往返步行试验(ISWT)中的步行距离。次要结局包括耐力往返步行试验(ESWT)中的时间、递增台阶试验中的步数、生活质量、股四头肌力量和日常身体活动。在干预前后及6个月后进行测量。

结果

干预后,HBPR组的ISWT距离较对照组增加,组间差异为87.9米(95%可信区间32.4 - 143.5米)。此外,在ESWT、递增台阶试验、生活质量和股四头肌力量方面发现组间差异,HBPR组更具优势。6个月后,两组之间未观察到差异。

结论

HBPR是支气管扩张症患者肺康复的一种有效替代方案。然而,随访6个月后该方案在维持疗效方面无效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2b0/8165366/90ed1a1cb0b7/00021-2021.01.jpg

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