运动和电刺激对改善囊性纤维化和轻至中度肺功能损害儿童的肌肉力量和心肺适能是否有效？：随机对照试验。

Is exercise and electrostimulation effective in improving muscle strength and cardiorespiratory fitness in children with cystic fibrosis and mild-to-moderate pulmonary impairment?: Randomized controlled trial.

作者信息

Donadio Márcio Vinícius Fagundes, Cobo-Vicente Fernando, San Juan Alejandro F, Sanz-Santiago Verónica, Fernández-Luna Álvaro, Iturriaga Tamara, Villa Asensi José Ramón, Pérez-Ruiz Margarita

机构信息

Laboratory of Pediatric Physical Activity, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Department of Physiotherapy, Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya (UIC Barcelona), Barcelona, Spain.

Faculty of Sport Science, Universidad Europea de Madrid, Madrid, Spain.

出版信息

Respir Med. 2022 May;196:106798. doi: 10.1016/j.rmed.2022.106798. Epub 2022 Mar 1.

DOI:10.1016/j.rmed.2022.106798

PMID:35306386

Abstract

BACKGROUND

Evidence on resistance-training programs for cystic fibrosis (CF) is limited and the possible benefits of the addition of neuromuscular electrical stimulation (NMES) are unknown. This study aimed to evaluate the effects of a supervised resistance-training program, associated or not with NMES, on muscle strength, aerobic fitness, lung function and quality of life in children with CF presenting mild-to-moderate pulmonary impairment.

METHODS

This is a randomized controlled trial including CF patients aged between 6 and 17years. Subjects were randomly allocated to control (CON); exercise (EX); or exercise and NMES (EX + NMES) groups, and evaluated at baseline and at the end of an 8-week individualized exercise-program (3 days/week, 60min/session). NMES was applied in the quadriceps and the interscapular region, simultaneously to the exercises. CON group followed the CF team recommendations. The main outcome measures were lung function, cardiorespiratory fitness, functional capacity, quality of life and muscle strength.

RESULTS

Twenty-seven patients, aged 12.6 ± 3.0 years, were analyzed. No significant interactions were found for cardiorespiratory fitness. Functional capacity presented significant differences, indicating a better performance in both EX and EX + NMES. No significant changes between groups were seen for quality of life and lung function. As for muscle strength, EX and EX + NMES presented large effect sizes and significant differences, compared to CON, for quadriceps (p = 0.004, η = 0.401), pectoral (p = 0.001, η = 0.487), dorsal (p = 0.009, η = 0.333) and handgrip (p = 0.028, η = 0.278).

CONCLUSION

A resistance exercise-training program led to improvements in muscle strength and functional capacity in CF patients with mild-to-moderate pulmonary impairment. The addition of NMES to the training program resulted in no extra favorable effects.

摘要

背景

关于囊性纤维化（CF）抗阻训练计划的证据有限，添加神经肌肉电刺激（NMES）的潜在益处尚不清楚。本研究旨在评估有监督的抗阻训练计划（无论是否联合NMES）对轻度至中度肺功能损害的CF儿童肌肉力量、有氧适能、肺功能和生活质量的影响。

方法

这是一项随机对照试验，纳入年龄在6至17岁之间的CF患者。受试者被随机分配至对照组（CON）、运动组（EX）或运动加NMES组（EX + NMES），并在基线和为期8周的个体化运动计划结束时（每周3天，每次60分钟）进行评估。NMES在股四头肌和肩胛间区域应用，与运动同时进行。CON组遵循CF团队的建议。主要结局指标为肺功能、心肺适能、功能能力、生活质量和肌肉力量。

结果

分析了27例年龄为12.6±3.0岁的患者。心肺适能方面未发现显著交互作用。功能能力存在显著差异，表明EX组和EX + NMES组的表现更佳。生活质量和肺功能在组间未见显著变化。至于肌肉力量，与CON组相比，EX组和EX + NMES组的效应量较大且存在显著差异，股四头肌（p = 0.004，η = 0.401）、胸肌（p = 0.001，η = 0.487）、背肌（p = 0.009，η = 0.333）和握力（p = 0.028，η = 0.278）。