不同运动训练方案对纤维性间质性肺疾病功能表现的影响：一项随机试验。
Effects of different exercise training programs on the functional performance in fibrosing interstitial lung diseases: A randomized trial.
机构信息
Department of Chest diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of medicine, Alexandria University, Alexandria, Egypt.
出版信息
PLoS One. 2022 May 26;17(5):e0268589. doi: 10.1371/journal.pone.0268589. eCollection 2022.
OBJECTIVES
We aimed to compare the effects of different aerobic exercise training (ET) programs on respiratory performance, exercise capacity, and quality of life in fibrosing interstitial lung diseases (f-ILD).
METHODS
A case-control study where 31 patients with f-ILD diagnosis based on chest high-resolution computed tomography were recruited from Main Alexandria University hospital-Egypt. Ten patients were randomly assigned for only lower limbs (LL) endurance training program, and 10 patients for upper limbs, lower limbs, and breathing exercises (ULB) program for consecutive 18 sessions (3 sessions/week for 6 consecutive weeks). Eleven patients who refused to participate in the ET program were considered as control. All patients were subjected for St George's respiratory questionnaire (SGRQ), 6-minute walk test (6-MWT), forced spirometry and cardiopulmonary exercise testing (CPET) before and after ET programs.
RESULTS
Fibrosing non-specific interstitial pneumonia (NSIP) and collagenic associated-ILD were the commonest pathologies among the ET groups (30% each) with mean age of 44.4±12.25 and 41.90±7.58 years for LL and ULB groups respectively and moderate-to-severe lung restriction. 6-MWT and SGRQ significantly improved after both ET programs (p<0.001). Peak oxygen consumption (VO2) improved significantly after both LL training (median of 22 (interquartile range (IQR) = 17.0-24.0) vs. 17.5 (IQR = 13.0-23.0) ml/kg/min, p = 0.032) and ULB training (median of 13.5 (IQR = 11.0-21.0) vs. 10.5 (IQR = 5.0-16.0) ml/kg/min, p = 0.018). Further, maximal work load and minute ventilation (VE) significantly improved after both types of ET training (p<0.05); however, neither ventilation equivalent (VE/VCO2) nor FVC% improved after ET (p = 0.052 and 0.259 respectively). There were no statistically significant important differences between LL and ULB training programs regarding 6-MWT, SGRQ or CPET parameters (p>0.05).
CONCLUSIONS
ET was associated with improvements in exercise capacity and quality of life in f-ILD patients irrespective of the type of ET program provided.
目的
比较不同有氧运动训练（ET）方案对纤维化间质性肺病（f-ILD）患者呼吸功能、运动能力和生活质量的影响。
方法
这是一项病例对照研究，共纳入 31 例基于胸部高分辨率计算机断层扫描诊断为 f-ILD 的患者，这些患者均来自埃及亚历山大大学附属医院。其中 10 例患者被随机分配接受仅下肢（LL）耐力训练方案，10 例患者接受上肢、下肢和呼吸训练（ULB）方案，共进行 18 个疗程（每周 3 次，连续 6 周）。11 例拒绝参加 ET 方案的患者被视为对照组。所有患者均接受圣乔治呼吸问卷（SGRQ）、6 分钟步行试验（6-MWT）、用力肺活量和心肺运动测试（CPET）评估，在 ET 方案前后进行。
结果
纤维化非特异性间质性肺炎（NSIP）和胶原相关间质性肺病是 ET 组中最常见的两种病理类型（各占 30%），LL 和 ULB 组的平均年龄分别为 44.4±12.25 岁和 41.90±7.58 岁，均存在中重度肺限制性疾病。两种 ET 方案均可显著改善 6-MWT 和 SGRQ（均<0.001）。LL 训练后（中位数为 22（IQR=17.0-24.0）比 17.5（IQR=13.0-23.0）ml/kg/min，p=0.032）和 ULB 训练后（中位数为 13.5（IQR=11.0-21.0）比 10.5（IQR=5.0-16.0）ml/kg/min，p=0.018）峰值氧耗量（VO2）均显著改善。进一步，两种 ET 训练后最大功和分钟通气量（VE）均显著改善（均<0.05）；然而，ET 后通气当量（VE/VCO2）和 FVC%均未改善（均 p=0.052 和 0.259）。在 6-MWT、SGRQ 或 CPET 等参数方面，LL 和 ULB 训练方案之间无统计学显著差异（均 p>0.05）。
结论
无论提供哪种类型的 ET 方案，ET 均可改善 f-ILD 患者的运动能力和生活质量。
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