吸气肌训练和高强度间歇训练对哮喘患者肺功能及呼吸肌功能的影响
Effects of Inspiratory Muscle Training and High-Intensity Interval Training on Lung Function and Respiratory Muscle Function in Asthma.
作者信息
Wang Qimin, Yang Feng, Gao Lianjun, Gao Wei
机构信息
Department of Respiratory and Critical Care Medicine, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.
出版信息
Respir Care. 2022 Oct 20;67(11):1465-1475. doi: 10.4187/respcare.09813.
BACKGROUND
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Although inspiratory muscle training (IMT) and high-intensity interval training (HIIT) are beneficial for patients with asthma, controversies persist. Therefore, we aimed to investigate the effects of IMT and HIIT on lung function and respiratory muscle function of subjects with asthma.
METHODS
We searched PubMed, Embase, Web of Science, and the Cochrane Library databases up to May 2021. Inclusion criteria were randomized controlled trials (RCTs) of subjects with asthma who received either IMT or HIIT. The outcome measures were changes in lung function and respiratory muscle function.
RESULTS
A total of 13 RCTs (10 in IMT and 3 in HIIT) were included, with a total of 598 subjects. The meta-analysis showed a significantly improved FEV of the expected value (FEV%pred) (mean difference [MD] 4.49% [95% CI 2.31-6.67], < .001; I = 13%), FVC of the expected value (FVC % pred) (MD 5.72% [95% CI 3.56-7.88], < .001; I = 0%), FEV/FVC % (MD 5.01% [95% CI 2.45-7.58], < .001; I = 25%), FVC (L) (MD 0.21 L [95% CI 0.03-0.40], = .02; I = 0%), maximum inspiratory pressure (P) (MD 27.62 cm HO [95% CI 6.50-48.74], = .01; I = 96%), and P (%pred) (MD 27.35% [95% CI 6.94-47.76], = .009; I = 83.5%) in the IMT group. There was no statistical significance in maximum expiratory pressure.
CONCLUSIONS
IMT improved pulmonary function (FEV%pred, FVC) and inspiratory muscle strength in subjects with stable asthma. Due to the small number of RCT studies included and the limited outcome measures involving HIIT, we were unable to draw conclusions about whether HIIT was beneficial in this meta-analysis. Moreover, clinical heterogeneity exists in different areas such as population and training programs; the above conclusions still need to be confirmed in future studies.
背景
哮喘是一种异质性疾病,通常以慢性气道炎症为特征。尽管吸气肌训练(IMT)和高强度间歇训练(HIIT)对哮喘患者有益,但争议仍然存在。因此,我们旨在研究IMT和HIIT对哮喘患者肺功能和呼吸肌功能的影响。
方法
我们检索了截至2021年5月的PubMed、Embase、Web of Science和Cochrane图书馆数据库。纳入标准为接受IMT或HIIT的哮喘患者的随机对照试验(RCT)。结局指标为肺功能和呼吸肌功能的变化。
结果
共纳入13项RCT(10项关于IMT,3项关于HIIT),共598名受试者。荟萃分析显示,IMT组的预计值第一秒用力呼气容积(FEV%pred)显著改善(平均差[MD]4.49%[95%CI 2.31 - 6.67],P <.001;I² = 13%)、预计值用力肺活量(FVC%pred)(MD 5.72%[95%CI 3.56 - 7.88],P <.001;I² = 0%)、FEV/FVC%(MD 5.01%[95%CI 2.45 - 7.58],P <.001;I² = 25%)、FVC(L)(MD 0.21 L[95%CI 0.03 - 0.40],P =.02;I² = 0%)、最大吸气压力(PImax)(MD 27.62 cmH₂O[95%CI 6.50 - 48.74],P =.01;I² = 96%)和PImax(%pred)(MD 27.35%[95%CI 6.94 - 47.76],P =.009;I² = 83.5%)。最大呼气压力无统计学意义。
结论
IMT改善了稳定期哮喘患者的肺功能(FEV%pred、FVC)和吸气肌力量。由于纳入的RCT研究数量较少且涉及HIIT的结局指标有限,我们无法在这项荟萃分析中得出HIIT是否有益的结论。此外,在人群和训练方案等不同领域存在临床异质性;上述结论仍需在未来研究中得到证实。