非囊性纤维化支气管扩张症患者肺康复家庭计划后的运动能力和体力活动：一项随机对照试验。
Exercise Capacity and Physical Activity in Non-Cystic Fibrosis Bronchiectasis after a Pulmonary Rehabilitation Home-Based Programme: A Randomised Controlled Trial.
机构信息
Respiratory Department, Virgen Macarena University Hospital, 41009 Seville, Spain.
Physical Medicine and Rehabilitation, Virgen Macarena University Hospital, 41009 Seville, Spain.
出版信息
Int J Environ Res Public Health. 2022 Sep 3;19(17):11039. doi: 10.3390/ijerph191711039.
BACKGROUND
Patients with chronic respiratory disease have low exercise capacity and limited physical activity (PA), which is associated with worsening dyspnoea, exacerbations, and quality of life. The literature regarding patients with non-cystic fibrosis bronchiectasis (non-CF BQ) is scarce, especially regarding the use of cardiopulmonary exercise tests (CPET) to assess the effects of home-based pulmonary rehabilitation programmes (HPRP). The aim was to evaluate the effect of an HPRP on the exercise capacity of non-CF BQ patients using CPET and PA using an accelerometer.
METHODS
Our study describes a non-pharmacological clinical trial in non-CF BQ patients at the Virgen Macarena University Hospital (Seville, Spain). The patients were randomised into two groups: a control group (CG), which received general advice on PA and educational measures, and the intervention group (IG), which received a specific 8-week HPRP with two hospital sessions. The variables included were those collected in the CPET, the accelerometer, and others such as a 6 min walking test (6MWT) and dyspnoea. The data were collected at baseline and at an 8-week follow-up.
RESULTS
After the intervention, there was a significant increase in peak VO in the IG, which was not evidenced in the GC (IG 66.8 ± 15.5 mL/min = 0.001 vs. CG 62.2 ± 14.14 mL/min, = 0.30). As well, dyspnoea according to the mMRC (modified Medical Research Council), improved significantly in IG (2.19 ± 0.57 to 1.72 ± 0.05, = 0.047) vs. CG (2.07 ± 0.7 to 2.13 ± 0.64, = 0.36). In addition, differences between the groups in walked distance (IG 451.19 ± 67.99 m, = 0.001 vs. CG 433.13 ± 75.88 m, = 0.981) and in physical activity (IG 6591 ± 3482 steps, = 0.007 vs. CG 4824 ± 3113 steps, = 0.943) were found.
CONCLUSION
Participation in a specific HPRP improves exercise capacity, dyspnoea, walked distance, and PA in non-CF BQ patients.
背景
慢性呼吸系统疾病患者的运动能力较低，身体活动（PA）受限，这与呼吸困难恶化、加重和生活质量下降有关。关于非囊性纤维化支气管扩张症（非 CF BQ）患者的文献很少，尤其是关于使用心肺运动测试（CPET）评估家庭为基础的肺康复计划（HPRP）效果的文献。目的是使用 CPET 和加速度计评估 PA，评估 HPRP 对非 CF BQ 患者运动能力的影响。
方法
我们的研究描述了西班牙塞维利亚 Virgen Macarena 大学医院的非 CF BQ 患者的非药物临床试验。患者被随机分为两组：对照组（CG），接受 PA 和教育措施的一般建议；干预组（IG），接受为期 8 周的特定 HPRP，包括 2 次住院。纳入的变量包括 CPET、加速度计以及 6 分钟步行测试（6MWT）和呼吸困难等其他变量。数据在基线和 8 周随访时收集。
结果
干预后，IG 的峰值 VO 显著增加，而 CG 则没有（IG 66.8 ± 15.5 mL/min = 0.001 vs. CG 62.2 ± 14.14 mL/min， = 0.30）。此外，IG 组根据 mMRC（改良的医学研究委员会）评估的呼吸困难也显著改善（2.19 ± 0.57 至 1.72 ± 0.05， = 0.047），而 CG 组（2.07 ± 0.7 至 2.13 ± 0.64， = 0.36）。此外，还发现两组之间的差异在步行距离（IG 451.19 ± 67.99 m， = 0.001 vs. CG 433.13 ± 75.88 m， = 0.981）和身体活动（IG 6591 ± 3482 步， = 0.007 vs. CG 4824 ± 3113 步， = 0.943）。
结论
参与特定的 HPRP 可改善非 CF BQ 患者的运动能力、呼吸困难、步行距离和 PA。
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