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八周呼吸肌训练对轻中度复发缓解型多发性硬化患者呼吸能力、功能能力和生活质量的影响:一项单盲随机对照试验。

Effect of eight weeks respiratory muscle training on respiratory capacity, functional capacity and quality of life on subjects with mild to moderate relapsing-remitting multiple sclerosis: A single-blinded randomized controlled trial.

机构信息

Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Mult Scler Relat Disord. 2022 Dec;68:104208. doi: 10.1016/j.msard.2022.104208. Epub 2022 Oct 2.

Abstract

BACKGROUND

Multiple Sclerosis (MS) is a chronic inflammatory disease of the nervous system leading to muscle weakness, including the respiratory muscles that cause pulmonary complications, impair functional capacity, increased fatigue, and as a result decreases the quality of life.

AIM

The purpose of the present study is to examine the influence of 8 weeks of respiratory muscle training (RMT) on pulmonary function and respiratory muscle strength in MS patients.

METHODS

The present study was a single-blind, randomized controlled trial that was conducted on 36 (27 Female, 9 Male) relapsing-remitting MS patients who were definitively diagnosed by a neurologist and randomly were divided into intervention and control groups. Both groups were educated on lifestyle modification with an emphasis on regular physical activity. In addition, the intervention group was prescribed eight weeks of respiratory muscle training with a threshold resistance device, daily, twice a day for three sets of 15 repetitions per set. Maximal expiratory pressure (PImax), maximal expiratory pressure (PEmax), spirometric indices, functional tests (six-minute walk test, timed up and go test), fatigue questionnaire, and questionnaire of quality of life were assessed before and after trials.

RESULTS

A total of 36 patients (75% female; mean age 38.00(8.86) years; BMI 26.56(2.64) kg/m) were included in the study. The strength of inspiratory and expiratory muscles, respiratory function, fatigue, and quality of life were significantly improved in the intervention group (p<0.005). In addition, there was a significant improvement in the rate of fatigue and quality of life in all their dimensions (p<0.005). Only in the six-minute walk test, no significant improvement was seen in the intervention group compared to the control group (p = 0.262).

CONCLUSION

Findings could help therapists to provide MS patients with more effective respiratory muscle training protocols to maximize the benefits of rehabilitation.

摘要

背景

多发性硬化症(MS)是一种慢性炎症性神经系统疾病,导致肌肉无力,包括呼吸肌,从而导致肺部并发症,降低功能能力,增加疲劳,从而降低生活质量。

目的

本研究旨在探讨 8 周呼吸肌训练(RMT)对 MS 患者肺功能和呼吸肌力量的影响。

方法

本研究为单盲、随机对照试验,纳入 36 例(27 名女性,9 名男性)确诊为复发缓解型 MS 的患者,由神经科医生明确诊断,并随机分为干预组和对照组。两组均接受生活方式改变教育,重点是定期进行身体活动。此外,干预组接受了为期 8 周的呼吸肌训练,使用阈电阻器,每天两次,每次三组,每组 15 次。在试验前后评估最大呼气压力(PImax)、最大呼气压力(PEmax)、肺功能指标、功能测试(六分钟步行测试、起立行走测试)、疲劳问卷和生活质量问卷。

结果

共有 36 例患者(75%为女性;平均年龄 38.00[8.86]岁;BMI 26.56[2.64]kg/m)纳入研究。干预组吸气和呼气肌肉力量、呼吸功能、疲劳和生活质量均显著改善(p<0.005)。此外,所有维度的疲劳和生活质量评分均显著改善(p<0.005)。只有在六分钟步行测试中,干预组与对照组相比没有显著改善(p=0.262)。

结论

这些发现可以帮助治疗师为 MS 患者提供更有效的呼吸肌训练方案,以最大限度地提高康复效果。

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