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新冠后长期症状患者呼吸肌训练计划后吸气肌功能变量的最小临床重要差异

Minimal Clinically Important Differences in Inspiratory Muscle Function Variables after a Respiratory Muscle Training Programme in Individuals with Long-Term Post-COVID-19 Symptoms.

作者信息

Del Corral Tamara, Fabero-Garrido Raúl, Plaza-Manzano Gustavo, Fernández-de-Las-Peñas César, Navarro-Santana Marcos José, López-de-Uralde-Villanueva Ibai

机构信息

Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain.

Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.

出版信息

J Clin Med. 2023 Apr 5;12(7):2720. doi: 10.3390/jcm12072720.

Abstract

OBJECTIVE

To establish the minimal clinically important difference (MCID) for inspiratory muscle strength (MIP) and endurance (IME) in individuals with long-term post-COVID-19 symptoms, as well as to ascertain which of the variables has a greater discriminatory capacity and to compare changes between individuals classified by the MCID.

DESIGN

Secondary analysis of randomised controlled trial of data from 42 individuals who performed an 8-week intervention of respiratory muscle training programme.

RESULTS

A change of at least 18 cmHO and 22.1% of that predicted for MIP and 328.5s for IME represented the MCID. All variables showed acceptable discrimination between individuals who classified as "improved" and those classified as "stable/not improved" (area under the curve ≥0.73). MIP was the variable with the best discriminative ability when expressed as a percentage of prediction (Youden index, 0.67; sensitivity, 76.9%; specificity, 89.7%). Participants classified as "improved" had significantly greater improvements in quality of life and lung function compared with the participants classified as "stable/not improved".

CONCLUSION

In individuals with long-term post-COVID-19 symptoms, the inspiratory muscle function variables had an acceptable discriminative ability to assess the efficacy of a respiratory muscle training programme. MIP was the variable with the best discriminative ability, showing better overall performance when expressed as a percentage of prediction.

摘要

目的

确定新冠后长期症状患者吸气肌力量(MIP)和耐力(IME)的最小临床重要差异(MCID),确定哪个变量具有更大的辨别能力,并比较根据MCID分类的个体之间的变化。

设计

对42名进行了为期8周呼吸肌训练计划干预的个体的数据进行随机对照试验的二次分析。

结果

MIP至少变化18 cmH₂O,即预测值的22.1%,IME变化328.5秒代表MCID。所有变量在分类为“改善”和“稳定/未改善”的个体之间均显示出可接受的辨别力(曲线下面积≥0.73)。以预测值的百分比表示时,MIP是辨别能力最佳的变量(约登指数为0.67;敏感性为76.9%;特异性为89.7%)。与分类为“稳定/未改善”的参与者相比,分类为“改善”的参与者在生活质量和肺功能方面有显著更大的改善。

结论

在新冠后长期症状患者中,吸气肌功能变量对评估呼吸肌训练计划的疗效具有可接受的辨别能力。MIP是辨别能力最佳的变量,以预测值的百分比表示时总体表现更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb05/10095020/ba87809f9201/jcm-12-02720-g001.jpg

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