吸气肌训练联合肺康复对放疗期间非小细胞肺癌患者的影响：一项初步临床研究。
The effects of inspiratory muscle training with pulmonary rehabilitation on NSCLC patients during radiation therapy: A pilot clinical study.
机构信息
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
出版信息
Thorac Cancer. 2023 Jun;14(17):1567-1573. doi: 10.1111/1759-7714.14899. Epub 2023 Apr 20.
BACKGROUND
The effects of inspiratory muscle training (IMT) with pulmonary rehabilitation (PR) on patients with non-small cell lung cancer (NSCLC) receiving radiotherapy (RT) have not previously been reported. This pilot study aimed to determine the effectiveness of IMT with PR on respiratory muscles and exercise capacity of NSCLC patients receiving RT.
METHODS
We retrospectively analyzed 20 patients who underwent RT for NSCLC. The rehabilitation included IMT, stretching, strengthening, and aerobic exercises three times a week for 4 weeks with concurrent RT. IMT training lasted 10 min, consisting of one cycle of 30 breaths using the Powerbreathe KH1 device in the hospital by a physical therapist. Patients underwent two IMT sessions at home daily at an intensity of approximately 30%-50% of the participant's maximum inspiratory muscle pressure (MIP) using the threshold IMT tool. We analyzed the results from the respiratory muscle strength test, pulmonary function test, 6-min walk test (6MWT), cardiopulmonary function test, cycle endurance test (CET), Inbody test, grip measurement, knee extensor/flexor strength measurement, Cancer Core Quality of Life Questionnaire (EORTCQ-C30), and NSCLC 13 (EORTC-LC13).
RESULTS
There were no adverse events during evaluation and IMT with PR. MIP (60.1 ± 25.1 vs. 72.5 ± 31.9, p = 0.005), 6MWT (439.2 ± 97.1 vs. 60.7 ± 97.8, p = 0.002), CET (181.39 ± 193.12 vs. 123.6 ± 87.6, p = 0.001), knee extensor (14.4 ± 5.3 vs. 17.4 ± 5, p = 0.012), and knee flexor (14.0 ± 5.2 vs. 16.9 ± 5.5, p = 0.004) significantly improved after IMT with PR.
CONCLUSION
IMT with PR appears effective on respiratory muscles and exercise capacity without adverse events in NSCLC patients who underwent RT.
背景
吸气肌训练（IMT）联合肺康复（PR）对接受放疗（RT）的非小细胞肺癌（NSCLC）患者的影响尚未见报道。本研究旨在评估 IMT 联合 PR 对 NSCLC 患者 RT 期间呼吸肌和运动能力的影响。
方法
我们回顾性分析了 20 例接受 NSCLC 放疗的患者。康复包括 IMT、伸展、力量训练和有氧运动，每周 3 次，持续 4 周，同时进行 RT。IMT 训练在医院由物理治疗师使用 Powerbreathe KH1 设备进行，每次 10 分钟，包括 1 个循环的 30 次呼吸，强度为参与者最大吸气肌肉压力（MIP）的 30%-50%。患者在家中每天进行 2 次 IMT 训练，使用阈值 IMT 工具，强度约为 30%-50%的 MIP。我们分析了呼吸肌力量测试、肺功能测试、6 分钟步行测试（6MWT）、心肺功能测试、循环耐力测试（CET）、Inbody 测试、握力测量、膝关节伸肌/屈肌力量测量、癌症核心生活质量问卷（EORTCQ-C30）和 NSCLC13（EORTC-LC13）的结果。
结果
在评估和 IMT 联合 PR 过程中，均未发生不良事件。MIP（60.1±25.1 比 72.5±31.9，p=0.005）、6MWT（439.2±97.1 比 60.7±97.8，p=0.002）、CET（181.39±193.12 比 123.6±87.6，p=0.001）、膝关节伸肌（14.4±5.3 比 17.4±5，p=0.012）和膝关节屈肌（14.0±5.2 比 16.9±5.5，p=0.004）在 IMT 联合 PR 后均显著改善。
结论
在接受 RT 的 NSCLC 患者中，IMT 联合 PR 对呼吸肌和运动能力有效，且无不良反应。
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