Institute of Sport Science The Jerzy Kukuczka Academy of Physical Education, 72A Mikolowska Street, 40-065 Katowice, Poland.
Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland.
Respir Physiol Neurobiol. 2023 Oct;316:104139. doi: 10.1016/j.resp.2023.104139. Epub 2023 Aug 12.
The purpose of the study was to determine the level of physical fitness assessed based on the physiological parameters and intensity of daily physical activity (PA) of patients with idiopathic pulmonary fibrosis (IPF). Additionally, we aimed to determine the intensity and duration of exercise that would bring beneficial modifications in the cardio-respiratory system of the patients with IPF. Eighteen patients with IPF (61.7 ± 4.3 years) and fifteen healthy volunteers performed a graded exercise test to exhaustion on a treadmill (Bruce protocol). Spirometry, dyspnea (mMRC, Borg scale) and fatigue (FAS) were measured. Total daily PA (kcal/day, MET) was monitored for seven days. The linear regression of PA (kcal/day) vs. peak oxygen uptake (%pred. peakVO) was used to determine the intensity of daily PA that should be used in the rehabilitation of the patients with IPF. The average energy expenditure of daily PA of patients with IPF was 147.9 ± 86.4 kcal/day and it was significantly lower compared to healthy individuals. The linear regression indicated that the predicted energy expenditure of daily PA (PAEE) is 280.0 kcal/day, estimated based on VO2peak 100%pred. Therefore, the patients should add about 30 min of exercise of the intensity of 4.5 ± 0.2 kcal (calculated at the anaerobic threshold) or about 3700 steps/day to their daily PA. Diffusion for carbon monoxide and physiological variables of aerobic capacity seem to be the most important determinants of PA limitation in patients with IPF. The method of estimating PAEE should be used to plan training loads in IPF rehabilitation.
本研究旨在根据特发性肺纤维化（IPF）患者的生理参数和日常体力活动（PA）强度来确定其体能水平。此外，我们还旨在确定能够使 IPF 患者心肺系统产生有益变化的运动强度和时长。18 名 IPF 患者（61.7±4.3 岁）和 15 名健康志愿者在跑步机上进行了直至力竭的分级运动试验（Bruce 方案）。测量了肺活量、呼吸困难（mMRC、Borg 量表）和疲劳（FAS）。连续 7 天监测患者的总日常 PA（千卡/天，MET）。使用 PA（千卡/天）与峰值摄氧量（%pred.peakVO）的线性回归来确定 IPF 患者康复所需的日常 PA 强度。IPF 患者日常 PA 的平均能量消耗为 147.9±86.4 千卡/天，与健康个体相比显著较低。线性回归表明，基于 VO2peak 100%pred，预测日常 PA 的能量消耗（PAEE）为 280.0 千卡/天。因此，患者应将其日常 PA 增加约 30 分钟，强度为 4.5±0.2 千卡（在无氧阈计算），或每天增加约 3700 步。一氧化碳弥散量和有氧能力的生理变量似乎是 IPF 患者 PA 受限的最重要决定因素。估计 PAEE 的方法应被用于规划 IPF 康复训练的负荷。
