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肺量容积复张手法如何增强多发性硬化症患者的呼吸功能:一项准随机试验研究。

How Lung Volume Recruitment Maneuvers Enhance Respiratory Function in Multiple Sclerosis Patients: A Quasi-Randomized Pilot Study.

机构信息

Physical Medicine and Rehabilitation Unit, Azienda ULSS, 3 Serenissima, 30126 Venice, Italy.

Healthcare Innovation Technology Lab., IRCCS San Camillo Hospital, 30126 Venice, Italy.

出版信息

Medicina (Kaunas). 2023 Oct 26;59(11):1896. doi: 10.3390/medicina59111896.

Abstract

: In patients with multiple sclerosis (MS), a decrease in muscle strength can lead to limitations in pulmonary functions, potentially causing respiratory complications. To address these challenges, the lung volume recruitment (LVR) maneuver has emerged as a potential intervention. This study sought to evaluate the impact of a four-week LVR protocol on respiratory function in secondary progressive MS patients. : In a quasi-randomized pre/post-controlled trial, 24 patients with secondary progressive MS were recruited. Participants aged 20-70 years with an EDSS score of 2 to 9 were alternately allocated to intervention ( = 12) or control groups ( = 12). The intervention group underwent a 4-week respiratory rehabilitation training focused on LVR, using a standardized cough machine treatment protocol twice daily. The control group received no respiratory intervention. Outcomes measured included forced vital capacity (FVC), maximal insufflation capacity (MIC), and peak cough flow (PCF), using turbine spirometry and other associated equipment. All measurements were taken at baseline (T) and after 4 weeks (T) by a blinded assessor. : For the intervention group, the mean difference pre/post-treatment in MIC (mL) was 0.45 (SD 1.13) ( = 0.02), and in MIC (%), it was 0.13 (SD 0.24) ( = 0.03). Compared to the control group ( = 10), the between-group mean difference for MIC (mL) was 0.54 ( = 0.02), and for MIC (%), it was 0.15 ( = 0.02). : The short-term daily LVR protocol notably improved passive lung capacity, despite minimal changes in active lung capacity or cough force. The LVR maneuver offers promise for enhancing respiratory function, especially passive lung capacity, in secondary progressive MS patients. Further research should explore optimal treatment durations and frequencies for more extensive respiratory gains.

摘要

在多发性硬化症(MS)患者中,肌肉力量的下降可能导致肺功能受限,从而引发呼吸并发症。为了应对这些挑战,肺容量复张(LVR)手法已成为一种潜在的干预手段。本研究旨在评估为期四周的 LVR 方案对继发性进展型 MS 患者呼吸功能的影响。

在一项半随机前后对照试验中,纳入了 24 例继发性进展型 MS 患者。参与者年龄在 20-70 岁之间,EDSS 评分为 2-9 分,以交替方式分配至干预组(n=12)或对照组(n=12)。干预组接受为期四周的呼吸康复训练,重点是 LVR,每天使用标准咳嗽机治疗方案进行两次治疗。对照组未接受呼吸干预。使用涡轮式肺活量计和其他相关设备测量用力肺活量(FVC)、最大吸气量(MIC)和峰值咳嗽流量(PCF)等指标。所有测量均由盲法评估者在基线(T)和 4 周后(T)进行。

对于干预组,MIC(mL)治疗前后的平均差值为 0.45(SD 1.13)( = 0.02),MIC(%)的平均差值为 0.13(SD 0.24)( = 0.03)。与对照组(n=10)相比,MIC(mL)的组间平均差值为 0.54( = 0.02),MIC(%)的组间平均差值为 0.15( = 0.02)。

短期每日 LVR 方案显著改善了被动肺容量,尽管主动肺容量或咳嗽力的变化很小。LVR 手法有望提高继发性进展型 MS 患者的呼吸功能,特别是被动肺容量。进一步的研究应探索最佳的治疗持续时间和频率,以获得更广泛的呼吸获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2744/10672745/e84d38956c95/medicina-59-01896-g001.jpg

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