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[物理治疗干预通过呼吸训练技术对肺移植术后受者呼吸肌的疗效:系统评价]

[Efficacy of Physiotherapy Interventions on the Respiratory Musculature Through Respiratory Training Techniques in Post-operative Lung Transplant Recipients: Systematic Review].

作者信息

Muelas-Gómez Laura, Martínez-Gimeno Lara, Escudero-Gómez Cristina, Atin Arratibel María Ángeles, Cebrià I Iranzo Maria Angels, Solís-Muñoz Montserrat

机构信息

Unidad de Rehabilitación Respiratoria, Servicio de Rehabilitación y Medicina Física, Hospital Universitario Puerta de Hierro Majadahonda, Grupo de Investigación en Enfermería y Cuidados de Salud, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana, Majadahonda, Madrid, España.

Fundación San Juan de Dios, Departamento de Ciencias de la Salud, Escuela de Enfermería y Fisioterapia San Juan de Dios, Universidad Pontificia Comillas, Madrid, España.

出版信息

Open Respir Arch. 2023 Dec 1;6(1):100288. doi: 10.1016/j.opresp.2023.100288. eCollection 2024 Jan-Mar.

DOI:10.1016/j.opresp.2023.100288
PMID:38274199
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10809207/
Abstract

INTRODUCTION

Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period.

METHODOLOGY

A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: "breathing exercise", "respiratory muscle training", "inspiratory muscle training", "respiratory exercise", "pulmonary rehabilitation", "lung rehabilitation"; in combination with "lung transplantation", "lung transplant", "posttransplant lung". No language limit.

RESULTS

Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test.

CONCLUSIONS

Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.

摘要

引言

呼吸肌是肺移植患者运动能力的限制因素。了解在成年肺移植患者术后管理中实施的特定呼吸肌训练技术的有效性很有必要。

方法

对临床试验进行了系统综述,其中包括接受移植后呼吸训练的成年肺移植患者。在2012年1月至2023年9月期间,使用以下术语在PubMed/Medline、EMBASE、Scopus、Web of Science、Cochrane图书馆等数据库中进行了检索:“呼吸锻炼”、“呼吸肌训练”、“吸气肌训练”、“呼吸运动”、“肺康复”、“肺部康复”;并与“肺移植”、“肺移植手术”、“移植后肺”相结合。无语言限制。

结果

纳入了11项试验,共分析了639例患者。大多数训练计划在出院时(移植后一个多月)开始,很少在早期(重症监护病房)进行。持续时间为移植后1至12个月。干预措施基于有氧运动训练和外周肌肉力量训练。其中一些包括呼吸锻炼和扩胸运动。最常用的结果变量是通过6分钟步行试验测量的次最大运动能力。

结论

训练成年移植患者的呼吸肌有利于提高运动能力和生活质量。有氧运动训练以及其他外周肌肉的力量训练有助于改善呼吸肌功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7603/10809207/8b154012363a/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7603/10809207/8b154012363a/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7603/10809207/8b154012363a/fx1.jpg

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本文引用的文献

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Chron Respir Dis. 2022 Jan-Dec;19:14799731221116588. doi: 10.1177/14799731221116588.
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The effect of early tracheal extubation combined with physical training on pulmonary rehabilitation of patients after lung transplantation: a randomized controlled trial.早期气管插管拔除联合体能训练对肺移植术后患者肺康复的影响:一项随机对照试验
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Post-operative, inpatient rehabilitation after lung transplant evaluation (PIRATE): A feasibility randomized controlled trial.
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Physiother Theory Pract. 2023 Jul 3;39(7):1406-1416. doi: 10.1080/09593985.2022.2041779. Epub 2022 Feb 22.
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The effectiveness of pulmonary rehabilitation in connection with lung transplantation in Hungary.匈牙利肺移植联合肺康复的有效性
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Inspiratory training and immediate lung recovery after resective pulmonary surgery: a randomized clinical trial.肺切除术后吸气训练与肺功能即刻恢复:一项随机临床试验
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Respiratory Muscle and Lung Function in Lung Allograft Recipients: Association with Exercise Intolerance.肺移植受者的呼吸肌和肺功能:与运动不耐受的关系。
Respiration. 2020;99(5):398-408. doi: 10.1159/000507264. Epub 2020 May 13.
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ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases.ERS 关于慢性肺部疾病心肺运动试验标准化的声明。
Eur Respir Rev. 2019 Dec 18;28(154). doi: 10.1183/16000617.0101-2018. Print 2019 Dec 31.
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The Efficacy of Outpatient Pulmonary Rehabilitation After Bilateral Lung Transplantation.门诊肺康复在双侧肺移植术后的疗效。
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Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level.肺切除术后高危患者进行吸气肌训练可能预防术后身体活动水平下降。
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