Muelas-Gómez Laura, Martínez-Gimeno Lara, Escudero-Gómez Cristina, Atin Arratibel María Ángeles, Cebrià I Iranzo Maria Angels, Solís-Muñoz Montserrat
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.
Open Respir Arch. 2023 Dec 1;6(1):100288. doi: 10.1016/j.opresp.2023.100288. eCollection 2024 Jan-Mar.
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.
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.
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.
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.
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。
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。
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。
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。