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身体觉知疗法对慢性阻塞性肺疾病患者平衡能力及跌倒恐惧的影响:一项随机对照试验

Effects of body awareness therapy on balance and fear of falling in patients with chronic obstructive pulmonary disease: a randomized controlled trial.

作者信息

Karaca Seda, Yildiz Özer Aysel, Karakurt Sait, Polat Mine Gülden

机构信息

Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Department, Faculty of Health Sciences, Marmara University, Süreyyapaşa Başıbüyük Street, Number:4, B, Maltepe, Istanbul, 34854, Turkey.

Department of Pulmonary Medicine, School of Medicine, Marmara University, Istanbul, Turkey.

出版信息

Biopsychosoc Med. 2024 Feb 26;18(1):6. doi: 10.1186/s13030-024-00303-x.

Abstract

BACKGROUND

Assessment of extrapulmonary comorbidities is essential in chronic obstructive pulmonary disease (COPD). Deterioration of balance and increasing fear of falling are two of the most significant extrapulmonary manifestations. Although pulmonary rehabilitation (PR) is well-known and effective for COPD patients, there is a need for alternative treatments to enhance balance and alleviate concerns about falling. This study aimed to investigate the effect of Body Awareness Therapy (BAT), in addition to the PR program, on balance and fear of falling in patients with COPD.

METHODS

Forty-three patients were randomized into two groups: the BAT + PR group (BAT: once a week, 60 min + PR: 30 min, seven days of the week) or the PR group (PR: 30 min, seven days of the week) for eight weeks. Primary (balance, fear of falling) and secondary (dyspnea, muscle strength, functional capacity) outcomes were assessed at two different times: the baseline and end of the eight weeks.

RESULTS

Significant improvements were found in dynamic balance (reaction time η = 0.777, movement velocity η = 0.789, endpoint excursion η = 0.687, maximal excursion η = 0.887), static balance on firm ground (eyes opened η = 0.679, eyes closed η = 0.705), dyspnea (η = 0.546), muscle strength (η = 0.803), and functional capacity (η = 0.859) of the BAT + PR group (p < 0.05 for all). The improvement in fear of falling was significantly greater in the BAT + PR group than in the PR group (p < 0.001, η = 0.331).

CONCLUSION

The BAT method added to PR was more effective than PR alone in improving balance and reducing the fear of falling in COPD patients.

TRIAL REGISTRATION

This randomized controlled study was registered at clinicaltrials.gov, NCT04212676 , Registered 28 December 2019.

摘要

背景

评估慢性阻塞性肺疾病(COPD)患者的肺外合并症至关重要。平衡能力下降和跌倒恐惧增加是最显著的两种肺外表现。尽管肺康复(PR)对COPD患者广为人知且有效,但仍需要替代疗法来增强平衡能力并减轻对跌倒的担忧。本研究旨在调查除PR计划外,身体意识疗法(BAT)对COPD患者平衡能力和跌倒恐惧的影响。

方法

43例患者随机分为两组:BAT+PR组(BAT:每周一次,60分钟+PR:每周7天,每天30分钟)或PR组(PR:每周7天,每天30分钟),为期8周。在两个不同时间评估主要(平衡能力、跌倒恐惧)和次要(呼吸困难、肌肉力量、功能能力)结局:基线和8周结束时。

结果

BAT+PR组在动态平衡(反应时间η=0.777,运动速度η=0.789,终点偏移η=0.687,最大偏移η=0.887)、坚实地面上的静态平衡(睁眼η=0.679,闭眼η=0.705)、呼吸困难(η=0.546)、肌肉力量(η=0.803)和功能能力(η=0.859)方面有显著改善(所有p<0.05)。BAT+PR组在跌倒恐惧方面的改善明显大于PR组(p<0.001,η=0.331)。

结论

在PR基础上增加BAT方法比单独使用PR在改善COPD患者平衡能力和降低跌倒恐惧方面更有效。试验注册:本随机对照研究在clinicaltrials.gov上注册,NCT04212676,2019年12月28日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50bd/10895779/20c5a1f1957a/13030_2024_303_Fig1_HTML.jpg

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