颈椎屈伸和颈部耐力练习加肺康复对脊髓损伤患者肺功能的影响：一项单盲随机对照试验的初步研究。

The effect of craniocervical flexion and neck endurance exercises plus pulmonary rehabilitation on pulmonary function in spinal cord injury: a pilot single-blinded randomised controlled trial.

机构信息

Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.

出版信息

Spinal Cord Ser Cases. 2024 Apr 23;10(1):27. doi: 10.1038/s41394-024-00637-2.

DOI:10.1038/s41394-024-00637-2

PMID:38654004

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11039743/

Abstract

STUDY DESIGN

Randomised controlled trial with computerised allocation, assessor blinding and intention-to-treat analysis.

OBJECTIVE

This study wanted to prove that cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training combined with common pulmonary rehabilitation is feasible for improving spinal cord injury people's pulmonary function.

SETTING

Taoyuan General Hospital, Ministry of Health and Welfare: Department of Physiotherapy, Taiwan.

METHOD

Thirteen individuals who had sustained spinal cord injury for less than a year were recruited and randomised assigned into two groups. The experimental group was assigned CCFEs and neck flexor endurance training plus normal cardiopulmonary rehabilitation. The control group was assigned general neck stretching exercises plus cardiopulmonary rehabilitation. Lung function parameters such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV), FEV/FVC, peak expiratory flow rate (PEFR), inspiratory capacity (IC), dyspnoea, pain, and neck stiffness were recorded once a week as short-term outcome measure.

RESULT

The experimental group showed significant time effects for FVC (pre-therapy: 80.4 ± 21.4, post-therapy: 86.9 ± 16.9, p = 0.021, 95% CI: 0.00-0.26) and PEFR (pre-therapy: 67.0 ± 33.4; post-therapy: 78.4 ± 26.9, p = 0.042, 95% CI: 0.00-0.22) after the therapy course. Furthermore, the experimental group showed significant time effects for BDI (experimental group: 6.3 ± 3.0; control group: 10.8 ± 1.6, p = 0.012, 95% CI: 0.00-0.21).

CONCLUSION

The exercise regime for the experimental group could efficiently increase lung function due to the following three reasons: first, respiratory accessory muscle endurance increases through training. Second, posture becomes less kyphosis resulting increasing lung volume. Third, the ratio between superficial and deep neck flexor is more synchronised.

IRB TRIAL REGISTRATION

TYGH108045.

CLINICAL TRIAL REGISTRATION

NCT04500223.

摘要

研究设计

采用计算机分配、评估者设盲和意向治疗分析的随机对照试验。

目的

本研究旨在证明颈椎屈曲运动（CCFE）和颈浅屈肌耐力训练结合常规肺康复对改善脊髓损伤患者的肺功能是可行的。

设置

桃园总医院，卫生福利部：物理治疗部，中国台湾。

方法

招募了 13 名脊髓损伤不到 1 年的患者，并将其随机分为两组。实验组接受 CCFE 和颈屈肌耐力训练加常规心肺康复。对照组接受常规颈部伸展运动加心肺康复。每周记录一次用力肺活量（FVC）、1 秒用力呼气量（FEV）、FEV/FVC、呼气峰流速（PEFR）、吸气量（IC）、呼吸困难、疼痛和颈部僵硬等肺功能参数，作为短期结果测量。

结果

实验组 FVC（治疗前：80.4±21.4，治疗后：86.9±16.9，p=0.021，95%CI：0.00-0.26）和 PEFR（治疗前：67.0±33.4；治疗后：78.4±26.9，p=0.042，95%CI：0.00-0.22）在治疗后均显示出显著的时间效应。此外，实验组 BDI（实验组：6.3±3.0；对照组：10.8±1.6，p=0.012，95%CI：0.00-0.21）也显示出显著的时间效应。