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基于家庭的远程康复辅助吸气肌训练对特发性肺纤维化患者的影响:一项随机对照试验。

Effects of home-based telerehabilitation-assisted inspiratory muscle training in patients with idiopathic pulmonary fibrosis: A randomized controlled trial.

机构信息

Department of Physiotherapy, Izmir University of Economics, Izmir, Turkey.

Department of Chest Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.

出版信息

Respirology. 2024 Dec;29(12):1077-1084. doi: 10.1111/resp.14810. Epub 2024 Aug 11.

Abstract

BACKGROUND AND OBJECTIVE

There are few studies that have used inspiratory muscle training (IMT) as an intervention for patients with isolated idiopathic pulmonary fibrosis (IPF). This study aimed to investigate and interpret the effects of home-based telerehabilitation-assisted IMT in patients with IPF.

METHODS

Twenty-eight participants with IPF took part in the study. Lung function tests, functional exercise capacity by 6-min walk distance (6MWD), dyspnoea perception by modified medical research council dyspnoea scale (mMRC), and inspiratory muscle strength by maximal inspiratory pressure (MIP) were assessed. IMT was performed twice a day, 7 days/week, for 8 weeks. The intervention group (n = 14) performed IMT at 50% of their baseline MIP while the control group (n = 14) performed IMT without applied resistance. Loading intensity was progressed by keeping the load at 4-6 on a modified Borg scale for the highest tolerable perceived respiratory effort for each patient.

RESULTS

Dyspnoea based on mMRC score (p < 0.001, η effect size = 0.48) significantly decreased within the intervention group compared with the control group. There were significant increases in the intervention group compared to the control group based on 6MWD (p < 0.001, η effect size = 0.43), MIP (p = 0.006, η effect size = 0.25) and MIP % predicted (p = 0.008, η effect size = 0.25).

CONCLUSION

The findings of this study suggest that an 8-week home-based telerehabilitation-assisted IMT intervention produced improvements in inspiratory muscle strength, leading to improvements in functional exercise capacity and dyspnoea.

摘要

背景与目的

仅有少数研究使用吸气肌训练(IMT)作为特发性肺纤维化(IPF)患者的干预措施。本研究旨在探讨和解释家庭远程康复辅助 IMT 对 IPF 患者的影响。

方法

28 名 IPF 患者参与了这项研究。评估了肺功能测试、6 分钟步行距离(6MWD)的功能运动能力、改良医学研究委员会呼吸困难量表(mMRC)的呼吸困难感知以及最大吸气压力(MIP)的吸气肌力量。IMT 每天进行两次,每周 7 天,持续 8 周。干预组(n=14)在基线 MIP 的 50%下进行 IMT,而对照组(n=14)在没有施加阻力的情况下进行 IMT。每个患者的最高耐受感知呼吸努力,通过保持改良 Borg 量表上的 4-6 级的加载强度来进行加载强度的进展。

结果

基于 mMRC 评分的呼吸困难(p<0.001,η效应大小=0.48)在干预组内显著降低,与对照组相比。与对照组相比,干预组在 6MWD(p<0.001,η效应大小=0.43)、MIP(p=0.006,η效应大小=0.25)和 MIP%预测(p=0.008,η效应大小=0.25)方面均有显著增加。

结论

本研究结果表明,为期 8 周的家庭远程康复辅助 IMT 干预可改善吸气肌力量,从而改善功能运动能力和呼吸困难。

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