家庭呼吸和胸廓运动锻炼改善长新冠合并心血管共病患者的心肺功能：一项随机研究。
The home-based breathing and chest mobility exercise improves cardiorespiratory functional capacity in long COVID with cardiovascular comorbidities: a randomized study.
机构信息
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
出版信息
BMC Cardiovasc Disord. 2024 Oct 18;24(1):574. doi: 10.1186/s12872-024-04196-0.
BACKGROUND
Beyond the acute phase, a considerable proportion of patients recovering from the coronavirus disease 2019 (COVID-19) experience long-term sequelae that profoundly impact their quality of life, particularly their physical fitness. This study aims to assess the effect of home-based breathing and chest mobility exercise on the cardiorespiratory functional capacity of long COVID with cardiovascular comorbidity.
METHODS
In this randomized, controlled, single-blind clinical trial, 46 long COVID with cardiovascular comorbidities were randomly assigned to either intervention or control group. The intervention group (n = 23) received additional home-based breathing and chest mobility exercise 3x/week for 12 weeks supervised by attending physicians, whereas the control group only received a home-based cardiac rehabilitation program. Baseline and post-intervention assessments consisted of laboratory (D-Dimer and CRP levels) and functional capacity, assessed through 6-minute walking test (6-MWT), exercise stress test's metabolic equivalents (METS), and predicted peak oxygen consumption (VO), peak expiratory flow rate (PEFR), peak cough flow (PCF), chest expansion, and EuroQoL's quality of life. Intention to treat analysis was performed.
RESULTS
At the 12th week, intervention subjects had significantly greater functional capacity with higher mean PEFR (p = .031) and PCF (p = .016). Similarly, 6-MWT was higher in the group receiving home-based breathing and chest mobility training (p = .032). The bottom part of the chest circumference was statistically different between the two groups (p = .01). METS and predicted VO2 peak were also higher in the intervention group. However, laboratory parameters and quality of life did not differ markedly (p > .05).
CONCLUSIONS
Home-based respiratory and chest mobility exercise could be an adjunct to cardiac rehabilitation in long COVID with cardiovascular comorbidities for improving cardiorespiratory functional capacity.
TRIAL REGISTRATION
The study protocol was registered at http://ClinicalTrial.gov.id NCT05077943 (14/10/2021).
背景
在急性阶段之后，相当一部分从 2019 年冠状病毒病（COVID-19）中康复的患者会出现长期后遗症，这极大地影响了他们的生活质量，尤其是他们的身体健康。本研究旨在评估家庭呼吸和胸部运动锻炼对伴有心血管合并症的长 COVID 患者心肺功能的影响。
方法
在这项随机、对照、单盲临床试验中，46 名伴有心血管合并症的长 COVID 患者被随机分配到干预组或对照组。干预组（n=23）接受额外的家庭呼吸和胸部运动锻炼，每周 3 次，由主治医生监督，共 12 周，而对照组仅接受家庭心脏康复计划。基线和干预后评估包括实验室（D-二聚体和 CRP 水平）和功能能力，通过 6 分钟步行测试（6-MWT）、运动应激测试的代谢当量（METs）以及预测峰值耗氧量（VO）、呼气峰流速（PEFR）、峰值咳嗽流量（PCF）、胸部扩张和欧洲五维健康量表（EQ-5D）的生活质量来评估。进行意向治疗分析。
结果
在第 12 周时，干预组的功能能力显著提高，平均 PEFR（p=0.031）和 PCF（p=0.016）更高。同样，接受家庭呼吸和胸部运动训练的组的 6-MWT 更高（p=0.032）。两组的胸下周长存在统计学差异（p=0.01）。干预组的 METs 和预测 VO2 峰值也更高。然而，实验室参数和生活质量没有明显差异（p＞0.05）。
结论
家庭呼吸和胸部运动锻炼可作为伴有心血管合并症的长 COVID 患者心脏康复的辅助手段，以提高心肺功能能力。
试验注册
该研究方案在 http://ClinicalTrial.gov.id 注册，NCT05077943（2021 年 10 月 14 日）。
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