膈肌呼吸练习与激励肺活量测定法对心力衰竭患者功能状态的比较：一项随机对照试验。
Comparison of diaphragmatic breathing exercises and incentive spirometry on the functional status of heart failure patients: a randomized controlled trial.
作者信息
Nasirmoghadas Amirhossein, Monjazebi Fateme, Nasiri Malihe, Feyzi Aydin, Borhani Fariba
机构信息
Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
BMC Cardiovasc Disord. 2025 Jan 10;25(1):17. doi: 10.1186/s12872-024-04464-z.
BACKGROUND
Respiratory muscle weakness in heart failure (HF) can deteriorate its symptoms such as fatigue, dyspnea, and impaired functional status. Pulmonary rehabilitation can strengthen these muscles. This study aimed to determine the impact of breathing exercises on fatigue severity, dyspnea, and functional classification in HF patients.
METHODS
A three-arm single-blind randomized controlled trial was conducted on 90 hospitalized HF patients in three 30-participant groups including diaphragmatic breathing group (DG), incentive spirometry group (SG), and control group (CG). The interventions were performed thrice daily for 10 days in DG and SG. The Fatigue Severity Scale (FSS), Borg dyspnea scale, and New York Heart Association (NYHA) functional classification were used before and after the intervention. Data were analyzed using SPSS-20 software.
RESULTS
After the intervention, the patients' frequency with severe fatigue decreased by 30% in both DG and SG (p < 0.001); the mean dyspnea score in DG and SG respectively reduced by 0.7 and 0.9 units at rest (p < 0.001) and reduced by 2.93 and 2.73 units during activity (p < 0.001); the total patients' frequency in functional class III and IV was significantly decreased by 30% in DG and 33.3% in SG (p < 0.001). The intervention groups were not significantly different regarding fatigue severity, dyspnea, and functional classification. While in CG these outcomes had no significant reduction after the intervention.
CONCLUSION
In this study breathing exercises could reduce fatigue and dyspnea, and improve NYHA functional classification of HF patients which can be included in nursing care plans for respiratory rehabilitation in HF.
TRIAL REGISTRATION
This study was prospectively registered by the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir/ ) on 14/04/2024 with registration ID: IRCT20240306061197N.
背景
心力衰竭（HF）患者的呼吸肌无力会使其疲劳、呼吸困难及功能状态受损等症状恶化。肺康复可增强这些肌肉。本研究旨在确定呼吸锻炼对HF患者疲劳严重程度、呼吸困难及功能分级的影响。
方法
对90例住院HF患者进行了一项三臂单盲随机对照试验，分为三组，每组30人，包括膈肌呼吸组（DG）、激励肺活量测定组（SG）和对照组（CG）。DG组和SG组每天进行3次干预，持续10天。干预前后使用疲劳严重程度量表（FSS）、Borg呼吸困难量表和纽约心脏协会（NYHA）功能分级。使用SPSS - 20软件进行数据分析。
结果
干预后，DG组和SG组严重疲劳患者的频率均下降了30%（p < 0.001）；DG组和SG组静息时的平均呼吸困难评分分别降低了0.7和0.9个单位（p < 0.001），活动时分别降低了2.93和2.73个单位（p < 0.001）；DG组和SG组中III级和IV级功能患者的总频率分别显著下降了30%和33.3%（p < 0.001）。干预组在疲劳严重程度、呼吸困难及功能分级方面无显著差异。而CG组干预后这些结果无显著改善。
结论
在本研究中，呼吸锻炼可减轻HF患者的疲劳和呼吸困难，并改善NYHA功能分级，可纳入HF呼吸康复护理计划。
试验注册
本研究于2024年4月14日由伊朗临床试验注册中心（https://irct.behdasht.gov.ir/ ）进行前瞻性注册，注册号：IRCT20240306061197N。
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