Huang Shiang-Yu, Hsieh Po-Chun, Huang Kuo-Liang, Yang Mei-Chen, Jao Lun-Yu, Tzeng I-Shiang, Lan Chou-Chin, Wu Yao-Kuang
Division of Respiratory Therapy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, Republic of China.
Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Jan 7;20:43-56. doi: 10.2147/COPD.S494666. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is characterized by airway inflammation, airflow limitation, reduced health-related quality of life (HRQL), and exercise intolerance. Pulmonary rehabilitation (PR) is essential for COPD management, but outcomes may be influenced by individual physiological factors. Cardiopulmonary exercise testing (CPET) measures oxygen pulse (O2P), an indicator of stroke volume, yet the impact of baseline O2P on PR effectiveness remains unclear.
This retrospective study included 97 participants with COPD who had received PR, of whom 48 were classified as Group 1 (normal O2P) and 49 as Group 2 (low O2P). PR involved 12 weeks of hospital-based endurance training on a bike, performed twice a week. Participants were assessed before and after PR using spirometry, respiratory muscle strength measurements, CPET, and HRQL evaluation with the St. George's Respiratory Questionnaire (SGRQ).
PR significantly improved exercise capacity (peak work rate and oxygen consumption), dyspnea score, and all domains of the SGRQ, maximum expiratory pressure, ventilatory equivalent, respiratory rate, and mean blood pressure at rest in both groups (p < 0.05). However, improvements in O2P, maximal inspiratory pressure, and tidal volume at rest were observed only in Group 2 but not in Group 1.
PR improves exercise capacity, HRQL and specific respiratory function in participants with COPD, regardless of baseline O2P levels. Individuals with lower baseline O2P experience more benefits from PR, including a significant increase in O2P.
慢性阻塞性肺疾病(COPD)的特征是气道炎症、气流受限、健康相关生活质量(HRQL)下降和运动不耐受。肺康复(PR)对COPD的管理至关重要,但结果可能受个体生理因素影响。心肺运动试验(CPET)可测量氧脉搏(O2P),它是每搏输出量的一个指标,然而基线O2P对PR效果的影响仍不清楚。
这项回顾性研究纳入了97名接受过PR的COPD患者,其中48人被归类为第1组(正常O2P),49人被归类为第2组(低O2P)。PR包括为期12周的基于医院的自行车耐力训练,每周进行两次。在PR前后,使用肺活量测定法、呼吸肌力量测量、CPET以及通过圣乔治呼吸问卷(SGRQ)进行HRQL评估对参与者进行评估。
两组患者的PR均显著改善了运动能力(峰值工作率和耗氧量)、呼吸困难评分、SGRQ的所有领域、最大呼气压力、通气当量、呼吸频率和静息平均血压(p < 0.05)。然而,仅在第2组中观察到静息时O2P、最大吸气压力和潮气量的改善,而第1组未观察到。
PR可改善COPD患者的运动能力、HRQL和特定呼吸功能,无论基线O2P水平如何。基线O2P较低的个体从PR中获益更多,包括O2P显著增加。