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体育锻炼对慢性呼吸困难患者步行距离和功能受限的影响。

Effects of Physical Exercise on Walking Distance and Functional Limitations in Patients with Chronic Dyspnea.

作者信息

Vindis Kinga, Nemeth Noemi, Marge Cristian, Pantis Carmen, Pop Mircea Gheorghe, Pop Manuela Simona, Bondar Laura Ioana, Jurcau Maria Carolina, Babeș Katalin

机构信息

Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.

Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.

出版信息

Medicina (Kaunas). 2025 Mar 30;61(4):636. doi: 10.3390/medicina61040636.

Abstract

: Chronic dyspnea is a common clinical manifestation in patients suffering from cardiovascular and respiratory diseases globally, representing an independent predictor of mortality for these patients. In addition, it may be a symptom associated with other conditions such as anemia, physical deconditioning, or anxiety. : A prospective study was conducted, between 1 January 2021 and 30 June 2022, at the Medical Recovery Section from "Dr. Pop Mircea Municipal Hospital Pop Mircea" in Marghita. A total of 163 consecutive patients with chronic dyspnea of various etiologies were evaluated for inclusion in the study. Patients who met the inclusion criteria followed a personalized physical training program of variable duration (between 20 and 40 min) up to the limit of exercise tolerance (grade 3-4 modified Borg scale or up to 70% of maximum heart rate, calculated with the formula 220 age in years); the first 10 days, the training was supervised by a physiotherapist, then patients followed a program of 30 min of exercise 5 days/week at home for 3 months. Assessments, performed at inclusion and after 3 months of training, consisted of the 6 min walk test (6MWT) and the London Chest Activity of Daily Living (LCADL) scale. : Pulmonary etiology is the most common cause of dyspnea in the cohort (61.65%). The number of patients without ventilatory defects is 56, or 38.35%. The mean value of initial functional limitation (LCADL1) improved significantly after 3 months (LACDL2) of rehabilitation treatment (38% versus 26.5%); at the same time, the mean walking distance (6MWT) increased by 76 m. : An adequate rehabilitation program and sedentary lifestyle change significantly reduce the functional limitation of the patient with chronic dyspnea and increase walking distance. Predictors for 6MWT gait test are age, LCADL score, dyspnea level, and cardiac etiology of chronic dyspnea.

摘要

慢性呼吸困难是全球心血管和呼吸系统疾病患者的常见临床表现,是这些患者死亡率的独立预测因素。此外,它可能是与其他病症相关的症状,如贫血、身体机能减退或焦虑。

2021年1月1日至2022年6月30日,在马尔吉塔的“波普·米尔恰市立医院”医疗康复科进行了一项前瞻性研究。共评估了163例连续患有各种病因慢性呼吸困难的患者以纳入研究。符合纳入标准的患者遵循个性化的体育训练计划,持续时间可变(20至40分钟),直至运动耐量极限(改良Borg量表3 - 4级或最高心率的70%,按公式220 - 年龄计算);前10天,训练由物理治疗师监督,然后患者在家中每周5天进行30分钟的运动,持续3个月。在纳入时和训练3个月后进行评估,包括6分钟步行试验(6MWT)和伦敦胸部日常生活活动(LCADL)量表。

肺部病因是该队列中呼吸困难最常见的原因(61.65%)。无通气功能缺陷的患者有56例,占38.35%。康复治疗3个月(LACDL2)后,初始功能受限(LCADL1)的平均值显著改善(38%对26.5%);同时,平均步行距离(6MWT)增加了76米。

适当的康复计划和久坐生活方式的改变显著降低了慢性呼吸困难患者的功能受限并增加了步行距离。6MWT步态试验的预测因素是年龄、LCADL评分、呼吸困难程度和慢性呼吸困难的心脏病因。

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