住院后重症肌无力患者吸气肌训练和有氧运动对呼吸肌力量的影响——一项随机对照试验

Inspiratory muscle training and aerobic exercise for respiratory muscle strength in myasthenia gravis post-hospitalization- a randomized controlled trial.

作者信息

Chang Chia-Ling, Fang Tien-Pei, Tsai Hsin-Mao, Chen Hui-Chin, Liu Shih-Feng, Lin Hui-Ling, Liu Jui-Fang

机构信息

Department of Respiratory Therapy, Kaohsiung Municipal Fong Shan Hospital - Under the management of Chang Gung Medical Foundation, Kaohsiung, 833, Taiwan.

Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 833, Taiwan.

出版信息

BMC Pulm Med. 2025 May 27;25(1):266. doi: 10.1186/s12890-025-03733-7.

DOI:10.1186/s12890-025-03733-7

PMID:40426137

Abstract

BACKGROUND

Previous studies have demonstrated the positive effects of long-term inspiratory muscle training (IMT) on inspiratory muscle strength and pulmonary function. However, the benefits of IMT with aerobic exercise (IMT + AE) in patients with myasthenia gravis (MG) remain unclear. This randomized controlled trial aimed to assess the impact of the early, 6-week, moderate-intensity interval IMT + AE on pulmonary function, functional capacity, and respiratory muscle strength in patients with MG post-hospitalization.

METHODS

Patients with Discharged MG were randomly assigned to either a control group receiving standard medical management or an intervention group undergoing six-week IMT + AE program. Respiratory status was evaluated using the maximum inspiratory/expiratory pressure (MIP/MEP) and pulmonary function tests. Modified Borg dyspnea scores and a six-minute walk test for functional capacity were also employed.

RESULTS

Fifty-four participants were assigned to either the control (sixn = 28) or IMT + AE groups (n = 26). At 6 weeks, the IMT + AE group showed significant improvements across all parameters, while the control group only showed notable differences in the modified Borg scale scores and walking distance. MIP improvements were 33.8 ± 36.1 cmHO in IMT and 22.1 ± 25.8 cmHO in control groups (P = 0.18). The IMT + AE group improvements were more substantial in MEP, modified Borg scale, and 6-minute walk distance, in addition to forced vital capacity (FVC) and FVC % of prediction (0.21 ± 0.24 L and 6.17 ± 6.01%, respectively), while the control group showed decreased volumes (-0.06 ± 0.30 L and - 1.79 ± 9.69%, respectively). FVC improvement was significant with IMT + AE (0.21 ± 0.24 L) vs. reduction in the control group (-0.06 ± 0.3 L; P = 0.001).

CONCLUSIONS

Implementing six-week moderate-intensity interval IMT + AE effectively enhanced respiratory muscle strength, alleviated dyspnea, improved physical capacity, and increased FVC in patients with MG following hospitalization after discharge.

CLINICAL TRIAL REGISTRATION

The study was registered in The Clinical Trials Clinical Trial (NCT06624345|| https://www.

CLINICALTRIALS

gov/ ) on October 12, 2024 (retrospectively registered).

摘要

背景

先前的研究已经证明长期吸气肌训练（IMT）对吸气肌力量和肺功能有积极影响。然而，重症肌无力（MG）患者进行吸气肌训练联合有氧运动（IMT+AE）的益处仍不明确。这项随机对照试验旨在评估早期、为期6周的中等强度间歇IMT+AE对MG患者出院后肺功能、功能能力和呼吸肌力量的影响。

方法

出院的MG患者被随机分配到接受标准药物治疗的对照组或接受为期六周的IMT+AE计划的干预组。使用最大吸气压/呼气压（MIP/MEP）和肺功能测试评估呼吸状态。还采用了改良的博格呼吸困难评分和用于评估功能能力的六分钟步行试验。

结果

54名参与者被分配到对照组（n=28）或IMT+AE组（n=26）。在6周时，IMT+AE组在所有参数上均有显著改善，而对照组仅在改良博格量表评分和步行距离上有显著差异。IMT组的MIP改善为33.8±36.1cmH₂O，对照组为22.1±25.8cmH₂O（P=0.18）。IMT+AE组在MEP、改良博格量表和六分钟步行距离方面的改善更为显著，此外还有用力肺活量（FVC）及其预测值的百分比（分别为0.21±0.24L和6.17±6.01%），而对照组的容积下降（分别为-0.06±0.30L和-1.79±9.69%）。IMT+AE组的FVC改善显著（0.21±0.24L），而对照组下降（-0.06±0.3L；P=0.001）。