Thornby M A, Haas F, Axen K
Department of Medicine, New York University School of Medicine, New York 10014, USA.
Chest. 1995 May;107(5):1213-7. doi: 10.1378/chest.107.5.1213.
We tested the hypothesis that a distractive stimulus, such as music, introduced during exercise can reduce perception of respiratory effort at any given level of exercise, whereas sensory deprivation increases effort perception. Thirty-six patients with moderate COPD participated in four sessions of symptom-limited exercise. The first session familiarized the subject with the protocol. The other sessions were performed under partial visual isolation while listening to music (M), or to grey noise (GN), or in silence (SIL), presented in randomized order. Subjects graded their respiratory effort using the Borg rating of perceived exertion (RPE) scale. Total exercise time (EXT) and external work (WT) were objective indices of exercise tolerance. EXT was 22% longer with M than with either GN or SIL (p < 0.001), and WT was 44% and 53% greater with M than with GN or SIL, respectively (p < 0.001). These increases occurred at a heart rate that was only a few beats higher than during GN or SIL (104 +/- 3 bpm for M and 101 +/- 3 bpm for GN and SIL), a minimal difference that was statistically significant (p < 0.001). At every level of exercise, perceived exertion with M was lower than for either GN or SIL (p < 0.001). Although the respective RPE was higher for SIL than for GN (p < 0.01) at every level of exercise, WT and EXT were no different. These data indicate that perceived effort can be significantly influenced by external factors. This in turn suggests that the use of distractive stimuli during exercise training programs with patients with COPD may significantly decrease perceived symptoms of respiratory discomfort, thus allowing the patient to exercise to a higher intensity, and potentially achieving more effective exercise reconditioning training.
在运动过程中引入诸如音乐之类的分散注意力的刺激，可以在任何给定的运动水平下降低对呼吸努力的感知，而感觉剥夺则会增加对努力的感知。36名中度慢性阻塞性肺疾病（COPD）患者参加了4次症状限制运动。第一次运动让受试者熟悉方案。其他运动在部分视觉隔离的情况下进行，同时听音乐（M组）、听灰色噪音（GN组）或保持安静（SIL组），以随机顺序进行。受试者使用Borg自觉用力程度（RPE）量表对其呼吸努力程度进行评分。总运动时间（EXT）和外部功（WT）是运动耐力的客观指标。与GN组或SIL组相比，M组的EXT长22%（p<0.001），与GN组或SIL组相比，M组的WT分别高44%和53%（p<0.001）。这些增加发生时的心率仅比GN组或SIL组高几次心跳（M组为104±3次/分钟，GN组和SIL组为101±3次/分钟），这一微小差异具有统计学意义（p<0.001）。在每个运动水平上，M组的自觉用力程度均低于GN组或SIL组（p<0.001）。尽管在每个运动水平上，SIL组的RPE均高于GN组（p<0.01），但WT和EXT并无差异。这些数据表明，自觉努力会受到外部因素的显著影响。这反过来表明，在对COPD患者进行运动训练项目时使用分散注意力的刺激，可能会显著减轻呼吸不适的自觉症状，从而使患者能够以更高的强度进行运动，并有可能实现更有效的运动康复训练。
