Wanke T, Toifl K, Merkle M, Formanek D, Lahrmann H, Zwick H
Pulmonary Department, Lainz-Hospital, Vienna, Austria.
Chest. 1994 Feb;105(2):475-82. doi: 10.1378/chest.105.2.475.
The aim of this study was to assess the usefulness of a specific inspiratory muscle training in Duchenne muscular dystrophy (DMD).
Fifteen patients with DMD started 6 months of training the inspiratory muscles and 15 patients served as a control group. Pulmonary and inspiratory muscle function parameters were assessed 3 months before and at the beginning of training, in the first and third month of training, at the end, and 6 months after its cessation. Maximal sniff assessed esophageal and transdiaphragmatic pressure values served as indices for global inspiratory muscle strength and diaphragmatic strength, respectively. Inspiratory muscle endurance was assessed by the length of time a certain inspiratory task could be maintained.
In 10 of the 15 patients, respiratory muscle function parameters improved significantly after 1 month of training. Further improvements were to be seen after 3 and after 6 months. Even 6 months after the end of training, those effects remained to a large extent. In the other five patients, there was no such improvement after 1 month of training, which was therefore discontinued. All these five patients had vital capacity values of less than 25 percent predicted and/or PaCO2 values of more than 45 mm Hg. The 15 control patients had no significant change in their respiratory muscle function parameters.
We conclude that a specific inspiratory muscle training is useful in the early stage of DMD.
本研究旨在评估特定吸气肌训练对杜氏肌营养不良症(DMD)的有效性。
15例DMD患者开始进行为期6个月的吸气肌训练,15例患者作为对照组。在训练前3个月、训练开始时、训练的第1个月和第3个月、训练结束时以及训练停止后6个月评估肺和吸气肌功能参数。最大吸气动作评估的食管压力和跨膈压值分别作为整体吸气肌力量和膈肌力量的指标。吸气肌耐力通过维持特定吸气任务的时间长度来评估。
15例患者中有10例在训练1个月后呼吸肌功能参数显著改善。在3个月和6个月后可见进一步改善。即使在训练结束6个月后,这些效果仍在很大程度上存在。在另外5例患者中,训练1个月后没有出现这种改善,因此停止训练。这5例患者的肺活量值均低于预测值的25%和/或动脉血二氧化碳分压值高于45 mmHg。15例对照患者的呼吸肌功能参数无显著变化。
我们得出结论,特定的吸气肌训练在DMD早期是有效的。