Clark C J, Cochrane L, Mackay E
Dept of Respiratory Medicine, Hairmyres Hospital, Glasgow, Scotland.
Eur Respir J. 1996 Dec;9(12):2590-6. doi: 10.1183/09031936.96.09122590.
This randomized, controlled study investigated the physiological effects of a specially designed 12 week programme of isolated conditioning of peripheral skeletal muscle groups. The programme required minimal infrastructure in order to allow continued rehabilitation at home after familiarization within hospital. Forty eight patients, aged 40-72 yrs with chronic obstructive pulmonary disease (COPD) (mean (SD) forced expiratory volume in one second (FEV1) 61 (27)% of predicted normal) were randomly allocated into training (n = 32) and control (n = 16) groups. Physiological assessments were performed before and after the 12 week study period, and included peripheral muscle endurance and strength, whole body endurance, maximal exercise capacity (maximum oxygen consumption (V'O2,max)) and lung function. The training group showed significant improvement in a variety of measures of upper and lower peripheral muscle performance, with no additional breathlessness. Whole body endurance measured by free arm treadmill walking increased by 6,372 (3,932-8,812) 3 (p < 0.001). Symptom-limited maximal V'O2 was unchanged. However, the training group showed a reduction in ventilatory equivalents for oxygen and carbon dioxide, both at peak exercise and at equivalent work rate (Wmax). In summary, low intensity isolated peripheral muscle conditioning is well-tolerated, simple and easy to perform at home. The various physiological benefits should enable patients across the range of severity of chronic obstructive pulmonary disease to improve daily functioning.
这项随机对照研究调查了一项专门设计的为期12周的外周骨骼肌群孤立训练计划的生理效应。该计划所需的基础设施极少，以便患者在医院熟悉训练后能够在家中继续康复训练。48名年龄在40 - 72岁之间的慢性阻塞性肺疾病（COPD）患者（一秒用力呼气量（FEV1）平均（标准差）为预测正常值的61（27）%）被随机分为训练组（n = 32）和对照组（n = 16）。在为期12周的研究期前后进行了生理评估，评估内容包括外周肌肉耐力和力量、全身耐力、最大运动能力（最大耗氧量（V'O2,max））和肺功能。训练组在各种上下肢外周肌肉表现指标上有显著改善，且没有额外的呼吸急促症状。通过自由臂跑步机行走测量的全身耐力增加了6372（3932 - 8812）3（p < 0.001）。症状限制下的最大V'O2没有变化。然而，训练组在峰值运动和同等工作率（Wmax）时，氧和二氧化碳的通气当量均有所降低。总之，低强度的外周肌肉孤立训练耐受性良好、简单且易于在家中进行。各种生理益处应能使不同严重程度的慢性阻塞性肺疾病患者改善日常功能。
