Walczak J, Koziorowski A
Zaklad Fizjopatologii Oddychania Instytutu, Gruźlicy i Chorób Pluc.
Pneumonol Alergol Pol. 1997;65(7-8):487-93.
The aim of the study was to testify the effectiveness and acceptance of combination of the resistive inspiratory muscle training and the following walking training in 26 stable COPD pts with FEVI%VC about 50%. Measurements of inspiratory (MIP cm H20) and expiratory (MEP cm H20) muscle strength and also spirometric examinations two times before the training and one time after every month of observation were done. During first 3 months of the training inspiratory resistor (Pflex) was used. Everyday 20 s MVV with smaller orifice of Pflex (strength training) and 30 min quiet breathing by medium orifice of Pflex 3 times a week (endurance training) were performed. In first 3 months of experiment 13 patients resigned of it. Other 13 pts (age 64 +/- 11.9. F-4 with medium FEVI%VC = 47.3 +/- 14.5, MIP = -54.1 +/- 11.4, MEP = = 99.8 +/- 40.5) were trained during 3 months. In 11 of them (FEVI%VC = 50.0 +/- 17.3) MIP improved by 33%. Values of other indices did not change at all. After 3 month of resistive training 11 pts (3-F) were qualified to walking training but only 5 (1-F) of them had finished it. After 5 month of exercises their MIP improved by 74% (p < 0.5) and MEP by 50% (p < 0.05). We conclude that our method of resistive breathing with Pflex is effective and well tolerated by stable COPD pts but accepted only by 50% of them. It may be used as the first step before conditioning training. Inspiratory muscle training is not alternative to pharmacological treatment but is valuable supplementation of it.
本研究的目的是验证阻力吸气肌训练与后续步行训练相结合对26例FEVI%VC约为50%的稳定期慢性阻塞性肺疾病（COPD）患者的有效性和可接受性。在训练前进行了两次吸气（最大吸气压，cm H₂O）和呼气（最大呼气压，cm H₂O）肌肉力量测量以及肺功能检查，在每个月的观察期后进行一次肺功能检查。在训练的前3个月使用吸气阻力器（Pflex）。每天进行20秒通过较小孔径Pflex的最大分钟通气量（MVV）（力量训练），每周3次通过中等孔径Pflex进行30分钟平静呼吸（耐力训练）。在实验的前3个月，有13名患者退出。其他13名患者（年龄64±11.9岁，4名女性，平均FEVI%VC = 47.3±14.5，最大吸气压 = -54.1±11.4，最大呼气压 = 99.8±40.5）接受了3个月的训练。其中11名患者（FEVI%VC = 50.0±17.3）的最大吸气压提高了33%。其他指标的值根本没有变化。在进行3个月的阻力训练后，11名患者（3名女性）符合步行训练条件，但其中只有5名（1名女性）完成了训练。在进行5个月的训练后，他们的最大吸气压提高了74%（p < 0.5），最大呼气压提高了50%（p < 0.05）。我们得出结论，我们使用Pflex进行阻力呼吸的方法对稳定期COPD患者有效且耐受性良好，但只有50%的患者接受。它可作为适应性训练前的第一步。吸气肌训练不是药物治疗的替代方法，而是其有价值的补充。
