O'Donnell D E, McGuire M, Samis L, Webb K A
Department of Medicine, Queen's University, and St. Mary's of the Lake Hospital, Kingston, Ontario, Canada.
Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1489-97. doi: 10.1164/ajrccm.157.5.9708010.
We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV1 = 41 +/- 3% predicted; mean +/- SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (V(LIM)), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 +/- 8%, 43 +/- 10%, 12 +/- 5%, and 34 +/- 9%, respectively (p < 0.05); quadriceps strength increased 21 +/- 5% (p < 0.01); MIP and MEP increased 29 +/- 11% and 27 +/- 11%, respectively (p < 0.05); V(LIM) increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production (VCO2), oxygen consumption (VO2), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): deltaB correlated with deltaF (r = 0.58, p < 0.01). Increased MIP and V(LIM) did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance.
我们研究了一项为期6周的有监督的多模式耐力运动训练计划（EXT）对慢性气流受限（CAL）患者通气和外周肌肉力量及耐力的影响，并确定潜在的改善是否分别有助于缓解运动性呼吸困难（B）和腿部用力/不适（LE）。20例稳定CAL的呼吸困难患者（FEV1 = 预测值的41±3%；平均值±标准误）在基线、非干预对照期（EXT前）和EXT后每隔6周进行一次测试。测量指标包括：肺功能测试（PFTs）、最大吸气/呼气压力（MIP、MEP）、吸气肌耐力（V（LIM））、股四头肌力量和耐力、运动耐力以及伴有心肺通气和症状反应的次最大强度自行车运动。基线和EXT前的测量相同。EXT后，PFTs未改变；在跑步机、自行车测力计、手臂测力计上测量的运动耐力以及6分钟步行距离分别增加了40±8%、43±10%、12±5%和34±9%（p<0.05）；股四头肌力量增加了21±5%（p<0.01）；MIP和MEP分别增加了29±11%和27±11%（p<0.05）；V（LIM）增加了近三倍（p<0.05）。在运动接近结束时的等时间点，EXT后B、LE、二氧化碳产生量（VCO2）、耗氧量（VO2）、通气量和呼吸频率（F）均下降（p<0.05）：ΔB与ΔF相关（r = 0.58，p<0.01）。MIP和V（LIM）的增加与呼吸困难或运动耐力的改善无关。同样，股四头肌力量和耐力的变化与LE或运动耐力的变化无关。总之，一般的非特异性EXT改善了重度CAL患者的通气和外周肌肉功能，但这种改善似乎并未对减轻运动症状和提高运动表现有显著贡献。
Zotero 插件