Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes.
Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes.
复制标题
慢性阻塞性肺疾病患者的吸气肌训练：结构适应和生理结果。
DOI：
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发表时间：
2002
影响因子：
24.7
通讯作者：
J. Gea
中科院分区：
文献类型：
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作者：
A. Ramírez;M. Orozco;R. Guell;E. Barreiro;N. Hernández;S. Mota;M. Sangenís;J. Broquetas;P. Casán;J. Gea
本研究旨在评估一种特定的吸气肌训练方案对慢性阻塞性肺疾病患者吸气肌结构的影响。14名患者（男性，FEV 1，24 +/- 7%预测值）被随机分配到吸气肌训练组或假训练组。使用阈值吸气装置进行监督呼吸，每天30分钟，每周5次，连续5周。吸气训练组接受相当于其最大吸气压力的40%至50%的吸气负荷。在训练期之前和之后，从外部肋间肌和股外侧肌（对照肌）进行活检。肌肉样品进行处理，使用单克隆抗体对肌球蛋白重链亚型I和II的形态测定分析。在吸气训练组中观察到吸气肌的力量和耐力增加。这种改善与I型纤维的比例增加（约38%，p < 0.05）和II型纤维的大小增加（约21%，p < 0.05）有关。在对照肌肉中未观察到变化。研究表明，吸气训练诱导吸气肌的特定功能的改善和适应性变化的结构中的外部肋间肌。
The present study was aimed at evaluating the effects of a specific inspiratory muscle training protocol on the structure of inspiratory muscles in patients with chronic obstructive pulmonary disease. Fourteen patients (males, FEV1, 24 +/- 7% predicted) were randomized to either inspiratory muscle or sham training groups. Supervised breathing using a threshold inspiratory device was performed 30 minutes per day, five times a week, for 5 consecutive weeks. The inspiratory training group was subjected to inspiratory loading equivalent to 40 to 50% of their maximal inspiratory pressure. Biopsies from external intercostal muscles and vastus lateralis (control muscle) were taken before and after the training period. Muscle samples were processed for morphometric analyses using monoclonal antibodies against myosin heavy chain isoforms I and II. Increases in both the strength and endurance of the inspiratory muscles were observed in the inspiratory training group. This improvement was associated with increases in the proportion of type I fibers (by approximately 38%, p < 0.05) and in the size of type II fibers (by approximately 21%, p < 0.05) in the external intercostal muscles. No changes were observed in the control muscle. The study demonstrates that inspiratory training induces a specific functional improvement of the inspiratory muscles and adaptive changes in the structure of external intercostal muscles.