Exercise and COPD.
Exercise and COPD.
复制标题
锻炼和慢性阻塞性肺病。
DOI：
10.1097/00000446-200405000-00018
复制
发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Larson,JanetL
中科院分区：
文献类型：
--
作者：
Covey,MargaretK;Larson,JanetL
It used to be thought that people with chronic obstructive pulmonary disease (COPD) couldn’t train intensively enough to produce an aerobic effect because COPD limited their ventilatory capacity. But exercise is now recommended in many guidelines. Pulmonary rehabilitation programs, which often include exercise training, use several approaches to improve the quality of patients’ lives, enhance their functional performance, and alleviate their symptoms. In the 1990s we and our colleagues conducted a study of nurse-supervised pulmonary rehabilitation, including exercises that were performed at home. 1 Fifty-three patients who had COPD with moderate-tosevere airflow obstruction were randomly assigned to groups that would involve one of four interventions: cycle ergometer training (using a stationary bicycle), inspiratory muscle training (IMT), cycle ergometer training and IMT, or education (without training—this was a control group). Changes in the patients’ overall functional capacity, respiratory muscle function, and symptoms were measured and collected over six years; each patient participated for four months. The study demonstrated that four months of nursesupervised, home-based cycle ergometer training or IMT can produce positive physiologic effects. Patients also experienced measurable decreases in exerciserelated breathlessness and leg fatigue. Such training may be a viable alternative for patients who can’t attend outpatient pulmonary rehabilitation programs. Mary Vernon (a pseudonym) was a 68-year-old woman who had been diagnosed with COPD and received bronchodilators to manage her symptoms. When continued breathlessness and fatigue interfered further with her daily activities, she volunteered for our study. When she entered, she had a history of 63 pack-years of smoking (the number of packs of cigarettes smoked per day times number of years smoked), and a chest X-ray showed emphysema with hyperinflation of the lung fields and flattening of the diaphragm. Pulmonary function tests revealed moderate airflow obstruction with minimal reversibility, a less than 20% improvement in airflow obstruction after inhaled bronchodilator use, and evidence of air trapping. Her inspiratory muscle strength was diminished, showing maximal inspiratory pressure at 59% of predicted value (using the standard reference values of Black and Hyatt). 2 (The patient exhales completely, then inhales using maximal force through a partly blocked mouthpiece connected to a pressure transducer, which measures the force of theMargaret K. Covey is research assistant professor in the Department of Medical–Surgical Nursing, University of Illinois at Chicago, where Janet L. Larson is professor and department head. They are current recipients of a grant (grant number NR08037) from the National Institutes of Health to study upperbody–strength training in people with chronic obstructive pulmonary disease. Beats and Breaths is coordinated by Julie Johnson Zerwic, PhD, RN: juljohns@ uic. edu.
