Exercise training and inspiratory muscle training in patients with bronchiectasis
Exercise training and inspiratory muscle training in patients with bronchiectasis
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DOI：
10.1136/thx.2004.028928
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发表时间：
2005-11-01
期刊：
影响因子：
10
通讯作者：
Hill, SL
中科院分区：
文献类型：
--
作者：
Newall, C;Stockley, RA;Hill, SL
背景资料：支气管扩张症是一种慢性化脓性肺病，通常以气流阻塞和过度充气为特征，并导致运动耐量下降和健康状况下降。肺康复（PR）和吸气肌训练（IMT）的作用还没有被调查在这组patients.Methods：32例特发性支气管扩张症患者被随机分配到三组之一：PR加假IMT（PR-SHAM），PR加靶向IMT（PR-IMT），或控制。所有患者（对照组除外）均接受了为期8周的PR或PR加靶向IMT的训练计划。PR期间每周进行三次运动训练，心率为峰值心率的80%。在8周的时间内，每天两次在家中进行IMT，每次15分钟。PR-SHAM和PR-IMT导致96.7米的增量穿梭行走测试显著增加（95%置信区间（CI）59.6至133.7）和124.5米（95% CI 63.2至185.9），耐力运动能力分别为174.9%（95% CI 34.7至426.1）和205.7%（95% CI 31.6至310.6）。两组之间在运动改善方面没有统计学显著差异。在PR-IMT组（21.4 cm H2O增加，95% CI 9.3至33.4; p=0.008）和PR-SHAM组（12.0 cm H2O增加，95% CI 1.1至22.9; p=0.04）中也观察到吸气肌力的显著改善，其幅度也相似（p=0.220）。运动能力的改善保持在PR-IMT组3个月后的培训，但不是在PR-SHAM group.Conclusion：PR是有效的，提高运动耐量支气管扩张症，但没有额外的优势，同时IMT。然而，IMT可能对训练效果的持久性很重要。
Background: Bronchiectasis is a chronic suppurative lung disease often characterised by airflow obstruction and hyperinflation, and leading to decreased exercise tolerance and reduced health status. The role of pulmonary rehabilitation (PR) and inspiratory muscle training (IMT) has not been investigated in this group of patients.Methods: Thirty two patients with idiopathic bronchiectasis were randomly allocated to one of three groups: PR plus sham IMT (PR-SHAM), PR plus targeted IMT (PR-IMT), or control. All patients (except the control group) underwent an 8 week training programme of either PR or PR plus targeted IMT. Exercise training during PR was performed three times weekly at 80% of the peak heart rate. IMT was performed at home for 15 minutes twice daily over the 8 week period.Results: PR-SHAM and PR-IMT resulted in significant increases in the incremental shuttle walking test of 96.7 metres (95% confidence interval (CI) 59.6 to 133.7) and 124.5 metres (95% CI 63.2 to 185.9), respectively, and in endurance exercise capacity of 174.9% (95% CI 34.7 to 426.1) and 205.7% (95% CI 31.6 to 310.6). There were no statistically significant differences in the improvements in exercise between the two groups. Significant improvements in inspiratory muscle strength were also observed both in the PR-IMT group (21.4 cm H2O increase, 95% CI 9.3 to 33.4; p=0.008) and the PR-SHAM group (12.0 cm H2O increase, 95% CI 1.1 to 22.9; p=0.04), the magnitude of which were also similar (p=0.220). Improvements in exercise capacity were maintained in the PR-IMT group 3 months after training, but not in the PR-SHAM group.Conclusion: PR is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous IMT. IMT may, however, be important in the longevity of the training effects.