Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing
Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing
复制标题
DOI：
10.3978/j.issn.2072-1439.2012.03.17
复制
发表时间：
2012-06-01
影响因子：
2.5
通讯作者：
Fukuchi, Yoshinosuke
中科院分区：
文献类型：
--
作者：
Yoshimi, Kaku;Ueki, Jun;Fukuchi, Yoshinosuke
背景资料：肺功能康复治疗能有效缓解COPD患者的症状，增强患者的运动耐力，改善患者的健康相关生活质量（QOL），但肺功能的恢复仍存在疑问。我们的创新康复计划的分析是针对记录患者的呼气气流限制，肺部症状和生活质量的变化。该计划的目的是提供“呼吸调节”，物理治疗师辅助的密集的灵活性训练，重点是拉伸和肋骨mobilization.Methods：31例COPD患者参加了1999年至2006年在顺天堂大学医院康复会议进行了分析。肺功能，呼气流量限制在潮式呼吸，6分钟步行距离（6 MWD），呼吸肌力，和圣乔治呼吸问卷（SGRQ）进行了测量之前和之后的肺rehabilitation.Results：在参与者年龄68 +/- 7岁，FEV1%预测值为39.3 +/-15.7%。肺功能康复治疗后6 MWD、SGRQ、呼吸肌肌力明显改善。尽管FEV1%预测值和FEV 1/FVC均未受到显著影响，表明对气流限制影响不大，但仰卧位和坐位潮气呼吸时的呼气流量限制均显著改善。此外，康复显着减少TLC%预测，FRC%预测，RV%预测和RV/TLC值，从而表明减少过度充气的肺在rest.Conclusions：目前的结果表明，我们的康复计划与呼吸调理显着降低过度充气的肺在休息，以及在潮气呼吸呼气流量限制。在COPD患者中，总体肺功能改善，运动耐力增加，健康相关QOL增强。
Background: Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients' expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide "respiratory conditioning", a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization.Methods: Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation.Results: In participants ages 68 +/- 7 years, the FEV1% predicted was 39.3 +/- 15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV1% predicted nor FEV1/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest.Conclusions: The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.