Dyspnea during daily activities in chronic spinal cord injury
Dyspnea during daily activities in chronic spinal cord injury
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DOI：
10.1016/j.apmr.2005.02.006
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发表时间：
2005-08-01
影响因子：
4.3
通讯作者：
Garshick, E
中科院分区：
文献类型：
--
作者：
Grandas, NF;Jain, NB;Garshick, E
Grandas NF, Jain NB, Denckla JB, Brown R, Tun CG, Gallagher ME, Garshick E.慢性脊髓损伤患者日常活动中的呼吸困难。中华医学康复杂志2005；86:1631-5。目的：探讨慢性脊髓损伤（SCI）患者日常活动中呼吸困难的相关因素。设计：横断面调查。工作地点：退伍军人事务、SCI服务和社区。参与者：在1994年至2003年间招募了441名脊髓损伤后1年或1年以上且无急性疾病的参与者，并根据他们独立行走、借助辅助行走或借助手动轮椅或机动轮椅（MWC）移动的能力进行分类。干预措施：评估损伤程度、呼吸道症状、吸烟、合并症和肺活量测定。主要观察指标：说话、进食或穿衣时呼吸困难。结果：MWC使用者（20/85,24%）比非使用者（20/ 356,6%）更常见呼吸困难。15名MWC使用者中与呼吸困难相关的主要活动是说话（18%）。在MWC使用者中，呼吸困难的风险与终生吸烟（优势比[OR]= 1.02； 95%可信区间[CI]，每包每年1.00-1.03）、慢性咳嗽（OR=7.8; 95% Cl, 2.0-32.7）和喘息（OR=3.5; 95% CI, 1.04-13.6）有关。脊髓损伤水平、I秒内预测用力肺活量和用力呼气量的百分比以及最大吸气压力与呼吸困难无关。结论：在选择的日常活动（最常见的是说话）中，在活动能力受损最严重的SCI参与者中，呼吸困难最严重，并与咳嗽、喘息和吸烟的报告相关。(c) 2005年由美国康复医学大会和美国物理医学和康复学会颁发。
Grandas NF, Jain NB, Denckla JB, Brown R, Tun CG, Gallagher ME, Garshick E. Dyspnea during daily activities in chronic spinal cord injury. Arch Phys Med Rehabil 2005;86:1631-5.Objective: To assess factors associated with breathlessness in chronic spinal cord injury (SCI) during daily activities.Design: Cross-sectional survey.Settings: Veterans Affairs SCI service and the community.Participants: Four hundred forty-one participants 1 or more years post-SCI, and without acute illness, were recruited between 1994 and 2003 and were categorized according to their ability to walk unassisted, walk with an aid, or to move about by either hand-propelled wheelchair or motorized wheelchair (MWC).Interventions: Assessment of injury extent, respiratory symptoms, cigarette smoking, comorbid medical conditions, and spirometry.Main Outcome Measures: Breathlessness during talking, eating, or dressing.Results: Breathlessness was more common in MWC users (20/85 users, 24%) than in nonusers (20/356, 6%). The main activity associated with breathlessness in 15 MWC users was talking (18%). In MWC users, the risk of breathlessness was related to lifetime cigarette smoking (odds ratio [OR]= 1.02; 95% confidence interval [CI], 1.00-1.03 per pack year), and reports of chronic cough (OR=7.8; 95% Cl, 2.0-32.7), and wheeze (OR=3.5; 95% CI, 1.04-13.6). SCI level, percentage of predicted forced vital capacity and forced expiratory volume in I second, and maximal inspiratory pressures were not related to breathlessness.Conclusions: Breathlessness during selected daily activities (most commonly talking) was greatest in SCI participants who were most impaired with regard to mobility and was associated with reports of coughing, wheezing, and cigarette smoking. (c) 2005 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.