General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation
General exercise training improves ventilatory and peripheral muscle strength and endurance in chronic airflow limitation
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DOI：
10.1164/ajrccm.157.5.9708010
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发表时间：
1998-05-01
影响因子：
24.7
通讯作者：
Webb, KA
中科院分区：
文献类型：
--
作者：
O'Donnell, DE;McGuire, M;Webb, KA
我们研究了一个为期6周的监督，多模态耐力运动训练计划（EXT）的慢性气流限制（CAL）患者的肌肉和外周肌肉的力量和耐力的影响，并确定潜在的改善是否有助于缓解劳力性呼吸困难（B）和感知腿部努力/不适（LE），分别。在基线、非干预对照期（EXT前）和EXT后，每隔6周对20例稳定CAL（FEV 1 = 41 +/- 3%预测值;平均值+/- SEM）的呼吸困难患者进行检测。测量包括：肺功能测试（PFT）、最大吸气/呼气压力（MIP、MEP）、吸气肌耐力（V-LIM）、四头肌力量和耐力、运动耐力和具有心脏舒张和症状反应的次极量循环运动。基线和EXT前的测量值相同。EXT后，PFT没有改变;在跑步机、自行车测力计、手臂测力计和6分钟步行距离上测量的运动耐力分别增加了40 +/-8%、43 +/-10%、12 +/-5%和34 +/-9%（p < 0.05）;股四头肌力量增加21 +/- 5%（p < 0.01）; MIP和MEP分别增加29 +/- 11%和27 +/-11%（p < 0.05）; V-LIM增加近3倍（p < 0.05）。在接近运动结束的等时，B、LE、二氧化碳产生量（（V）/点（CO2））、氧消耗量（（V）/点（O2））、通气量和呼吸频率（F）均在EXT后下降（p < 0.05）：Delta B与Delta F相关（r = 0.58，p < 0.01）。MIP和V-LIM的增加与呼吸困难或运动耐力的改善无关。同样，股四头肌力量和耐力的变化与LE或运动耐力的变化无关。总之，一般非特异性EXT改善了重度CAL患者的排便和外周肌肉功能，但这种改善似乎并没有显着减少劳力症状和增强运动表现。
We studied the impact of a 6-wk supervised, multimodality endurance exercise training program (EXT) on strength and endurance of ventilatory and peripheral muscles in patients with chronic airflow limitation (CAL), and determined whether potential improvements contributed to relief of exertional breathlessness (B) and perceived leg effort/discomfort (LE), respectively. Twenty breathless patients with stable CAL (FEV1 = 41 +/- 3% predicted; mean +/- SEM) were tested at 6-wk intervals at baseline, after a nonintervention control period (pre-EXT), and post-EXT. Measurements included: pulmonary function tests (PFTs), maximal inspiratory/expiratory pressures (MIP, MEP), inspiratory muscle endurance (V-LIM), quadriceps strength and endurance, exercise endurance, and submaximal cycle exercise with cardioventilatory and symptom responses. Measurements at baseline and pre-EXT were identical. Post-EXT, PFTs did not change; exercise endurance measured on the treadmill, cycle ergometer, arm ergometer, and by 6-min walk distance increased 40 +/- 8%, 43 +/- 10%, 12 +/- 5%, and 34 +/- 9%, respectively (p < 0.05); quadriceps strength increased 21 +/- 5% (p < 0.01); MIP and MEP increased 29 +/- 11% and 27 +/- 11%, respectively (p < 0.05); V-LIM increased almost threefold (p < 0.05). At isotime near end-exercise, B, LE, carbon dioxide production ((V) over dot(CO2)), oxygen consumption ((V) over dot(O2)), ventilation, and breathing frequency (F) all fell after EXT (p < 0.05): Delta B correlated with Delta F (r = 0.58, p < 0.01). increased MIP and V-LIM did not correlate with improved breathlessness or exercise endurance. Similarly, changes in quadriceps strength and endurance did not correlate with changes in LE or exercise endurance. In conclusion, general nonspecific EXT improved ventilatory and peripheral muscle function in severe CAL, but such improvements did not appear to contribute significantly to reduced exertional symptoms and enhanced exercise performance.