Abstract：
OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is characterized by decreasing exercise capacity and deteriorating quality of life (QoL). Recent evidence indicates that combining exercise with manual therapy (MT) delivers greater improvements in exercise capacity than exercise alone in moderate COPD. The aim of this study was to investigate whether this combination delivers similar results in mild COPD.
METHODS: A total of 71 participants aged 50-65 yr with mild COPD were randomly allocated to two groups: exercise only (Ex) or MT plus exercise (MT + Ex). Both groups received 16 wk of exercise with the MT + Ex group also receiving 8 MT sessions. Lung function (forced vital capacity [FVC] and forced expiratory volume in the 1 st sec [FEV 1 ]), exercise capacity (6-min walk test [6MWT]), and QoL (St George\'s Respiratory Questionnaire [SGRQ] and Hospital Anxiety and Depression Scale [HADS]) were measured at baseline, 4, 8, 16, 24, 32, and 48 wk.
RESULTS: Although there was no difference in the mean effect over time between groups for lung function (FEV 1 , P = .97; FVC, P = .98), exercise capacity (6MWT, P = .98), and QoL (SGRQ, P = .41; HADS anxiety, P = .52; and HADS depression, P = .06), there were clinically meaningful improvements at 48 wk for 6MWT (30 m; 95% CI, 10-51 m; P < .001), SGRQ (6.3 units; 95% CI, 2.5-10.0; P < .001), and HADS anxiety (1.5 units; 95% CI, 0.3-2.8 units; P = .006) across the entire cohort.
CONCLUSIONS: While adding MT to Ex did not produce any additional benefits, exercise alone did deliver sustained modest improvements in exercise capacity and QoL in mild COPD.
METHODS: A total of 71 participants aged 50-65 yr with mild COPD were randomly allocated to two groups: exercise only (Ex) or MT plus exercise (MT + Ex). Both groups received 16 wk of exercise with the MT + Ex group also receiving 8 MT sessions. Lung function (forced vital capacity [FVC] and forced expiratory volume in the 1 st sec [FEV 1 ]), exercise capacity (6-min walk test [6MWT]), and QoL (St George\'s Respiratory Questionnaire [SGRQ] and Hospital Anxiety and Depression Scale [HADS]) were measured at baseline, 4, 8, 16, 24, 32, and 48 wk.
RESULTS: Although there was no difference in the mean effect over time between groups for lung function (FEV 1 , P = .97; FVC, P = .98), exercise capacity (6MWT, P = .98), and QoL (SGRQ, P = .41; HADS anxiety, P = .52; and HADS depression, P = .06), there were clinically meaningful improvements at 48 wk for 6MWT (30 m; 95% CI, 10-51 m; P < .001), SGRQ (6.3 units; 95% CI, 2.5-10.0; P < .001), and HADS anxiety (1.5 units; 95% CI, 0.3-2.8 units; P = .006) across the entire cohort.
CONCLUSIONS: While adding MT to Ex did not produce any additional benefits, exercise alone did deliver sustained modest improvements in exercise capacity and QoL in mild COPD.
摘要：
目的：慢性阻塞性肺疾病（COPD）的特征是运动能力下降和生活质量（QoL）恶化。最近的证据表明，在中度COPD中，运动与手动治疗（MT）的结合比单独运动更能改善运动能力。这项研究的目的是调查这种组合在轻度COPD中是否有类似的结果。
方法：将71名年龄在50-65岁的轻度COPD患者随机分为两组：仅运动（Ex）或MT加运动（MT+Ex）。两组均接受了16周的锻炼，MT+Ex组也接受了8次MT训练。肺功能（第1秒用力肺活量[FVC]和用力呼气量[FEV1]），运动能力（6分钟步行测试[6MWT]），和QoL（圣乔治呼吸问卷[SGRQ]和医院焦虑和抑郁量表[HADS]）在基线测量，4、8、16、24、32和48周。
结果：尽管肺功能组之间随时间的平均效果没有差异（FEV1，P=0.97；FVC，P=.98)，运动能力(6MWT，P=.98)，和QoL(SGRQ，P=.41；HADS焦虑，P=0.52；和HADS抑郁，P=.06），6MWT在48周时有临床意义的改善（30m;95％CI，10-51m;P<.001），SGRQ（6.3个单位；95%CI，2.5-10.0；P<.001），和HADS焦虑（1.5个单位；95%CI，0.3-2.8个单位；P=.006）。
结论：虽然向Ex添加MT并没有产生任何额外的好处，在轻度COPD患者中,单纯运动确实能持续适度改善运动能力和QoL.
方法：将71名年龄在50-65岁的轻度COPD患者随机分为两组：仅运动（Ex）或MT加运动（MT+Ex）。两组均接受了16周的锻炼，MT+Ex组也接受了8次MT训练。肺功能（第1秒用力肺活量[FVC]和用力呼气量[FEV1]），运动能力（6分钟步行测试[6MWT]），和QoL（圣乔治呼吸问卷[SGRQ]和医院焦虑和抑郁量表[HADS]）在基线测量，4、8、16、24、32和48周。
结果：尽管肺功能组之间随时间的平均效果没有差异（FEV1，P=0.97；FVC，P=.98)，运动能力(6MWT，P=.98)，和QoL(SGRQ，P=.41；HADS焦虑，P=0.52；和HADS抑郁，P=.06），6MWT在48周时有临床意义的改善（30m;95％CI，10-51m;P<.001），SGRQ（6.3个单位；95%CI，2.5-10.0；P<.001），和HADS焦虑（1.5个单位；95%CI，0.3-2.8个单位；P=.006）。
结论：虽然向Ex添加MT并没有产生任何额外的好处，在轻度COPD患者中,单纯运动确实能持续适度改善运动能力和QoL.
