背景:建议在支气管镜肺减容术(BLVR)之前进行肺康复(PR),以优化患者的预后。然而,对公关内容缺乏明确的指导。我们研究的目的是检查在BLVR之前将吸气肌肉训练(IMT)添加到标准PR对运动能力的影响,呼吸困难,疲劳水平和生活质量。
方法:64例患者随机分为PR组(PRGr)或PR伴IMT组(IMTGr)。两组都接受了为期8周的标准公关计划,包括呼吸练习,肌肉加强,和走路。此外,IMTGr收到了IMT会话。结果测量包括六分钟步行距离(6MWD),最大吸气和呼气压力(MIP,MEP),外周肌肉力量,改良医学研究委员会呼吸困难评分,疲劳症状量表,肺活量测定参数,圣乔治生活质量问卷(SGRQ),国际身体活动问卷简表(IPAQ-SF),医院焦虑和抑郁量表。
结果:我们的研究发现IMTGr和PRGr在运动能力改善方面没有显着差异。然而,与PRGr相比,IMTGr显示MIP的显著改善。两组都经历了呼吸困难的改善,疲劳,和抑郁分数,以及6MWD的增强,MEP,外周肌肉力量,IPAQ-SF和SGRQ分数。
结论:在符合BLVR标准的患者中,将IMT添加到PR中并没有显示两组之间的显著差异。然而,改善呼吸肌力量可能有积极的临床意义。需要进一步的研究来探索短期和长期的影响。
BACKGROUND: Pulmonary rehabilitation (PR) is recommended prior to bronchoscopic lung volume reduction (BLVR) procedures to optimize patient outcomes. However, there\'s a lack of clear guidance on PR content. The aim of our study is to examine the effect of adding inspiratory muscle training (IMT) to standard PR before BLVR on exercise capacity, dyspnea, fatigue level and quality of life.
METHODS: Sixty-four patients were randomly assigned to either the PR Group (PRGr) or the PR with IMT group (IMTGr). Both groups underwent an 8-week standard PR program, including breathing exercises, muscle strengthening, and walking. Additionally, IMTGr received IMT sessions. Outcome measures comprised six-minute walking distance (6MWD), maximal inspiratory and expiratory pressures (MIP, MEP), peripheral muscle strength, modified Medical Research Council dyspnea score, fatigue symptom scale, spirometric parameters, Saint George Quality of Life Questionnaire (SGRQ), International Physical Activity Questionnaire Short Form (IPAQ-SF), and Hospital Anxiety and Depression Scale.
RESULTS: Our study found no significant difference in exercise capacity improvement between IMTGr and PRGr. However, IMTGr showed significant improvement in MIP compared to PRGr. Both groups experienced improvements in dyspnea, fatigue, and depression scores, as well as enhancements in 6MWD, MEP, peripheral muscle strength, IPAQ-SF and SGRQ scores.
CONCLUSIONS: Adding IMT to PR did not show a significant difference between groups among BLVR-eligible patients. However, improved respiratory muscle strength may have positive clinical implications. Further research is needed to explore short and long-term effects.