背景:手动呼吸辅助技术(MBAT)是一种常见的物理治疗技术,用于促进气道清除并改善通气和氧合。慢性阻塞性肺疾病(COPD)患者干预期间和干预后立即的影响尚不清楚。本研究旨在探讨MBAT对肺容量的急性影响及潜在机制。呼吸困难,COPD患者的氧合。
方法:这项非随机准实验性测试前/测试后研究包括来自Tagami医院肺康复计划(COPD组)和社区锻炼计划(健康组)的参与者。在一次会议期间,在每次呼气期间应用MBAT持续10分钟。呼吸困难和肺容量(潮气量;VT,吸气量;IC,吸气储备容量;IRV,在基线和MBAT后收集呼气储备容量;ERV)。脉搏血氧饱和度(SpO2),骨骼肌氧合(SmO2),和氧和脱氧血红蛋白(O2Hb和HHb)使用近红外光谱(NIRS)在基线收集,during,MBAT之后。使用Mann-WhitneyU检验和卡方分析进行组间比较。使用Wilcoxon符号秩检验分析MBAT前后的组内变化。使用Kruskal-Wallis检验来检测每个阶段和随时间的NIRS变量的差异。
结果:30名COPD患者,年龄和性别相匹配,包括在内,每组15个人。VT的差异评分,IRV,健康组的IC明显高于COPD组,但COPD组呼吸困难和SpO2的改善程度明显更高.与基线相比,两组ERV均显著下降,仅在COPD组中呼吸困难和SpO2显着改善。与健康组相比,在COPD组的MBAT期间,吸气副肌ΔO2Hb和ΔHHb(分别)显著较高和较低。此外,与基线相比,仅COPD组MBAT期间和之后SmO2升高.
结论:MBAT在COPD患者中具有急性生理作用,可通过促进呼气和减少副呼吸肌的募集来减轻呼吸困难。MBAT可以帮助COPD患者在肺康复计划中进行运动治疗之前减少呼吸困难。
BACKGROUND: Manual breathing assist technique (MBAT) is a common physical therapy technique used to facilitate airway clearance and improve ventilation and oxygenation. The effects during and immediately after intervention in individuals with chronic obstructive pulmonary disease (COPD) are unknown. This study aimed to investigate the acute effects and potential mechanisms of MBAT on lung volume, dyspnea, and oxygenation in individuals with COPD.
METHODS: This non-randomized quasi-experimental pre-test/post-test study included participants from pulmonary rehabilitation programs at Tagami Hospital (COPD group) and a community exercise program (Healthy group). During a single session, MBAT was applied during the expiration of every breath for 10 minutes. Dyspnea and lung volumes (tidal volume; VT, inspiratory capacity; IC, inspiratory reserved capacity; IRV, expiratory reserve capacity; ERV) were collected at baseline and after MBAT. Pulse oximetry (SpO2), skeletal muscle oxygenation (SmO2), and oxy- and deoxy-hemoglobin (O2Hb and HHb) using near-infrared spectroscopy (NIRS) were collected at baseline, during, and after MBAT. Between-group comparisons were conducted using the Mann-Whitney U-test and chi-square analyses. Within-group changes before and after MBAT were analyzed using the Wilcoxon signed-rank test. The Kruskal-Wallis test was used to detect differences in NIRS variables in each phase and over time.
RESULTS: Thirty participants with COPD, matched for age and sex, were included, with 15 individuals per group. The difference scores of VT, IRV, and IC were significantly higher in the Healthy group than in the COPD group, but improvements in dyspnea and SpO2 were significantly higher in the COPD group. Compared to baseline, ERV decreased significantly in both groups, with dyspnea and SpO2 improving significantly only in the COPD group. Inspiratory accessory muscle ΔO2Hb and ΔHHb were significantly higher and lower (respectively) during MBAT in the COPD group compared to the Healthy group. Additionally, only the COPD group had increased SmO2 during and after MBAT compared to baseline.
CONCLUSIONS: MBAT in patients with COPD had acute physiological effects in reducing dyspnea by facilitating expiration and decreasing the recruitment of accessory respiratory muscles. MBAT may help individuals with COPD reduce dyspnea before exercise therapy in a pulmonary rehabilitation program.