背景:呼吸系统并发症是脊髓损伤(SCI)患者发病和死亡的主要原因。我们检查了呼吸肌训练(RMT)对急性宫颈SCI患者的影响。
方法:这项前瞻性试验纳入了44例急性宫颈SCI患者,其中20例接受RMT,24例没有接受RMT。呼吸功能,心血管自主神经功能,比较了反应性氧化物质(ROS)。实验组每周7天接受40分钟高强度家庭RMT,持续10周。对照组接受类似时期的假干预。主要结果是RMT对肺和心血管自主神经功能的影响,急性宫颈SCI患者的ROS产生。
结果:在6个月的随访中,发现两组在心血管自主神经功能和对深呼吸的心率反应方面存在显着差异(p=0.017)。在RMT之后,最大吸气压力(p=0.042)和硫代巴比妥酸反应性物质(TBARS)(p=0.006)显着改善,而最大呼气压力没有显着差异。在6个月时,两组的潮气量(p=0.005)和快速浅呼吸指数(p=0.031)之间存在显着差异。值得注意的是,在6个月的随访中,RMT组的SF-36(身体(PCS)和精神(MCS)成分汇总)显着下降,而RMT治疗后临床评分无显著差异(p=0.333).
结论:高强度家用RMT可改善损伤后呼吸肌无力患者的肺功能和耐力,减轻呼吸困难。建议用于脊髓损伤后的康复。
BACKGROUND: respiratory complications are a leading cause of morbidity and mortality in individuals with spinal cord injury (SCI). We examined the effects of respiratory muscle training (RMT) in patients with acute cervical SCI.
METHODS: this prospective trial enrolled 44 adults with acute cervical SCI, of which twenty received RMT and twenty-four did not receive RMT. Respiratory function, cardiovascular autonomic function, and reactive oxidative species (ROS) were compared. The experimental group received 40-min high-intensity home-based RMT 7 days per week for 10 weeks. The control group received a sham intervention for a similar period. The primary outcomes were the effects of RMT on pulmonary and cardiovascular autonomic function, and ROS production in individuals with acute cervical SCI.
RESULTS: significant differences between the two groups in cardiovascular autonomic function and the heart rate response to deep breathing (p = 0.017) were found at the 6-month follow-up. After RMT, the maximal inspiratory pressure (p = 0.042) and thiobarbituric acid-reactive substances (TBARS) (p = 0.006) improved significantly, while there was no significant difference in the maximal expiratory pressure. Significant differences between the two groups in tidal volume (p = 0.005) and the rapid shallow breathing index (p = 0.031) were found at 6 months. Notably, the SF-36 (both the physical (PCS) and mental (MCS) component summaries) in the RMT group had decreased significantly at the 6-month follow-up, whereas the clinical scores did not differ significantly (p = 0.333) after RMT therapy.
CONCLUSIONS: High-intensity home-based RMT can improve pulmonary function and endurance and reduce breathing difficulties in patients with respiratory muscle weakness after injury. It is recommended for rehabilitation after spinal cord injury.