Group training in patients with COPD – Long-term effects after decreased training frequency

Purpose.?To investigate effects of decreased training frequency in patients with COPD.

Methods.?Forty-three COPD patients participated in a controlled study. The intervention group (30 patients) trained 3 times a week during 3 months and once a week during 6 months. Before, after 3 and 9 months all patients performed walking tests, cycle ergometer tests and responded questionnaires on health-related quality of life (HRQoL) (SGRQ, SF-36).

Results.?At 9 months compared to 3 months there were no changes in distance walked in the groups. Both groups decreased their VO_2peak and the training group deteriorated in HRQoL. At 9 months compared to baseline the training group showed increased distance walked compared to the control group. In the disease-specific SGRQ the training group tended to improve their activity score while the control group tended to deteriorate in total score. In SF-36 the control group decreased their physical component score.

Conclusion.?Training once a week does not seem to be sufficient to maintain the level achieved after the 3-month period of training in COPD patients. However, training once a week during 6 months preceded by 3 months of high frequency training seems to prevent deterioration in physical capacity and HRQoL compared to baseline. Further studies are needed to investigate how to best sustain the benefits gained after physical training.     

Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial

Purpose: To evaluate the effects of progressive resistance and balance (PRB) exercises on physical and psychological functions of post-stroke individuals.

Materials and methods: In a randomized controlled trial with follow-up at 3, 6 and 15 months, 67 community-living individuals (76% male; 65–85 years) with a stroke 1–3 years previously were allocated to an intervention group (IG, n?=?34; PRB exercises combined with motivational group discussions twice weekly for 3 months) or a control group (CG, n?=?33). The primary outcomes were balance (Berg Balance Scale, 0–56 points) and mobility (Short Physical Performance Battery, 0–12 points) at 3 months. The secondary outcomes were 10 m comfortable walking speed, physical activity levels, health-related quality of life, depression and fall-related self-efficacy.

Results: At 3 months, the IG exhibited significant improvements in balance (MD 2.5 versus 0 points; effect size [ES], 0.72; p?p?=?0.01) relative to the CG. A faster walking speed persisted at 6 months. No differences were found for the other outcomes.

Conclusions: In chronic stroke patients, 3 months of PRB exercises and motivational discussions induced improvements in balance at 3 months and in walking speed at 3 and 6 months.

• Implications for Rehabilitation

• A progressive resistance and balance exercise program supported by motivational group discussions and one home-based exercise appears to be an effective means of improving the short-term balance and the walking speed in individuals with chronic stroke.

• People with poor balance and motor function discontinued the study more often and may require additional support.

• There is a need for powerful and cost-effective strategies that target changes in behavior to obtain long-term changes in physical function after exercising.

     

6分钟步行试验在老年慢性心衰患者康复中的应用

目的:采用6分钟步行试验探讨运动训练对老年慢性心衰患者的生活质量和心功能的恢复的影响。方法:实验分两组:训练组(n=50)和对照组(n=48)。两组分别在入院时和治疗两月后接受6分钟步行试验,心脏B超和生活质量调查。结果:训练组2月后与入院时相比HR、RPP、6分钟步行距离、EF值及生活质量评分均有明显改善,P<0.05;对照组入院时与治疗2月后相比差异无显著意义,P>0.05。结论:适度的运动训练对慢性心力衰竭患者可以有显著的生理和心理改善作用。     

有氧训练和呼吸训练对老年慢性阻塞性肺疾病患者的肺功能及生存质量的影响

目的探讨有氧训练和呼吸训练对老年慢性阻塞性肺疾病(chronicobstructivepulmonarydisease,COPD)患者的康复作用。方法29例老年COPD患者每天进行慢、中速度步行训练及缩唇呼气、控制性深呼吸训练,6个月后进行肺功能及生存质量评估比较。结果康复训练组生存质量较训练前明显提高,肺功能指标有改善。结论有氧训练和呼吸训练可明显提高COPD病人的生存质量。     

肢体康复训练指导对老年高血压合并脑卒中患者预后生存质量的应用效果

目的探讨肢体康复训练指导对老年高血压合并脑卒中患者预后生存质量的应用效果。方法选取本院接受诊治的86例老年高血压合并脑卒中患者作为研究对象,根据随机数表法分为对照组和研究组各43例,对照组接受血压控制、用药指导、生活能力训练等常规护理,研究组在对照组常规护理基础上实施肢体康复训练指导。比较2组患者护理前、护理2个月后活动能力、神经功能、肢体运动功能及生存质量变化。结果护理后2组患者活动能力评分均高于护理前,且研究组高于对照组;护理后2组患者神经功能评分均低于护理前,且研究组低于对照组;护理后2组患者上肢、下肢的运动功能评分均高于护理前,且研究组高于对照组;护理后2组患者的总体健康评分、精神健康评分、社会功能评分、生理职能评分均高于护理前,且研究组高于对照组。结论肢体康复训练指导能有效促进高血压合并脑卒中患者运动功能及神经功能恢复,改善患者生存质量,提高预后效果。     

步行锻炼对COPD患者肺功能和生存质量的影响

目的 :探讨步行锻炼对慢性阻塞性肺疾病 (chronicobstructiveplumonarydisease,COPD)患者肺功能和生存质量的影响。方法 :28例轻、中度COPD患者每天进行30min以上的匀速步行锻炼 ,持续2个月 ,锻炼前后分别测试肺功能指标 (FVC、FEV1、%FVC、?V1、FEV1/FVC % )和评估生存质量。结果 :COPD患者锻炼后肺功能指标无明显差异 (P均>0.05) ,但生存质量评分明显优于锻炼前 (P均>0.05)。结论 :生存质量指标评估肺康复更敏感。     

Combined endurance and muscle strength training in female and male patients with chronic heart failure

BACKGROUND: Exercise training has now become established practice in patients with chronic heart failure. Women are often under-represented in intervention studies compared to men. For this reason it was our aim to conduct a combined endurance and muscle strength training program to evaluate its effect on clinical performance data and health-related psychosocial factors in women and men. METHODS: One hundred and sixteen women, mean age 69 +/- 9 years, body mass index (BMI) 25.8 +/- 4.9, and 169 men, mean age 66 +/- 9 years, BMI 26.6 +/- 3.6 underwent combined endurance/resistance training. The training program lasted 29 +/- 7 days and comprised bicycle ergometer training, a 6-min walk test as a training unit and muscle strength training for the lower and upper extremities. RESULTS: Differences between women and men were found in clinical parameters. In particular, statistically significant differences were revealed between the women and men with regard to cardiopulmonary performance. Quality of life was significantly improved on discharge with regard to both physical and mental health, whereas anxiety and depression showed no significant alteration. CONCLUSION: A specialized in-hospital program for women and men combining endurance/resistance training and education is feasible. But our program revealed a very low level of cardiopulmonary performance in women. Women need to be encouraged and motivated to participate in such programs.     

中老年冠心病患者经皮冠状动脉介入治疗术后开展心脏运动训练的康复效果

目的:探讨中老年冠心病(coronar y heart disease,CHD)患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)出院后开展心脏运动训练的康复效果。方法:前瞻性选取2017年6月至2019年6月期间在中国人民解放军陆军第七十三集团军医院接受PCI术的80例CHD患者,纽约心脏病协会(New York Heart Association,NYHA)心功能分级I~II级,患者均对研究知情同意。采用计算机随机分组法分为常规组(n=40)和康复组(n=40),常规组患者PCI术后给予常规心内科治疗和护理,康复组在对照组基础上开展心脏运动训练,由专业康复医护人员负责指导和跟踪,均持续随访观察3个月,比较2组治疗前后超声心动图心功能指标、血清N端B型脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP)、6 min步行试验(6 min walking test,6MWT)、心肺运动试验中峰值摄氧量(peak or maximum oxygen uptake,VO2peak)和西雅图心绞痛调查量表(Seattle Angina Questionnaire,SAQ)变化情况。结果:2组治疗3个月后LVEF、6MWT、VO2peak较治疗前均明显提高,LVEDD均显著下降,差异有统计学意义(P<0.05),2组治疗前后血清NT-proBNP水平无明显变化(P>0.05),康复组治疗3个月后LVEF、6MWT、VO2peak明显高于常规组,LVEDD显著低于常规组,差异有统计学意义(P<0.05)。2组治疗3个月后SAQ量表“躯体活动受限程度”“心绞痛稳定程度”“心绞痛发作频率”“治疗满意程度”和“疾病认知程度”评分均较治疗前显著升高,差异有统计学意义(P<0.05),且康复组治疗3个月SAQ量表上述5个维度评分均显著高于常规组,差异有统计学意义(P<0.05)。结论:中老年CHD患者PCI术后开展心脏运动训练康复效果显著,能有效改善心功能和提高运动耐力,改善患者术后生活质量,值得推广应用。     

Comparison two-year effects of once-weekly and twice-weekly water exercise on health-related quality of life of community-dwelling frail elderly people at a day-service facility

Purpose. The purpose of this study was to compare two-year effects of once-weekly and twice-weekly water exercise programmes at a day-service facility on the health-related quality of life (HRQL) of frail elderly people.

Method. This single blind, prospective, longitudinal randomized pilot study separated 22 community-dwelling frail elderly people into once-weekly (once group: n = 10) and twice-weekly (twice group: n = 12) groups: the two-year exercise interventions were once- or twice-weekly 1-h sessions. Water exercise sessions comprised warming-up on land, activities of daily living (ADL) exercise, stretching, strength, and relaxation in water. The HRQL was evaluated using the Medical Outcomes Survey Short Form-36 questionnaire (SF-36); ADL dependence was assessed using the Functional Independence Measure (FIM).

Result. Both groups showed significant increases over pre-intervention (pre) scores at 6 months and 12 months on Physical Component Summary and Mental Component Summary. In the once group, both were lower at 24 months than at 6 months and 12 months. The FIM scores were significantly different from pre at 6 months and 12 months in both once and twice groups, and between pre and 24 month in the twice group.

Conclusion. Better than once-weekly exercise, twice-weekly water exercise controlled deterioration of HRQL, ADL, and knee extensor muscle strength (KEX) with ageing.     

The effects of physical exercises to mental state and quality of life in patients with schizophrenia

The purpose of this study was to examine the effects of 10 weeks of physical exercises programme on mental states and quality of life (QOL) of individuals with schizophrenia. The study involved 30 inpatients or outpatients with schizophrenia who were assigned randomly into aerobic exercise (n = 15) group and control (n = 15) group, participated to the study voluntarily. There were no personal differences such as age, gender, disorder duration, medication use between the both groups. An aerobic exercise programme was applied to the subject group, the periods of 10 weeks as 3 days in a week. Data were collected by using the Brief Symptom Inventory, the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and to the both group before and after the exercise programme. After the 10‐week aerobic exercise programmes the subjects in the exercise programme showed significantly decreases in the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and the Brief Symptom Inventory points and their World Health Organization Quality of Life Scale‐Turkish Version points were increased than controls. These results suggest that mild to moderate aerobic exercise is an effective programme for decreasing psychiatric symptoms and for increasing QOL in patients with schizophrenia.     

Comparison of Short Form-36 Health Survey and Nottingham Health Profile in moderate to severe patients with COPD

Objective  To compare the health-related quality of life (HRQoL) assessed by Short Form-36 Health Survey (SF-36) and Nottingham Health Profile (NHP) on the basis of lung function and exercise capacity parameters in patients with moderate to severe chronic obstructive pulmonary disease (COPD).
Methods and materials  The investigation was a prospective, quality-of-life survey and cross-sectional study of 130 consecutive COPD patients. The NHP and SF-36 as generic HRQoL instruments, the Chronic Respiratory Disease questionnaire (CRQ) as a disease-specific HRQoL instrument and 6-minute walking test, severity of dyspnea, leg fatigue and lung function, were the measurements and instruments used in the study.
Results  It was determined that the subscales of both questionnaires were generally related with the FEV₁, walking distance, CRQ, severity of dyspnea and leg fatigue values ( P  < 0.05). The much higher correlation coefficient was determined between these parameters and NHP compared with the SF-36. Only NHP was found to be correlated with the age, body mass index and smoking consumption ( P  < 0.05).
Conclusions  The stronger relation of NHP with the clinical and physical parameters of the patients compared with that of SF-36 may be associated with the increased sensitivity of NHP to the clinical state owing to the increasing respiratory symptoms of our old patients with moderate to severe obstruction and/or the more intelligible and easy-to-respond nature of NHP compared with SF-36.     

Immediate and long-term functional impact of repetitive locomotor training as an adjunct to conventional physiotherapy for non-ambulatory patients after stroke

Purpose. The aim of the present study was to assess the heart rate intensity during gait training and to evaluate the relationship between heart rate intensity during gait training and walking ability of patients after stroke.

Methods. We included non-ambulatory patients within six weeks after first stroke. Over four weeks patients were trained five times a week, with either 20 minutes of repetitive locomotor training and 25 min of physiotherapy (RLT-PT), or 45 min of PT alone. We assessed the heart rate intensity during training period. Additionally we assessed walking ability (Functional Ambulation Categories) and the rate of independent ability to perform activities of daily life (Barthel Index) at the end of study and six months and three years later on.

Results. We included 30 patients in each group. Patients in RLT-PT group exercised longer in the HR target zone than in the PT group (16.1 ± 11.8 min vs. 5.3 ± 5.6 min, p < 0.001). Higher heart rates were associated with independent walking at the end of study, at six months and at three years after the end of study (Fishers exact test, p = 0.014, p = 0.012 and p = 0.017, respectively).

Conclusions. Higher heart rate intensities during gait-training of non-ambulatory post-stroke patients may improve walking function.     

减重步行训练对脑卒中患者步行功能改善的作用

目的：观察不同减重量步行训练（BWSTT）和传统神经发育疗法对脑卒中后患者的步行功能恢复的影响。方法：60例脑卒中患者随机分为30%BWS组、0%BWS组和对照组,每组各20例。入组后,30%BWS组患者予30%初始减重量加电动跑台,0%BWS组患者予无减重量加电动跑台,对照组予传统神经发育疗法训练;每次30min,每天1次,每周5d,连续4周。应用Berg平衡量表（BBS）、功能性步行分级（FAC）、Tinetti步态评测表、步速和步长、步行距离评估患者治疗前后的步行功能。结果：三组患者治疗前BBS、FAC、Tinetti、步速和步长、步行距离比较差异均无显著性意义（P〉0.05）,具有可比性。治疗后,30%BWS组和0%BWS组患者BBS、FAC、Tinetti、步速和步长、步行距离均明显改善,分别与治疗前比较差异均有显著性意义（P〈0.05）,且30%BWS组上述指标改善情况优于0%BWS组（P〈0.05）;对照组患者BBS、FAC和步行距离分别与治疗前比较差异均有显著性意义（P〈0.05）;0%BWS组患者BBS、步速和步行距离的改善情况优于对照组（P〈0.05）。结论：在减重加电动跑台条件下,改善患者步态和步行能力的效果最佳,无减重加电动跑台次之,传统神经发育疗法的效果较慢。     

系统心肺康复训练对冠心病病人运动耐力和生活质量的影响

[目的]探讨系统心肺康复训练对冠心病(CHD)病人运动耐力和生活质量的影响。[方法]按随机数字法将100例康复期CHD病人分为对照组和实验组各50例。对照组按照CHD治疗指南进行常规药物治疗及常规干预,而实验组在对照组基础上进行系统心肺康复训练。于干预前及干预后检测两组病人心功能各项指标,采用6min步行距离测试(6MWD)评价运动耐力,并采用健康调查量表(SF-36)评价病人生活质量。[结果]实验组病人干预后心功能各项指标及6MWD结果较干预前均有明显改善,且优于对照组,差异有统计学意义(P0.05);实验组干预后SF-36量表中各维度评分均高于对照组(P0.05)。[结论]系统心脏康复训练能明显改善康复期CHD病人心功能,提高病人的运动耐力,改善病人的生活质量。     

运动训练对肝硬化患者运动功能的疗效观察

目的:观察运动训练对肝硬化患者运动功能的影响。方法:将20例肝硬化患者随机分为运动组和常规组各10例,均接受常规药物治疗,运动组在此基础上给予8周的适度运动训练。分别在治疗前后采用超声下股四头肌的厚度评估肌肉质量,等速肌力测试评估伸膝肌力,6min步行距离(6MWD)评估运动能力,同时采用慢性肝病调查问卷(CLDQ)评估健康相关生活质量(HRQoL),监测运动前后肝硬化严重程度及血液指标变化。结果:干预后运动组患者的6MWD、股四头肌的厚度、伸膝肌力、CLDQ评估中乏力、活动2项评分较治疗前及常规组比较均有显著提高(P0.05)。结论:适度的运动训练可提高肝硬化患者的运动功能,提高健康相关生活质量。     

徒步行走训练对慢性心力衰竭病人生活质量的影响

[目的] 探讨徒步行走训练对慢性心力衰竭(CHF)病人生活质量的影响.[方法] 将81例CHF病人随机分为实验组和对照组.在常规抗心力衰竭药物治疗和护理的基础上,实验组增加徒步行走训练与指导,分别于干预前和干预后第4周、第8周、第12周、第16周、第20周、第24周随访时填写明尼苏达心力衰竭生活质量(QOL)调查表及MLHF调查表.[结果]实验组评分低于对照组,经比较差异有统计学意义(P<0.05).[结论]徒步行走训练能提高CFH病人的生活质量.     

有氧运动对老年慢性阻塞性肺疾病康复的影响

[目的]观察有氧运动对老年慢性阻塞性肺疾病(COPD)呼吸困难和生活质量的影响。[方法]将86例老年COPD病人随机分成观察组42例和对照组44例,对照组给予常规治疗和一般康复护理,观察组在对照组的基础上给予有氧运动康复干预,疗程均为12周,对两组病人在康复前后测评呼吸困难分级和圣乔治呼吸问卷(SGRQ)评分进行比较。[结果]两组病人在康复治疗后的呼吸困难评分和SGRQ总分均较治疗前降低,差异有统计学意义(P0.01),观察组治疗后的呼吸困难改善效果更为突出,与对照组相比评分差异有统计学意义(P0.05)。[结论]有氧运动可改善老年COPD病人的呼吸困难、提高病人的生活质量。     

自我管理训练对精神分裂症患者心理健康、希望及生活质量的影响研究

目的探讨自我管理训练对精神分裂症患者心理健康、希望及生活质量的影响。方法将204例精神分裂症患者采用抽签法分为观察组(101例)和对照组(103例),对照组实施一般健康教育,观察组进行自我管理训练,包括:建立患者档案;与患者建立良好的护患关系;制订自我管理教育处方;学习采用集体授课方式。两组患者于干预前(入组时)及干预后(1年后)采用症状自评量表、Herth希望指数量表及世界卫生组织生存质量简表进行评价。结果干预后观察组症状自评量表各因子得分低于对照组(P0.01),而Herth希望指数量表总分和各因子得分及世界卫生组织生存质量简表各因子得分显著高于对照组(P0.01)。结论自我管理训练可改善精神分裂症患者的心理障碍,并提高其希望水平及生活质量。