BACKGROUND Stroke often results in significant respiratory dysfunction in patients.Respiratory muscle training(RMT)has been proposed as a rehabilitative intervention to address these challenges,but its effectiveness c...BACKGROUND Stroke often results in significant respiratory dysfunction in patients.Respiratory muscle training(RMT)has been proposed as a rehabilitative intervention to address these challenges,but its effectiveness compared to routine training remains debated.This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance,muscle strength,and pulmonary function in post-stroke patients.AIM To systematically assess the efficacy of RMT in improving exercise tolerance,respiratory muscle strength,and pulmonary function in patients recovering from a stroke,and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population.METHODS Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,a comprehensive search across PubMed,Embase,Web of Science,and the Cochrane Library was conducted on October 19,2023,without temporal restrictions.Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT,control groups,and outcome measures[including forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV),peak expiratory flow(PEF),maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP),and 6-min walking test(6MWT)].Only randomized controlled trials(RCTs)were included.Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool.Statistical analyses,including those using the fixed-effect and random-effects models,sensitivity analysis,and publication bias assessment,were performed using Review Manager software.RESULTS A total of 15 RCTs were included.Results indicated significant improvements in MIP(12.51 cmH2O increase),MEP(6.24 cmH2O increase),and various pulmonary function parameters(including FEV1,FVC,MVV,and PEF).A substantial increase in 6MWT distance(22.26 meters)was also noted.However,the heterogeneity among studies was variable,and no significant publication bias was detected.CONCLUSION RMT significantly enhances walking ability,respiratory muscle strength(MIP and MEP),and key pulmonary function parameters(FEV1,FVC,MVV,and PEF)in post-stroke patients.These findings support the incorporation of RMT into post-stroke rehabilitative protocols.展开更多
Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were random...Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.展开更多
Objective:Chronic obstructive pulmonary disease(COPD)can be prevented and treated,although presenting with persistent airflow restriction;the airflow restriction caused by COPD is mostly progressive.In recent years,mo...Objective:Chronic obstructive pulmonary disease(COPD)can be prevented and treated,although presenting with persistent airflow restriction;the airflow restriction caused by COPD is mostly progressive.In recent years,more attention has been paid to the home-based pulmonary rehabilitation(PR)and its influence on COPD.Exercise training is the basic constituent of PR.However,it is not clear which exercise trainings are the ideal ways to deliver home-based PR.Methods:In this review,we focus on the effect of home-based exercise training on patients with COPD.We searched literature,which was necessarily required to be randomized controlled trails(RCTs)from the establishment of the four respective databases(Medline,PubMed,Web of Science,and China National Knowledge Infrastructure)from January 2008 to January 2018.We used the Cochrane collaborative“risk of bias”tool to assess the quality of evidence.A total of 21 trials(1694 participants)were included.Through the analysis of the literature,we find that a simple,low-cost,and low-intensity family-based lung-rehabilitation plan to adapt to the real life may lead to the improvement of the ability to exercise,the reduction of the difficulty in breathing,and the improvement of carrying out daily activities.Results:In the exercise training of home-based PR,lower limb exercise(LLE)training demonstrated a more perceptible effect in improving the quality of life of patients with COPD.At the same time,the combination of LLE training,breathing training,and upper limb exercise training is more obvious than the simple LLE training.In addition,home-based low-intensity aerobic training may sometimes be no less than the outpatient or center intervention to improve dyspnea,health status,and exercise tolerance.In conclusion,the simple and easy home-based PR exercise program is useful.Long-term home-based PR may require an enhanced need for maintenance.Conclusions:A simple,low-cost,and low-intensity high blood pressure response(HBPR)plan to adapt to the real life may lead to an augmentation in the ability to exercise,a reduction of the difficulty in breathing,and an improvement in carrying out day-to-day activities.HBPR strategies can benefit patients(elderly patients with COPD at home)in the long term.展开更多
Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR gr...Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.展开更多
Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.M...Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.Methods Twenty-nine older people(66–90 years old)with COPD were randomly assigned to 12 weeks of exercise training(ET;power-oriented RT+HIIT)or a control group(CON).Waist circumference,diastolic(DBP)and systolic blood pressure(SBP),and serum fasting glucose,triglycerides and HDL cholesterol levels were assessed at baseline and after 12 weeks.Linear mixed-effects models were used to assess the effects of the intervention,and data were reported as mean and 95%confidence interval values.Results Waist circumference increased in the CT group,but not in the ET group(2.0[0.2,3.7]vs.1.0[−1.3,3.2]cm,respectively).No changes in fasting glucose(−4.1[−10.3,2.1]vs.−1.0[−8.7,6.7]mg dL−1),triglycerides(3.9[−13.4,21.3]vs.−13.9[−35.6,7.7]mg dL−1)or HDL cholesterol(1.0[−3.4,5.4]vs.2.9[−2.6,8.4]mg dL−1)were found in the CT or ET group,respectively.The ET group exhibited decreased DBP(−5.2[−9.5,−0.8]mmHg)and SBP(−2.7[−22.7,−2.7]mmHg),while no changes were found in the CT group(0.3[−3.2,3.7]and−3.5[−11.4,4.5]mmHg).MetS z-score declined in ET but remained unchanged in CT(−0.88[−1.74,−0.03]vs.0.07[−0.62,0.76],respectively).Conclusions A 12-week exercise training program led to a reduction in blood pressure and MetS z-score in older people with COPD.展开更多
基金Scientific Research Project of Hebei Administration of Traditional Chinese Medicine,No.2022307.
文摘BACKGROUND Stroke often results in significant respiratory dysfunction in patients.Respiratory muscle training(RMT)has been proposed as a rehabilitative intervention to address these challenges,but its effectiveness compared to routine training remains debated.This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance,muscle strength,and pulmonary function in post-stroke patients.AIM To systematically assess the efficacy of RMT in improving exercise tolerance,respiratory muscle strength,and pulmonary function in patients recovering from a stroke,and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population.METHODS Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,a comprehensive search across PubMed,Embase,Web of Science,and the Cochrane Library was conducted on October 19,2023,without temporal restrictions.Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT,control groups,and outcome measures[including forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal voluntary ventilation(MVV),peak expiratory flow(PEF),maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP),and 6-min walking test(6MWT)].Only randomized controlled trials(RCTs)were included.Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool.Statistical analyses,including those using the fixed-effect and random-effects models,sensitivity analysis,and publication bias assessment,were performed using Review Manager software.RESULTS A total of 15 RCTs were included.Results indicated significant improvements in MIP(12.51 cmH2O increase),MEP(6.24 cmH2O increase),and various pulmonary function parameters(including FEV1,FVC,MVV,and PEF).A substantial increase in 6MWT distance(22.26 meters)was also noted.However,the heterogeneity among studies was variable,and no significant publication bias was detected.CONCLUSION RMT significantly enhances walking ability,respiratory muscle strength(MIP and MEP),and key pulmonary function parameters(FEV1,FVC,MVV,and PEF)in post-stroke patients.These findings support the incorporation of RMT into post-stroke rehabilitative protocols.
基金Capital medical development research fund (2017-3147)
文摘Objective:To explore the clinical effect of ambroxol hydrochloride combined with rehabilitation training on COPD and its effect on pulmonary function.Methods:92 patients with COPD from May 2017 to may 2019 were randomly divided into control group(n=46)and observation group(n=46).The control group was treated with oxygen inhalation,expectorant,antispasmodic,anti infection and so on.The observation group was treated with ambroxol hydrochloride combined with rehabilitation training on this basis.Blood gas,lung function and inflammatory factors were compared before and after treatment.Results:the levels of SaO2 and PaO2 in the two groups were significantly higher than those before treatment P There was significant difference between the two groups(P<0.05-0.01).Besides,the level of lung function related indexes in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:ambroxol hydrochloride combined with rehabilitation training has a significant clinical effect on COPD,which can effectively improve the blood gas index and reduce the level of blood gas inflammatory factors,thus affecting the lung function of COPD patients.
文摘Objective:Chronic obstructive pulmonary disease(COPD)can be prevented and treated,although presenting with persistent airflow restriction;the airflow restriction caused by COPD is mostly progressive.In recent years,more attention has been paid to the home-based pulmonary rehabilitation(PR)and its influence on COPD.Exercise training is the basic constituent of PR.However,it is not clear which exercise trainings are the ideal ways to deliver home-based PR.Methods:In this review,we focus on the effect of home-based exercise training on patients with COPD.We searched literature,which was necessarily required to be randomized controlled trails(RCTs)from the establishment of the four respective databases(Medline,PubMed,Web of Science,and China National Knowledge Infrastructure)from January 2008 to January 2018.We used the Cochrane collaborative“risk of bias”tool to assess the quality of evidence.A total of 21 trials(1694 participants)were included.Through the analysis of the literature,we find that a simple,low-cost,and low-intensity family-based lung-rehabilitation plan to adapt to the real life may lead to the improvement of the ability to exercise,the reduction of the difficulty in breathing,and the improvement of carrying out daily activities.Results:In the exercise training of home-based PR,lower limb exercise(LLE)training demonstrated a more perceptible effect in improving the quality of life of patients with COPD.At the same time,the combination of LLE training,breathing training,and upper limb exercise training is more obvious than the simple LLE training.In addition,home-based low-intensity aerobic training may sometimes be no less than the outpatient or center intervention to improve dyspnea,health status,and exercise tolerance.In conclusion,the simple and easy home-based PR exercise program is useful.Long-term home-based PR may require an enhanced need for maintenance.Conclusions:A simple,low-cost,and low-intensity high blood pressure response(HBPR)plan to adapt to the real life may lead to an augmentation in the ability to exercise,a reduction of the difficulty in breathing,and an improvement in carrying out day-to-day activities.HBPR strategies can benefit patients(elderly patients with COPD at home)in the long term.
基金This work was financially supported by the Instructive Research Program of Changzhou Municipal Commission of Health and Family Planning(WZ201417)
文摘Objectives:This study aimed to assess the effects of modified pulmonary rehabilitation(PR)on patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:A total of 125 patients(63 in the PR group and 62 in the control group)were recruited in this study.The patients in the PR group received 12 weeks of conventional treatment,nursing,and modified pulmonary rehabilitation,while the patients in the control group underwent 12 weeks of conventional treatment,nursing,pursed-lip breathing training,and abdominal breathing training.Baseline characteristics,St.George's Respiratory Questionnaire(SGRQ),the six-minute walk test(6MWT),modified medical research council(MMRC)dyspnea scale,and lung function were compared between the two groups.Results:A total of 112 patients(58 patients in the PR group and 54 patients in the control group)completed the 12-week monitoring and follow-up.The SGRQ scores,symptoms(54.933±11.900),activity(52.644±14.334),impact(55.400±9.905),and total score(54.655±10.681)of the PR group did not significantly differ in pre-and post-treatments(P<0.05).No significant change was also observed in the control group(P>0.05).6MWT[(372.089±67.149)m]was significantly improved in the PR group(P<0.05)but was not significantly different in the control group(P>0.05).MMRC(actual rank sum 1719,rank sum 2047.5)was significantly reduced in the PR group(P<0.05)but not in the control group(P>0.05).The lung function(FVC,FEV1,FEV1/FVC,FEV1%and PEF)of the patients in both groups did not significantly change(P>0.05).Conclusion:Modified PR reduces the symptoms of dyspnea,increases exercise capacity,and improves the quality of life of patients with moderate to severe COPD.
文摘Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.Methods Twenty-nine older people(66–90 years old)with COPD were randomly assigned to 12 weeks of exercise training(ET;power-oriented RT+HIIT)or a control group(CON).Waist circumference,diastolic(DBP)and systolic blood pressure(SBP),and serum fasting glucose,triglycerides and HDL cholesterol levels were assessed at baseline and after 12 weeks.Linear mixed-effects models were used to assess the effects of the intervention,and data were reported as mean and 95%confidence interval values.Results Waist circumference increased in the CT group,but not in the ET group(2.0[0.2,3.7]vs.1.0[−1.3,3.2]cm,respectively).No changes in fasting glucose(−4.1[−10.3,2.1]vs.−1.0[−8.7,6.7]mg dL−1),triglycerides(3.9[−13.4,21.3]vs.−13.9[−35.6,7.7]mg dL−1)or HDL cholesterol(1.0[−3.4,5.4]vs.2.9[−2.6,8.4]mg dL−1)were found in the CT or ET group,respectively.The ET group exhibited decreased DBP(−5.2[−9.5,−0.8]mmHg)and SBP(−2.7[−22.7,−2.7]mmHg),while no changes were found in the CT group(0.3[−3.2,3.7]and−3.5[−11.4,4.5]mmHg).MetS z-score declined in ET but remained unchanged in CT(−0.88[−1.74,−0.03]vs.0.07[−0.62,0.76],respectively).Conclusions A 12-week exercise training program led to a reduction in blood pressure and MetS z-score in older people with COPD.