| 蒋孝翠,苏 敏,闫振壮,夏晓昧.渐进抗阻吸气肌训练对颈脊髓损伤患者膈肌功能的影响[J].中国康复医学杂志,2021,(12):1512~1517 |
| 渐进抗阻吸气肌训练对颈脊髓损伤患者膈肌功能的影响 点此下载全文 |
| 蒋孝翠 苏 敏 闫振壮 夏晓昧 |
| 苏州大学附属第一医院康复医学科，苏州，215006 |
| 基金项目：国家自然科学基金面上项目（81672244）；国家重点研发项目（2017YFC4300）；苏州市民生科技关键技术研究项目（SS2019051） |
| DOI：10.3969/j.issn.1001-1242.2021.12.005 |
| 摘要点击次数: 1105 |
| 全文下载次数: 773 |
| 摘要： |
| 摘要
目的：观察渐进抗阻吸气训练联合常规呼吸训练对颈脊髓损伤患者膈肌功能的影响。
方法：选取2018年6月—2019年12月在我院住院的颈脊髓损伤患者60例，采用随机数字表法随机分为对照组与观察组（每组各30例），观察组中ASIA分级为A、B级损伤的患者设为A组，ASIA分级为C、D级损伤的患者设为B组（每组15例）。观察组和对照组均采用综合康复训练，对照组在此基础上采用常规的呼吸训练方式，20min/次，2次/天。观察组采用渐进抗阻吸气肌训练，20min/次，1次/天，常规呼吸训练20min/次，1次/天。2组患者均每周训练6天，连续训练4周。分别于治疗前和治疗4周后（治疗后）测量患者的膈肌厚度和膈肌移动度、最大吸气压（MIP）、吸气流速峰值（PIF）、吸入空气量（V）对患者的膈肌功能进行评估。
结果：与治疗前比较，对照组患者膈肌厚度、膈肌移动度、MIP、PIF、V值分别增加了0.47±0.09、0.79±0.15、11.56±2.52、1.12±0.19、0.74±0.27。观察组分别增加了0.67±0.09、1.02±0.20、28.81±11.94、1.60±0.66、1.38±0.67。治疗前后比较，两组膈肌功能均明显改善（P<0.05），观察组改善程度明显高于对照组（P<0.05）。比较A组和B组，A组患者膈肌厚度、膈肌移动度、MIP、PIF、V值分别增加了0.60±0.50、0.84±0.68、21.33±9.25、1.17±0.58、1.07±0.26，B组患者分别增加了0.72±0.08、1.20±0.09、36.29±9.49、2.03±0.41、1.70±0.81，治疗前后比较，两组膈肌功能均有明显改善（P<0.05），B组改善程度明显高于A组（P<0.001）。
结论：渐进抗阻吸气肌训练联合常规的呼吸训练能明显改善颈脊髓损伤患者的膈肌功能，其效果优于单纯常规呼吸训练，对于损伤平面为C3-5颈脊髓损伤患者，ASIA分级为C、D级的效果更优。 |
| 关键词：脊髓损伤 渐进抗阻吸气肌训练 膈肌 |
| Influence of PowerBreathe progressive resistance inspiratory training on inspiratory muscle function in patients with cervical spinal cord injury Download Fulltext |
|
| The First Affiliated Hospital of Soochow University，Suzhou，215006 |
| Fund Project: |
| Abstract: |
| Abstract
Objective：To observe the effect of PowerBreathe progressive resistance inspiratory training combined with conventional respiratory training on diaphragmatic function in patients with cervical spinal cord injury.
Method：A total of 60 patients with cervical spinal cord injury admitted to our hospital from January 2019 to December 2019 were selected and randomly divided into the control group and observation group (30 patients in each) using the random number table. Patients with grade A and B ASIA injuries were set as Group A， and patients with Grade C and D ASIA injuries were set as group B (15 in each). Both the observation group and the control group adopted comprehensive rehabilitation training. Besides， the control group adopted conventional respiratory training， 20min/ time and 2 times/day. And the observation group used the PowerBreathe progressive resistance inspiratory training apparatus and the Breath-Link breathing training software for inhalation muscle training (20min/ time， 1 time/day)， together with routine breathing training (20min/ time， 1 time/day). Both groups trained 6 days per week for 4 weeks. Diaphragmatic muscle thickness and mobility， maximum inspiratory pressure (MIP)， peak inspiratory velocity (PIF)， and air intake (V) were measured before and 4 weeks after treatment， respectively.
Result：Compared with before treatment， diaphragmatic muscle thickness（mm）， diaphragmatic muscle mobility(cm)， MIP（cmH2O）， PIF（L/s） and V (L) values increased by 0.47±0.09， 0.79±0.15， 11.56±2.52， 1.12±0.19 and 0.74±0.27， respectively in the control group . And those were 0.67±0.09， 1.02±0.20， 28.81±11.94， 1.60±0.66 and 1.38±0.67， respectively in the observation group. After treatment， the diaphragm function of the two groups was significantly improved (P<0.05). The improvement of the observation group was significantly more than that of the control group (P<0.05). Comparing group A and group B，parameters increased by 0.60±0.50， 0.84±0.68， 21.33±9.25， 1.17±0.58， 1.07±0.26 in group A, group B and increased by 0.72±0.08， 1.20±0.09， 36.29±9.49， 2.03±0.41mm， 1.70±0.81 in group B. The improvement in both groups were significant (P<0.05)，but group B was significantly higher than group A (P<0.05).
Conclusion：PowerBreathe progressive resistance inspiratory training combined with conventional breathing training can significantly improve the diaphragmatic function of patients with cervical spinal cord injury， which is better than simple conventional breathing training. For patients with c3-5 cervical spinal cord injury， ASIA grade C and D have better effects than those of ASIA grade A and B. |
| Keywords:spinal cord injury progressive anti-aspirating muscle training diaphragm |
|
| 查看全文 查看/发表评论 |
