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首页> 外文期刊>COPD: Journal of Chronic Obstructive Pulmonary Disease >Impact of pulmonary rehabilitation on the major dimensions of dyspnea in COPD
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Impact of pulmonary rehabilitation on the major dimensions of dyspnea in COPD

机译：肺康复对COPD呼吸困难主要维度的影响

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摘要

The evaluation of dyspnea and its responsiveness to therapy in COPD should consider the multidimensional nature of this symptom in each of its sensory-perceptual (intensity, quality), affective and impact domains. To gain new insights into mechanisms of dyspnea relief following pulmonary rehabilitation (PR), we examined effects on the major domains of dyspnea and their interaction with physiological training effects. This randomized, controlled study was conducted in 48 subjects with COPD. Subjects received either 8-weeks of PR or usual care (CTRL). Pre- and post-intervention assessments included: sensory-perceptual (i.e., exertional dyspnea intensity, dyspnea descriptors at end-exercise), affective (i.e., intensity of breathing-related anxiety during exercise, COPD self-efficacy, walking self-efficacy) and impact (i.e., activity-related dyspnea measured by the Baseline/Transition Dyspnea Index, Chronic Respiratory Questionnaire dyspnea component, St. George's Respiratory Disease Questionnaire activity component) domains of dyspnea; functional performance (i.e., 6-minute walk, endurance shuttle walk); pulmonary function; and physiological measurements during constant work rate cycle exercise at 75% of the peak incremental work rate. Forty-one subjects completed the study: PR (n = 17) and CTRL (n = 24) groups were well matched for age, sex, body size and pulmonary function. There were no significant between-group differences in pre- to post-intervention changes in pulmonary function or physiological parameters during exercise. After PR versus CTRL, significant improvements were found in the affective and impact domains but not in the sensory-perceptual domain of dyspnea. In conclusion, clinically meaningful improvements in the affective and impact domains of dyspnea occurred in response to PR in the absence of consistent physiological training effects.
机译：呼吸困难的评估及其对COPD治疗的反应性应在其感官知觉（强度，质量），情感和影响领域中考虑该症状的多维性质。为了获得对肺康复（PR）后呼吸困难缓解机制的新见解，我们研究了呼吸困难的主要领域及其与生理训练作用之间的相互作用。这项随机对照研究是针对48名COPD患者进行的。受试者接受了8周的PR或常规护理（CTRL）。干预之前和之后的评估包括：感官知觉（即劳累性呼吸困难强度，运动结束时的呼吸困难描述符），情感性（即运动期间与呼吸相关的焦虑强度，COPD自我效能感，步行自我效能感）呼吸困难的影响域和影响（即，通过基线/过渡呼吸困难指数，慢性呼吸问卷调查的呼吸困难成分，圣乔治呼吸疾病问卷调查的活动成分测量的与活动有关的呼吸困难）;功能表现（即6分钟步行，耐力穿梭步行）;肺功能在恒定工作量周期运动期间进行生理和生理测量，最高运动量为峰值工作量的75％。 41名受试者完成了该研究：PR（n = 17）和CTRL（n = 24）组在年龄，性别，体型和肺功能方面都非常匹配。在运动期间，干预前后肺功能或生理参数的变化没有明显的组间差异。 PR和CTRL后，在呼吸困难的情感和影响领域发现了显着改善，而在呼吸困难的感觉-感知领域没有发现。总之，在缺乏一致的生理训练作用的情况下，对PR的反应在呼吸困难的情感和影响方面发生了临床上有意义的改善。

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