Name: home-based prescribed pulmonary exercise in patients with stable chronic obstructive pulmonary disease
Uploaded: 2019-08-24T13:00:00
Description: Watch this Scientific Journal Video about Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease at JoVE.com

本研究得到国家体育总局全民健身项目（第2017B021号）的支持，上海市科委重点基础研究经费（第16JC1400500号），定向研究经费上海市科学技术委员会（第18DZ1200600号）和国家自然科学基金委员会（第81472163号）。

该议定书已获上海中医药大学附属岳阳中西医综合医院伦理委员会批准。
1. 视频构建和学习设计
<ol><li>构建规定的肺运动的视频。我们的视频基于中国国家体育总局发布的TCE视频。<ol>
<li>在视频中，有一个研究小组的成员在宽敞的地方展示，并给出一个一般介绍规定肺运动的不同特点。</li>
		<li>让成员模拟不同维度的练习，以阐明这些特征。 注：此处使用的视频是中文?...

<ol>
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W., Quirk, F. H., Baveystock, C. M., Littlejohns, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+self-complete+measure+of+health+status+for+chronic+airflow+limitation.+The+St.+George's+Respiratory+Questionnaire.">A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire.</a> The American Review of Respiratory Disease. 145 (6), 1321-1327 (1992).</li><li>Leung, R., McKeough, Z., Peters, M., Alison, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Short-form+Sun-style+t'ai+chi+as+an+exercise+training+modality+in+people+with+COPD.">Short-form Sun-style t'ai chi as an exercise training modality in people with COPD.</a> European Respiratory Journal. 41 (5), 1051-1057 (2013).</li><li>Grosbois, J. 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B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reproducibility+and+Sensitivity+of+the+6-Minute+Stepper+Test+in+Patients+with+COPD.">Reproducibility and Sensitivity of the 6-Minute Stepper Test in Patients with COPD.</a> COPD. 12 (5), 533-538 (2015).</li><li>Alexander, J., Phillips, W., Wagner, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+strength+training+on+functional+fitness+in+older+patients+with+chronic+lung+disease+enrolled+in+pulmonary+rehabilitation.">The effect of strength training on functional fitness in older patients with chronic lung disease enrolled in pulmonary rehabilitation.</a> Rehabilitation Nursing. 33 (3), 91-97 (2012).</li><li>Chen, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+home-based+lower+limb+resistance+training+on+muscle+strength+and+functional+status+in+stable+COPD+patients.">Effects of home-based lower limb resistance training on muscle strength and functional status in stable COPD patients.</a> Journal of Clinical Nursing. 27 (5-6), e1022-e1037 (2017).</li><li>Covey, M., Collins, E., Reynertson, S., Dilling, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resistance+training+as+a+preconditioning+strategy+for+enhancing+aerobic+exercise+training+outcomes+in+COPD.">Resistance training as a preconditioning strategy for enhancing aerobic exercise training outcomes in COPD.</a> Respiratory Medicine. 108 (8), 1141-1152 (2014).</li><li>Chan, A., Lee, A., Lee, D., Sit, J., Chair, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+the+sustaining+effects+of+Tai+Chi+Qigong+in+the+sixth+month+in+promoting+psychosocial+health+in+COPD+patients:+a+single-blind,+randomized+controlled+trial.">Evaluation of the sustaining effects of Tai Chi Qigong in the sixth month in promoting psychosocial health in COPD patients: a single-blind, randomized controlled trial.</a> ScientificWorldJournal. 2013, 425082 (2013).</li><li>Wuytack, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+outpatient+and+home-based+exercise+training+programmes+for+COPD:+a+systematic+review+and+meta-analysis.">Comparison of outpatient and home-based exercise training programmes for COPD: a systematic review and meta-analysis.</a> Respirology. 23 (3), 272-283 (2018).</li></ol>

在这项研究中，在干预计划中使用了称为规定肺运动的修改性TCE，并使用了一些健身测试来调查家庭处方肺运动对运动能力和生活质量的影响。稳定的COPD患者。主要发现，经过3个月的干预，上肢和下肢运动能力、耐力锻炼能力和生活质量有了很大提高。结果表明，处方肺运动作为COPD靶向和易学的中医，可用于家庭和社区COPD康复项目。
在这项研究中，3个月的干预后完成率为...

慢性非传染性疾病已逐渐成为全球健康的最大威胁，占全球死亡率的70%。大多数此类死亡是由四种主要疾病引起的，而慢性阻塞性肺病排名第三，仅次于心血管疾病和癌症。此外，COPD在导致生命丧失数年的排名从2007年的第11位上升到2017年的第七位。这一变化表明目前治疗对COPD进展康复的影响不尽人意。更多的研究已经认识到，慢性阻塞性肺病不仅是一种呼吸道疾病，而且是一种复杂、多系统、多复杂的情况2，3。COPD并发症（即骨骼肌功能障碍）存在于疾病的所有阶段，并在进展和预后4中发挥重要作用。考虑到呼吸症状与运动能力之间的相互作用，运动能力的恢复得到了很多关注。
肺康复作为一项综合干预计划，包括但不限于运动训练、健康教育和自我管理，已对COPD患者的身体和心理状况表现出有效。在不同类型的运动训练中，有氧运动对提高耐力和肌肉力量起着至关重要的作用。相比之下，阻力运动在提高肌肉力量和功能锻炼能力方面显示出优势。此外，这两种运动类型的干预机制也不同。与阻力运动相比，有氧运动在调节炎症细胞因子水平和诱导四头肌8、9的氧化表型方面更有效。
虽然这两种常规运动在肺康复中的效果已经得到证明，但无论地点（在医院还是在家里）10、11，常规运动训练的实施仍在由于特定设备、宽敞空间和安全监控的要求而受到限制。这些限制不仅给患者家庭带来负担，而且给医疗保健系统带来负担。替代干预，如神经肌肉电刺激和全身振动训练，有相同的限制12，13。
传统的中国运动（TCE），包括太极拳、刘子菊、吴琴西、巴段金、易锦静等，属于自体类，侧重于呼吸的调整，伴着协调动作。这些练习还依靠心理-生理-形态机制来实现与健康相关的健身。以前的研究表明，1） TCE 作为一种中低强度有氧运动，诱导最大心率为 43%-49% 14，2） 运动强度范围为 1.5 到 2.6 代谢等效能量 （MET）15，3）它发挥积极通过临床和家庭康复对患有稳定慢性阻塞性肺病的患者的影响，包括16、17、18、19。与传统的锻炼训练相比，TCE 的优点是无需任何设备或空间限制即可轻松在家中执行。
作为一种改良的TCE，本议定书中描述的处方肺运动是从中医理论发展起来的，旨在恢复COPD呼吸困难和运动能力。以往的研究表明，运动能力（6分钟步行试验，6MWT），日常生活（中山COPD生活质量问卷）和处方肺后COPD患者全身炎症水平有显著改善练习20.然而，规定肺运动对上肢和下肢运动能力和COPD患者生活质量的影响仍不清楚。
本研究比较了3个月常规药物治疗，无需运动干预（对照组，CG）与3个月的处方肺运动干预（PG）在稳定的COPD患者，以调查处方肺运动的效果。上肢运动能力对上肢运动能力的影响通过30秒手臂卷曲测试进行评估，对下肢运动能力的影响由30秒坐到站测试（30秒SST）评估，对耐力锻炼能力的影响由6分钟步行测试（6MWT）评估，效果圣乔治呼吸问卷（SGRQ）评估的生活质量。

<table>
	<tbody>
		<tr>
			<td>4643a</td>
			<td>Tanita</td>
			<td></td>
			<td>Used for the evaluation of height, weight, and body mass index</td>
		</tr>
		<tr>
			<td>Borg CR10</td>
			<td>None</td>
			<td></td>
			<td>Used for the evaluation of dyapnea</td>
		</tr>
		<tr>
			<td>PASS 15.0</td>
			<td>NCSS, LLC</td>
			<td></td>
			<td>Used for power calculation</td>
		</tr>
		<tr>
			<td>Polar team 2</td>
			<td>Polar</td>
			<td></td>
			<td>Used for supervising the heart rate of participants</td>
		</tr>
		<tr>
			<td>SGRQ software</td>
			<td>Developed by Peking Union Medical College</td>
			<td></td>
			<td>Used for calculating the score of quality of life</td>
		</tr>
		<tr>
			<td>SPSS 24.0</td>
			<td>IBM Corporation</td>
			<td></td>
			<td>Used for statistical analysis</td>
		</tr>
	</tbody>
</table>

home-based prescribed pulmonary exercise in patients with stable chronic obstructive pulmonary disease

慢性阻塞性肺病（COPD）作为一种全身性疾病，影响呼吸系统，引起不安和运动呼吸困难。它还影响运动能力，形成恶性循环，进一步加剧患者病情，加速疾病进展。传统的中国运动（TCE）作为一种功能性的整体练习，在调节呼吸、协调运动的基础上，在COPD的康复中起着重要的作用。本研究调查了处方肺运动（从TCE修改）对上肢和下肢运动能力、耐力锻炼能力和稳定COPD患者生活质量的影响。目标是确定这些规定的练习在慢性阻塞性肺病康复中的可及性。参与者被随机分为非运动对照组（CG）或规定的肺运动组（PG），比例为1：1。PG 每周 7 天，每天接受 60 分钟的干预，共 3 个月。强度使用博格类别比 10 刻度和心率监视器进行测量。然后，在正式干预前后的1周内进行运动能力测试和生活质量问卷。经过3个月的干预，30秒的手臂卷曲测试，30秒坐到站测试，6分钟步行测试，生活质量显示COPD患者显著改善（p<0.05）。这些发现表明，处方肺运动可以作为替代，方便，有效的家庭和社区为基础的运动，为稳定的慢性阻塞性肺病患者。

上述方案描述了一个随机对照试验，以调查处方肺运动是否提高运动能力和生活质量的稳定COPD患者。44名参与者被征聘，只有37人（84%）参与者完成了研究（CG = 19，PG = 18）。因此，对37名参与者进行了数据分析，两组基本特征（包括年龄、性别、BMI、持续时间和疾病等级）没有显著差异（表1）。
经过3个月的干预，重复：30s手臂卷曲测试从21.3±4.4增加到22.9×4;30 s ...

Watch this Scientific Journal Video about Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease at JoVE.com

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

这里介绍的是一个协议，以研究家庭处方肺运动对稳定慢性阻塞性肺病（COPD）患者的影响，这是根据呼吸困难和有限，根据中国传统运动修改在慢性阻塞性肺病患者中观察到的运动能力。

稳定慢性阻塞性肺病患者家庭处方肺运动

As a systemic disease, chronic obstructive pulmonary disease (COPD) affects the respiratory system, inducing restless and exercise dyspnea. It also ...

该协议可作为一种方便的替代和有效的社区锻炼计划，为稳定的COPD患者。规定的肺运动是中医理论发展起来的，旨在恢复慢性阻塞性肺病的呼吸困难和运动能力。该方法还可用于老年病，改善心血管和肌肉骨骼的体能，延缓老年患者的体质逐渐下降。与运动协调操作的技能对于新手来说可能是技术中最具挑战性的部分。演示测试程序的将是李培军，一个研究生从我的实验室。在正式训练课前，在两周内三次为规定的肺运动参与者提供入门培训课程。要求学员在每次培训课程后学习每次干预的完整操作和呼吸要求。在正式训练课时，向规定的肺练习组的参与者提供规定的肺练习视频和练习记录手册。指导规定的肺运动参与者按照干预计划进行规定的肺运动。指导规定的肺运动参与者进行10分钟的热身运动，主要侧重于参与的肌肉群的动态弹性练习和肌肉的伸展。热身结束时，让学员们进行规定的胡、西声肺练习，在柳子菊中推上天空调节三温，并鞠躬射击巴丹金秃鹰，在武秦溪进行吊车动作，在宜津进行40分钟的交叉武装铁器。当所有练习完成后，指示规定的肺运动参与者进行10分钟的冷却练习，主要侧重于伸展和放松肌肉。指导学员在练习记录手册中记录每次锻炼后的详细信息，包括有关锻炼方法、时间、持续时间、强度和地点的信息。在运动治疗期结束时，向参与者解释六分钟的步行测试，并告知参与者，当出现不适或疲惫时，可以暂时休息。在开始测试之前，使用 Borg CR10 评估每个参与者的呼吸困难程度。然后让参与者在一条标记的 30 米直线上以尽可能快的方式来回走动，使用标准化的鼓励短语进行每一分钟。六分钟后，请参与者保持静止，以米为单位记录他们的距离和呼吸困难程度。休息 30 分钟后，让学员进行第二次测试。在开始 30 秒臂卷曲测试之前，请解释并演示测试过程。让参与者坐在一个43厘米高，直背，无臂椅子直立的位置，他们的脚平放在地上。当参与者手臂处于手臂卷曲位置的向下位置时，让参与者执行手臂卷曲运动一到两次，而不移动手腕来熟悉动作。当每个参与者准备好时，让他们在主导手中拿着一个适当加权的哑铃，并在移动信号上，让参与者在30秒内尽可能快地通过全范围的运动卷曲体重，同时站在一边，记录结果。要准备 30 秒的站立坐测试，首先将靠背靠在墙上的椅子放在一起，并解释和演示测试过程。接下来，让参与者坐在椅子中间，背直，双臂交叉在胸前，双手放在对面的肩膀上，双脚分开，膝盖弯曲约90度。让学员进行一到两次站立动作，以熟悉动作。然后，让参与者在 30 秒内尽快、尽可能多次地站起来坐下，同时站在一边的时间并记录结果。在这项具有代表性的研究中，对37名参与者的数据进行了分析，对照组和规定的肺运动组的基本参与者特征没有显著差异。经过三个月的干预，在规定的肺运动组，30秒手臂卷曲和30秒坐立测试的重复次数增加。此外，对照组的活动分数显著增加，而圣乔治呼吸问卷的总分和项目得分在规定的肺运动组显著下降。规定的肺运动视频、由参与者自己注册的练习记录手册以及工作人员表扬的鼓励和指导，对本协议的成功起到了不可替代的作用。可以进行测试，以评估肺和骨骼肌的功能，结果可以进一步了解规定的肺运动的效果。这些程序也可以适用于其他慢性非传染性疾病，以确定规定的肺运动的有效性。

Research

JoVE Journal

Behavior

Behavioral Phenotyping of Murine Disease Models with the Integrated Behavioral Station (INBEST)

Behavioral Phenotyping of Murine Disease Models with the Integrated Behavioral Station INBEST

小鼠疾病模型的集成行为车站行为表型（INBEST）

Due to rapid advances in genetic engineering, small rodents have become the preferred subjects in many disciplines of biomedical research. In studies of ...

科研

行为学

Getting to Compliance in Forced Exercise in Rodents: A Critical Standard to Evaluate Exercise Impact in Aging-related Disorders and Disease

让合规的强制锻炼鼠害：一项关键的标准在衰老相关的疾病和疾病评估运动的影响

There is a major increase in the awareness of the positive impact of exercise on improving several disease states with neurobiological basis; these ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

眼跟踪控制，以评估患者的认知功能与肌萎缩性脊髓侧索硬化症

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation

多列铅脊髓刺激术后腰痛的治疗

Failed back surgery syndrome (FBSS) refers to persistent, chronic pain following spinal surgery. Spinal cord stimulation with dorsal epidural leads can be ...

Novel Object Recognition and Object Location Behavioral Testing in Mice on a Budget

一种新的小鼠目标识别与目标定位行为测试

Ethologically relevant behavioral testing is a critical component of any study that uses mouse models to study the cognitive effects of various ...

Supramaximal Intensity Hypoxic Exercise and Vascular Function Assessment in Mice

小鼠低血压运动的下位强度及血管功能评估

Exercise training is an important strategy for maintaining health and preventing many chronic diseases. It is the first line of treatment recommended by ...

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

一种新型的家庭心脏康复监控数字平台

Despite the evidence that cardiac rehabilitation (CR) reduces the risk of recurrent cardiac events, only a minority of eligible patients are willing to ...

Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

使用单向旋转改善前庭功能障碍患者的前庭系统不对称性

The vestibular system provides information about head movement and mediates reflexes that contribute to balance control and gaze stabilization during ...

Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training

高强度间歇锻炼和中强度连续运动对心脏肌钙蛋白T级在训练早期阶段的影响

An elevation in cardiac troponin T (cTnT), as a highly specific biomarker of cardiomyocyte damage, after moderate-intensity continuous exercise (MCE) has ...

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

沉默脑血管病变高血压患者认知表现评估

Evidence accumulated from the last decade has proven that silent cerebrovascular lesions (SCLs) and their underlying pathogenic processes contribute to ...