Reducing Dynamic Hyperinflation through Breathing Retraining

通过呼吸再训练减少动态恶性通货膨胀

• 批准号: 7888245
• 负责人: Eileen G Collins
• 金额: --
• 依托单位: EDWARD HINES JR VA HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7888245
• 关键词: American; Auditory; Breathing; Cardiovascular system; Cause of Death; Chest; Chronic; Chronic Obstructive Airway Disease; Complex; Critical Care; Data; Data Analyses; Development; Dyspnea; Enrollment; Environmental air flow; Exercise; Exhalation; Feedback; General Population; Goals; Health; Helium; Hospitalization; Hospitals; Human Resources; Impairment; Individual; Inspiratory Capacity; Intention; Intervention; Intervention Studies; Investigation; Journals; Life; Living Wills; Lung; Measurement; Measures; Mechanics; Medicine; Methods; Modeling; Muscle; Muscle function; Office Visits; Oxygen; Oxygen Therapy Care; Patients; Pattern; Performance; Peripheral; Physical activity; Physicians; Press Releases; Publications; Publishing; Pulmonary function tests; Randomized; Randomized Controlled Clinical Trials; Regression Analysis; Rehabilitation therapy; Reporting; Research; Respiratory Muscles; Sampling; Sampling Studies; Societies; Solid; Stress; Symptoms; System; Techniques; Testing; Time; Training; Training Programs; Treadmill Tests; United States; Veterans; Visit; Visual; Walking; Work; Workload; abstracting; auditory feedback; base; clinical practice; compare effectiveness; computer program; coping; cost effectiveness; disability; follow-up; health administration; improved; innovation; interest; meetings; muscle strength; news; novel; primary outcome; programs; prototype; quadriceps muscle; respiratory; standard of care; user-friendly; visual feedback; American; Auditory; Breathing; Cardiovascular system; Cause of Death; Chest; Chronic; Chronic Obstructive Airway Disease; Complex; Critical Care; Data; Data Analyses; Development; Dyspnea; Enrollment; Environmental air flow; Exercise; Exhalation; Feedback; General Population; Goals; Health; Helium; Hospitalization; Hospitals; Human Resources; Impairment; Individual; Inspiratory Capacity; Intention; Intervention; Intervention Studies; Investigation; Journals; Life; Living Wills; Lung; Measurement; Measures; Mechanics; Medicine; Methods; Modeling; Muscle; Muscle function; Office Visits; Oxygen; Oxygen Therapy Care; Patients; Pattern; Performance; Peripheral; Physical activity; Physicians; Press Releases; Publications; Publishing; Pulmonary function tests; Randomized; Randomized Controlled Clinical Trials; Regression Analysis; Rehabilitation therapy; Reporting; Research; Respiratory Muscles; Sampling; Sampling Studies; Societies; Solid; Stress; Symptoms; System; Techniques; Testing; Time; Training; Training Programs; Treadmill Tests; United States; Veterans; Visit; Visual; Walking; Work; Workload; abstracting; auditory feedback; base; clinical practice; compare effectiveness; computer program; coping; cost effectiveness; disability; follow-up; health administration; improved; innovation; interest; meetings; muscle strength; news; novel; primary outcome; programs; prototype; quadriceps muscle; respiratory; standard of care; user-friendly; visual feedback

Abstract Dynamic hyperinflation limits exercise duration in chronic obstructive pulmonary disease (COPD). To limit dynamic hyperinflation during exercise and thus improve exercise duration, we successfully developed a visual-auditory ventilation-feedback system. The system retrains patient's breathing pattern during exercise. The goal of the current proposal is to develop a user-friendly ventilation-feedback technique with a novel auditory feedback system. We reason that the proposed feedback system plus exercise training will be superior to exercise training alone while having the potential for an easier application into clinical practice. Hypotheses: The primary hypothesis is that the exercise duration of patients with moderate-to-severe COPD who successfully complete a 12-week program of breathing retraining plus exercise will be longer than that of patients who complete a 12-week program of treadmill exercise training alone. We also hypothesize that the primary predictor of improved exercise duration will be a reduction in dynamic hyperinflation and to a lesser extent, improvement in peripheral muscle function. Lastly, we hypothesize that dyspnea will be reduced in patients assigned to breathing retraining plus exercise when compared to exercise training alone. Methods: The proposed study is a randomized controlled clinical trial. 246 patients with moderate-to-severe COPD will be enrolled and randomized into breathing retraining plus exercise or exercise training alone. Both groups will receive 12-weeks of treadmill exercise training three times weekly. The breathing retraining plus exercise group will also receive auditory feedback to decrease respiratory rate and prolong exhalation. The goal of breathing retraining is to reduce exercise- induced dynamic hyperinflation. Follow-up testing will be completed at 6, 12, and 24 weeks. Testing will include a pulmonary function test, symptom-limited and constant workrate treadmill tests, six-minute walk, dyspnea measurements, testing of respiratory muscle strength and endurance, and quadriceps muscle endurance testing. Analysis: Measures of central tendency will be used to describe the study sample. A two-sample t-test (¿ = 0.05) will be used to analyze changes from baseline to 12-weeks between the breathing retraining plus exercise group and exercise training alone group. In data analysis, intention-to-treat principles will be used. Since several measures will be taken on each patient, mixed-models analysis will be used to compare changes over time between the two groups. Multiple regression analysis will be employed to determine the predictors of improved exercise performance.

抽象的 动态性超充电限制了慢性阻塞性肺部疾病的运动持续时间 （COPD）。为了限制运动过程中的动态过度充电，从而改善运动持续时间， 我们成功地开发了一个视觉通风反馈系统。系统重新训练 运动过程中患者的呼吸方式。当前建议的目的是开发 具有新颖的听觉反馈系统的用户友好通风反馈技术。我们推理 提议的反馈系统加运动训练将优于运动训练 独自一人有可能更轻松地应用于临床实践。假设： 主要假设是中度至重度COPD的患者的运动持续时间 谁成功完成为期12周的呼吸训练和练习计划 比完成为期12周的跑步机运动训练计划的患者长 独自的。我们还假设，改善运动持续时间的主要预测指标将是 减少动态过度充气，并在较小程度上改善周围肌肉 功能。最后，我们假设分配给呼吸的患者将减少呼吸困难 与仅运动训练相比，再训练加运动。方法：提议 研究是一项随机对照临床试验。 246例中度至重度COPD患者将 被招收并随机进入呼吸再训练，仅运动或锻炼训练。 两组将每周三次接受12周的跑步机运动训练。这 呼吸再训练加运动组也将接收听觉反馈以减少 呼吸率和延长呼气。呼吸训练的目的是减少运动 - 诱导的动态过度充气。后续测试将在6、12和24周完成。 测试将包括肺功能测试，症状限制和恒定的工作绩效跑步机 测试，步行六分钟，呼吸困难测量，呼吸肌强度和 耐力和股四头肌肌肉耐力测试。分析：中央度量 趋势将用于描述研究样本。将使用两个样本t检验（»= 0.05） 分析从基线到12周之间的变化 小组和锻炼训练小组。在数据分析中，意向性治疗原则将是 用过的。由于将对每个患者采取多种措施，因此将是混合模型分析 用于比较两组之间的变化。多回归分析将 员工以确定改善运动表现的预测因素。