【論文摘要】Effects of Upper Limb Resistance Exercise Training on Balance Control in Patients With Chronic Obstructive Pulmonary Disease

【論文摘要】上肢阻力運動訓練對於慢性阻塞性肺部疾病患者之平衡表現的影響

蔡依蓉(Yi-Jung Tsai) ； 趙容儀(Jung-I Chao) ； 廖健芬(Chien-Fen Liao) ； 陳靜玉(Jing-Yu Chen) ； 李和昇(Ho-Sheng Lee)

《物理治療》 47卷4期 (2022/12) Pp. 304-305

https://doi.org/10.6215/FJPT.202212.P08

摘要

Background and Purpose: Chronic obstructive pulmonary disease (COPD) is an irreversible chronic lung disease. The impairments of muscle strength, functional performance or balance control are often found. Though the resistance training of upper limbs has been suggested in COPD patients to improve the chest function, the effects on balance control need more evidence. Methods: Fourteen patients (age: 69.5 ± 12.3 years, BMI: 22.2 ± 3.3 kg/m^2, FEV_1 = 55.8 ± 19.0%) diagnosed with COPD were recruited. The strength of shoulder external rotator, shoulder flexor, elbow flexor and knee extensor were measured by handheld dynamometer before balance test. The static balance was conducted pre- and post- a six-minute walking test (6-MWT) by a pressure platform (FDM-S, zebris Medical GmbH, Isny im Allgäu, Germany). The resistance training of biceps, pectoralis major, and trapezius by the Thera-band was taught by the physical therapist to improve the chest function. Patients need to perform the home exercise 30 repetitions for each muscle per day and 5 days/week in sitting position. The second evaluation was conducted after 3 months. The displacements of center of pressure (COP) were calculated to represent the ability of balance control. Results: No significant improvements in muscle strength (p ＞ 0.05) after training. Patients walked an average of 403.0 ± 139.0 m and 416.9 ± 123.0 m during the 6-MWT at the initial and follow-up, respectively (p ＞ 0.05). Comparisons of standing balance pre- and post- 6-MWT, the trends of increased 95% confidence ellipse area of COP, path length, major axis of ellipse area were found at both evaluations. Comparisons of initial and follow-up found that the 95% confidence ellipse area of COP was smaller (p = 0.04) after 3-month training while the path length, velocity, and major axis of ellipse area only had the trends of decrease (p ＞ 0.05). Conclusions: The patients with COPD showed the improvements in static standing balance after training, though the muscle strength did not increase significantly. The evaluation of chest function could be conducted to clarify the evidence of training effects in the future. Clinical Relevance: The training protocol can be applied on the rehabilitation program in COPD patients especially in those with insufficient balance control or falling history.