透過您的圖書館登入
IP:44.223.37.137
  • 學位論文

比較時間增長型與強度增強型運動訓練計畫對慢性阻塞性肺疾病患者成效之探討

Comparison of effectiveness between duration-increased exercise training and intensity-increased exercise training among patients with COPD

指導教授 : 鄭綺
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


本研究的目的有二:(一)探討時間增長型和強度增強型運動訓練,對個案肺部通氣功能、尖峰攝氧量、最大工作負荷、呼吸困難和生活品質的影響。(二)比較時間增長型和強度增強型運動訓練,對個案的肺部通氣功能、尖峰攝氧量、最大工作負荷、呼吸困難和生活品質影響之差異。 本研究採類實驗法,選取北市某三家醫學中心符合收案條件之慢性阻塞性肺疾病門診患者,依序將個案分入時間增長型運動訓練組與強度增強型運動訓練組。共22人完成此研究,其中時間增長組10人、強度增強組12人,分別接受連續八週的運動訓練。運動訓練前後經測試:肺部通氣功能(FEV1% pred)、尖峰攝氧量、最大工作負荷、3METs運動負荷下呼吸困難程度、整體性呼吸困難程度和SF-36生活品質問卷等資料收集。資料分析以SPSS10.0套裝軟體,進行百分比、平均值、標準差、 Mann-Whitney test及Wilcoxon Signed Rank test,以探討兩種運動訓練之影響成效,及比較兩組成效之差異。 研究結果發現:(一) 不論時間增長或強度增強運動訓練計畫,對肺部通氣功能和尖峰攝氧量均無顯著改善。(二) 經八週的時間增長型運動訓練後,最大工作負荷,由3.80 ±0.92 MET增加至5.46 ±1.29 MET (Z=-2.80,p=0.01)、在3METs運動負荷下的Borg呼吸困難指數,平均由3.20 ±1.32分降至2.10 ±0.57分 (Z=-2.23,p=0.03),。(三) 經八週強度增強型運動訓練後,最大工作負荷,由3.80 ±0.63 MET增加到5.47 ±1.01 MET (Z=-2.94,p=0.003)、在3METs運動負荷下的Borg呼吸困難指數,由3.08 ±1.38分降低至1.13 ±1.05分 (Z=-2.83,p=0.01)、整體性呼吸困難程度由7.67 ±2.10分增加到9.67 ±1.83分 (Z=-2.85,p=0.004)及生活品質方面:心理層面,由62.34 ±17.88分增加到75.75 ±14.98分 (Z=-2.13,p=0.03)、生理層面,由63.02 ±15.73分增加到80.88 ±11.16分 (Z =-2.67,p=0.01)、總分由62.68 ±15.41分增加到78.31 ±11.80分 (Z=-2.67,p=0.01)。(四) 比較時間增長組與強度增強組運動訓練成效之差異顯示:在肺部通氣功能、尖峰攝氧量、最大工作負荷量、3METs運動負荷下的呼吸困難程度、整體性呼吸困難程度和生活品質等各方面,兩組運動訓練後成效之差異,都未達統計上顯著意義。 由本研究結果顯示,兩種運動訓練方式對慢性阻塞性肺疾病患者均有助益,特別是在最大工作負荷量的提昇及在3METs運動負荷下呼吸困難程度的下降。

並列摘要


The purpose of this study were to: (1) Explore the effects of duration-increased and intensity-increased exercise training in pulmonary function (FEV1%pred), peak VO2, maximal workload, dyspnea, and quality of life for patients with COPD. (2) Comparison of duration-increased and intensity-increased exercise training effectiveness in pulmonary function (FEV1%pred), peak VO2, maximal workload, dyspnea, and quality of life for patients with COPD. A quasi-experimental design was used to guide the study. Subjects who met the selection criteria were referred from chest medical outpatient department of three medical centers in Taipei. Twenty-two patients enrolled in our study and were randomly assigned into either a duration-increased group (n=10) or an intensity-increased group (n=12). A graded treadmill exercise test was performed for each subject to determine his/her maximal workload and the exercise prescription. The exercise training program was three times per week for eight weeks. Pulmonary function (FEV1%pred), peak VO2, maximal workload, dyspnea, and quality of life were measured at pre- and post-exercise training. Percentage, mean, standard deviation, Mann-Whitney test and Wilcoxon Signed Rank test were used for data analysis. The results of research were shown as follow: (1) Pulmonary function (FEV1%pred) and peak VO2 were not improved significantly in both groups. (2) After an 8-week exercise training, the maximal workload (3.80 ±0.92 vs. 5.46 ±1.29 METs, Z=-2.80, p=0.01) and Borg dyspnea index under 3METs exercise workload (3.20 ±1.32 vs. 2.10 ±0.57, Z=-2.23, p=0.03) significantly improved in duration-increased group. (3) after an 8-week exercise training, a significant improvement was observed in maximal workload (3.80 ±0.63 vs. 5.47 ±1.01 METs, Z=-2.94, p=0.003), Borg dyspnea index under 3METs exercise workload (3.08 ±1.38 vs. 1.13 ±1.05, Z=-2.83, p=0.01), overall dyspnea score (7.67 ±2.10 vs. 9.67 ±1.83, Z=-2.85, p=0.004), and quality of life (62.68 ±15.41 vs. 78.31 ±11.80, Z=-2.67, p=0.01) in intensity-increased group. (4) A significant difference in improvement of all measured variables was not observed between duration-increased group and intensity-increased group. Base of the result of study, it was concluded that both duration-increased and intensity-increased exercise training programs had benefic for patients with COPD, particularly in increasing maximal workload and decreasing perceived dyspnea under 3METs workload.

參考文獻


鄭綺、楊小娟、蔡仁貞(2000)?輕中度和重度肺功能障礙慢性阻塞性肺疾病患者運動自我效能與運動測試結果比較之探討?護理研究,8(1),13-24。
鄭綺(1999)?冠狀動脈繞道術患者最大攝氧量、自覺體能效能及生活品質之探討?護理研究, 7, 531-541.
吳淑鈴(1998)?慢性阻塞性肺疾病患者之身體症狀、功能狀態與不確定感?未發表的碩士論文,高雄:高雄醫學院。 邱怡玟、蔡素華、李選(1999)?探討慢性阻塞性肺疾病住院患者之憂鬱狀況與日常生活功能的相關性?護理研究,7(2),145-155。
Wang, K. Y., Chou, W. C., & Kao, C. W. (1998). Factors influencing quality of life in patients with chronic obstructive pulmonary disease. Journal of Medical Science, 18(6), 400-410.
徐敏芳(1998)?慢性呼吸道阻塞患者實施肺部復健運動方案成效之探討?未發表的碩士論文,台北:長庚大學。 張文(2000)?建立慢性阻塞性肺疾病患者日常活動耗氧量之標準並分析其影響因素?未發表的碩士論文,台北:台北醫學院。 張麗銀、馬鳳歧、吳清平、郭英調(1999)?慢性阻塞性肺部疾病患者之因應方式與功能狀況關係之探討?榮總護理,16(1),34-46。

被引用紀錄


莊文齡(2010)。慢性阻塞性肺疾病患主要照顧者負荷及其相關因素之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831%2fTMU.2010.00134
江奇霙(2003)。家庭支持對慢性病患遵醫囑行為的影響〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714531139
湯梅芬(2004)。居家運動訓練指導改善癌症病患睡眠障礙與生活品質成效之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714570926
林育霜(2006)。規律運動訓練對僧帽瓣脫垂女性患者症狀困擾與生活品質成效之探討〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200715031608

延伸閱讀