慢性阻塞性肺部患者整合復健中有關運動的考量－病例報告

Exercise and Physical Conditioning as Part of a Comprehensive Program for Patients with Chronic Obstructive Pulmonary Disease

吳英黛(Ying-Tai Wu)

《物理治療學會雜誌》 12卷 (1987/11) Pp. 101-108

https://doi.org/10.29617/JPT.198711.0014

摘要

本文旨在報告四名慢性阻塞性肺病患者在症狀限制的極限運動測試時，其運動反應及因應其反應的不同所給予運動訓練量時的考量。其中一名病例甚至達不到無氧性界限(anaerobic threshold)，一名則在達到無氧性界限後不久就不能再繼續運動，另外兩名患者則可運動超過無氧性界限而到達其最大心跳數和最大攝氧量。對於這兩名運動反應類似正常者，以接近無氧性界限的運動量作爲訓練量似乎是恰當而可行的，否則應在症狀限制的程度來幫忙建立運動處方，或以間歇運動的方式或以較低的最大心跳數的比例作爲訓練量直到病人能持續運動十五至二十分鍾的方式來訓練病人，在臨床上才不致於使病人過度疲勞或呼吸困難而中止訓練。四名病人中只有兩名完成兩個月的腳踏車訓練，結果顯示以這樣的運動計劃，兩名病人均提高了其最大運動量和最大攝氧量，攝氧的換氯效率和氧脈亦有明顯進步。一名病人則在最大換氧量、最大潮量和最大呼吸頻率等呼吸指標上顯示出進步，另一名病人則顯示其可能在低限量的運動(Submaximal exercise)上有較好的耐受力，不過比仍需在低限運動時的穩定狀態下做進一步的探討。

並列摘要

To investigate the exercise responses in patients with chronic obstructive pulmonary disease. 4 male outpatients were studied by symptom-limited maxmal graded exercise test (SL-GXT) on bicycle ergometer. One patient could not achieve his anaerobic threshold. The other one quit the exercise soon after the anaerobic threshold. The remaining two patients were able to achieve their anaerobic threshold and maximal oxygen consumption. For those who had the exercise response similar to the normals in a SL-GXT, exercising at the level near to their anaerobic threshold as training intensity appears to be feasible and appropriate. Otherwise the symptom-limited level ts helpful in the development of an exercise prescription for pulmonary patients. Lower percentage of the maximal achieved heart rate can be used to build the ability of continuous exercise for minimum 15 to 20 minutes. Two of the 4 patients completed 2-month physical training on bicycle ergometer and they demonstrated improvements in performed workload, exygoo consumption, oxygen pulse and ventilatory equivalent for 02 at maximal exercise. One of them also showed improvements in the ventilatory parameters at maximal exercise and the other one showed the better tolerance at non-steady state submaximal exercise level from the data of SL-GXT. It needs further study on responses in steady state condition to substantiate the improvements at submaximal exercise workload.

並列關鍵字

Chronic obstructive pulmonary disease ； Anaerobic threshold ； Exercise training