| Summary: | 碩士 === 高雄醫學大學 === 運動醫學系碩士在職專班 === 106 === Background:
Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation. According to the World Health Organization (WHO), it will become the third leading cause of death in 2020. The respiratory symptoms and acute exacerbation declined the cardiopulmonary function and exercise tolerance in COPD patients, which in turn seriously affect their daily activity and health associated life quality. Therefore, establishing a new strategy of pulmonary rehabilitation for COPD patients is very important.
After reviewing previous studies, we did not find any study for investigating the effect of high-frequency chest wall oscillation vibratory vest combing whole body vibration on COPD patients. For answering this questing, we designed this study for evaluating the effects of high-frequency chest wall oscillation vibratory vest combing whole-body vibration training (WBVT) on the sputum clearance ability, exercise capacity and life quality of COPD outpatients.
Methods
We enrolled 24 COPD outpatients form the pulmonary rehabilitation center in Kaohsiung medical center between December 2017 to July 2018. This study was approved by ethic committee (KMUHIRB-E(Ⅱ)-20170267), and all participants had written inform consent before enrollment. All patients received a regular high-frequency chest wall oscillation vibratory vest (HFCWO vibratory vest) rehabilitation program and 13 of them who received additional WBVT (two times a week for 8 weeks) were allocated to the intervention group (WBVT group). The remaining 11 participants were the control group. We recorded the demographic data, cardiopulmonary parameters (including 6-min-walking-distance (6MWD), lung function test), upper-limb, lower-limb muscle strength and endurance, chest radiography severity, and health related quality of life (including sputum assessment, the modified British Medical Research Council (mMRC), COPD assessment test (CAT) score, and St George’s respiratory questionnaire (SGRQ)). Independent sample t test was used to analyse the intergroup difference of continuous variables and Wilcoxon’s signed rank test was used for intra-group analysis.
Results
All patients completed the 8 week program in this study. The mean age was 67.4 19.6, the male/female ratio was 2.4. The baseline of lung function test, bronchodilator medication, questionnaire scores, image severity and other physical parameters were no difference between WBVT group and control group.
Subjects in control group had a higher percentage of hypertension than WBVT group (63.6% v.s. 15.4%, p=0.033). The improvement of 6MWD was significantly higher in WBVT group when compared to control group (WBVT: 378m, control: 330m with a between-group difference of 58m, p=0.015). Participants in WBVT group improved more than the control group on two symptomatic measures including CAT score (WBVT:11 points, control:7 points, p=0.013) and SGRQ (WBVT: 41.69 points, control:26.86 points, p=0.001). The lower limb muscle strength and endurance increased significantly after WBVT (WBVT: 24 lbs., control: 26.5 lbs. with a between-group difference of 2.1 lbs., p=0.005). No difference was noted over sputum clearance ability and lung function test.
Conclusions
WBVT is a new, safe and effective exercise modality and should be recommended as a regular pulmonary rehabilitation program due to the excellent improvement of the symptoms, muscle strength and life quality for COPD outpatients.
Keywords：Chronic obstructive pulmonary disease, Whole-body vibration training, Pulmonary rehabilitation
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