在患有断奶困难的患者中,在不同的呼吸条件下,启发性努力和呼吸肌肉激活:一项探索性研究
Diego Poddighe1, Marine Van Hollebeke1, Beatrix Clerckx2
1KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, B-3000, Leuven, Belgium; University Hospitals Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
在患有断奶困难的患者中,快速,低负荷的启发性肌肉训练 (IMT) 提供了与高负荷IMT相比的刺激. 这种训练方法大大超越了缓慢的IMT和不支持的呼吸,以增强鼓舞力.
科学领域:
- 呼吸系统生理学 呼吸系统生理学
- 肺部康复治疗 肺部康复治疗
- 关键护理医学 关键护理医学
背景情况:
- 启发性肌肉训练 (IMT) 可能有利于患有断奶困难的患者.
- 在IMT过程中,外部负荷 (ΔPaw) 和吸入力 (ΔPes) 之间的关系尚不清楚.
- 需要澄清吸入力,气道压力和肌肉激活之间的关联.
研究的目的:
- 为了比较消化管压力波动 (ΔPes) 和呼吸道压力波动 (ΔPaw) 在各种呼吸条件的患者与断奶困难.
- 调查 ΔPes, ΔPaw 和启发性肌肉激活之间的关系.
- 评估不同IMT协议提供的培训刺激.
主要方法:
- 在压力支通风,无支自发呼吸,低负荷缓慢的IMT,低负荷快速的IMT和高负荷快速的IMT期间测量了ΔPes和肌肉激活 (scalene,sternocleidomastoid,parasternal intercostals).
- 在自发呼吸和IMT条件下记录了ΔPaw,终吸入肺体积和峰值吸入流量.
- 利用混合模型分析进行比较和斯皮尔曼相关性来评估肌肉激活和压力变化之间的关系.
主要成果:
- 在无辅助呼吸和IMT过程中,ΔPes是 ΔPaw 的 3-4 倍.
- 与低负荷快速IMT和高负荷IMT相比,与低负荷缓慢IMT和无辅助呼吸相比,低负荷快速IMT和高负荷IMT表现出相似的,显著更高的ΔP值,结膜质激活,肺体积和峰值流量.
- 启发性肌肉激活显示了与 ΔPes 的中等相关性,与 ΔPaw 的较弱相关性.
结论:
- 在患有断奶困难的患者中,低负荷快速IMT提供了与高负荷IMT相比的训练刺激.
- 两种快速IMT协议 (低负荷和高负荷) 与缓慢的IMT和无支持的自发呼吸相比,都提供了更好的训练刺激.
- 研究结果表明,低负荷快速IMT是这种患者群体中启发性肌肉训练的可行策略,应该为未来的IMT研究提供信息.
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