ABSTRACT
Objective To explore the effect of pulmonary rehabilitation training on the respiratory function,motor function,life quality,survival and complications of patients with non-operative lung cancer.Methods A group of 88 patients with non-operative lung cancer was randomly divided into a training group (n=45) and a control group (n=43).Both groups were given anti-tumor therapy,while the training group was additionally provided with systematic respiratory training,including breathing pattern training,cough and expectoration training,respiratory gymnastics and walking training.Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured at the outset and after 8,16 and 24 weeks of the training.The 6-minute walk test (6MWT) was administered along with the QLQ-C30 assessment of the European Organization for Research and Treatment of Cancer.Complications in both groups were also recorded and analyzed.The progression-free survival (PFS) and overall survival (OS) were followed up after the treatment.Results After 8,16 and 24 weeks of the treatment,the average FVC and FEV1 volumes and the 6MWT times of the training group were significantly better than those before treatment and significantly better than the control group averages.Indeed,no significant improvement was observed in the control group's average FVC,FEV1 or 6MWT results.After 24 weeks the treatment group's average scores on the physical function,social function,emotional function,fatigue,nausea and vomiting,pain,dyspnea,insomnia,appetite,constipation,and overall quality of life sub-scales of the QLQ-C30 had all improved significantly more than in the control group.The incidence of pulmonary complications in the control group (26％) was significantly higher than that in the training group.(11％).The median PFS and OS of the training group (14.3 and 27.3 months) were not significantly better than those of the control group,however.Conclusion Respiratory exercise training and aerobic exercise training combined with the anti-tumor therapy,while not prolonging survival,can effectively improve the life quality of patients with non-operative lung cancer,reducing the incidence of complications and promoting the recovery of respiratory function.The combination is worthy of popularization in clinical practice.
ABSTRACT
Objective To explore the effect of short-term intensive rehabilitation training on respiratory function, motor function and the life quality of patients with obstructive sleep apnea combined with chronic obstruc-tive pulmonary disease ( OSA-COPD) . Methods Fifty-seven patients with OSA-COPD were randomly divided in-to an observation group and a control group. Both groups were treated with non-invasive positive pressure ventilation ( NPPV) , oxygen therapy and a bronchodilator, while the observation group was additionally provided with 8 weeks of intensive lung rehabilitation training, including respiratory function training and limb exercise training. Polysom-nography was used to monitor the apnea hyponea index ( AHI) , the lowest oxygen saturation level during the night ( LowSpO2 ) and the nocturnal oxygen saturation ratio for ＜ 90% of total sleep time ( tst90) . Arterial blood gases, forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1 ) were measured. The 6-minute walk test (6MWT) and St. George's respiratory questionnaire ( SGRQ) were used to evaluate all the patients before and after the intervention. Results After 8 weeks of treatment, the average AHI, LowSpO2 , TST90 and PaO2 had improved significantly in both groups. There was no significant difference between them. After the treatment the average FVC, FEV1 and 6MWT time of the observation group were significantly better than before the treatment and the significantly better than the control group's averages. After treatment, the average SGRQ score and activity abili-ty score of the observation group were also significantly improved and significantly better than the control group's av-erages. Conclusions NPPV can effectively improve OSA-COPD patients'tolerance of short-term intensive pulmo-nary rehabilitation training. With that assistance, short-term intensive rehabilitation training can promote the recov-ery of respiratory function and motor function, and improve the life quality of patients. Therefore, such therapy is worthy of clinical promotion and application.