RESUMO
Objective: To develop a multi-component exercise training program for elderly patients with chronic obstructive pulmonary disease (COPD) and skeletal muscle dysfunction (SMD), and to explore its application value. Methods: This study involved 68 elderly patients with both COPD and SMD who were hospitalized at The First Affiliated Hospital of Hainan Medical College from September 2019 to August 2021. They were randomly divided into an intervention group and a control group. The intervention group received a 12-month multi-component exercise training program, while the control group received routine intervention. We compared skeletal muscle function, strength, lung function, and oxygen saturation between the groups before and at 3, 6, and 12 months after the intervention. The patient's daily living activities and dyspnea severity were assessed using the Modified Barthel Index (MBI) and the modified British Medical Research Council (mMRC) dyspnea scale. Flow cytometry was used to determine changes in the proportion of CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, and the CD3+CD4+/CD3+CD8+ ratio in the patients' lymphocytes before and after the intervention. Results: The six-minute walk distance of the intervention group at 6 and 12 months after the intervention was longer than that of the control group. The peak torque of elbow flexion and extension and knee flexion and extension muscles of the intervention group at 12 months after intervention was higher than that of the control group (P < .05). The forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC of the intervention group at 6 and 12 months after intervention were higher than those of the control group. The oxygen saturation (SaO2) and partial pressure of oxygen (PaO2) of the intervention group at 6 and 12 months after the intervention were higher than those of the control group (P < .05). The MBI and mMRC scores of the intervention group at 6 and 12 months after intervention were higher than those of the control group (P < .05). The indexes of T lymphocyte immune function, CD3+T cells, CD3+CD4+T cells, and the ratio of CD3+CD4+/CD3+CD8+ in the intervention group were also higher than those in the control group at 3, 6, and 12 months (P < .05). Conclusion: Multi-component exercise training program intervention can effectively improve skeletal muscle function and lung function in elderly COPD patients with SMD, reduce the degree of hypoxia and dyspnea, and improve patients' daily living activities and immune function recovery.
