The Effect Of Resistance Training On Rehabilitation Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

?Objective?The purpose of this study was to explore the effect of quadriceps resistance training on the rehabilitation of patients with chronic obstructive pulmonary disease?COPD?during acute exacerbation.Furthermore,it provides ideas and references for standardized exercise intervention guidance for patients with acute exacerbation of COPD in the future.?Method?Prospective study was used in this study.65 AECOPD patients who were hospitalized in the first affiliated Hospital of Hainan Medical College from May 2018to January 2019 were randomly divided into two groups:control group and exercise group.The patients in the control group were given routine treatment and daily activity guidance,and the exercise group was given resistance exercise of the quadriceps on the basis of the control group.The lower limb muscle strength,exercise capacity,lung function,quality of life and activities of daily living of the two groups before and after intervention were assessed to evaluate their effects on the rehabilitation of AECOPD patients.?Result?1.Baseline of two groups:there was no significant difference in socio-demographic,disease-related data and baseline evaluation indicators between the two groups before intervention?P>0.05?.2.Muscle strength of quadriceps in two groups:After 7 days of intervention,the1RM in the control group decreased from 9.19±3.03kg to 8.58±3.00kg,with an average decrease of 0.61±0.87kg?7%?.In the exercise group,the 1RM increased from 9.19±2.45kg to 13.18±2.63kg,with an average increase of 3.98.±1.06kg?43%?.There was interaction between time and treatment?F=335.126,P<0.001?,that is,the changes of 1RM in control group and exercise group were different before and after intervention.With the increase of hospitalization time,the 1RM of control group showed a decreasing trend,while the patients in the exercise group showed an upward trend.3.Exercise load before and after intervention in exercise group:exercise load increased from 6.74±1.76kg before intervention to 9.65±1.97kg after intervention,with an average increase of 2.91±0.62kg?43%?,the difference was statistically significant?P<0.001?.4.Subjective feelings in exercise group:86.67%of patients felt lower limb fatigue,43.33%of them felt dyspnea.The average score of subjective dyspnea and fatigue degree of Borg was 3.90±0.61.5.The changes of SPO₂ and PR in the exercise group before and after exercise:the SPO₂ in the exercise group decreased and the PR increased after each exercise,the difference was statistically significant?P<0.001?,and with the increase of exercise days,the SPO₂ of the patients showed an upward trend,PR showed a downward trend.6.Pulmonary function in two groups:After 7 days of intervention,the FEV1,FEV1%pred,FVC values of the control group decreased,and the FEV1,FEV1%pred,FVC values of the exercise group increased,and there was an interaction between time and treatment?P<0.001?,that is,the changes of FEV1,FEV1%pred,FVC values before and after intervention in the two groups were different.With the increase of hospitalization time,the FEV1,FEV1%pred,FVC of the control group showed a downward trend,while patients in the exercise group showed an upward trend.7.The exercise capacity in two groups:After 7 days of intervention,the 6MWD of the control group decreased from 345.77±73.43m to 336.23±71.35m,with an average decrease of 9.53±24.30m,and the 6MWD of the exercise group increased from 344.97±79.55m to 406.37±71.06m,with an average increase of 61.4±26.81m.There was interaction between time and treatment?F=115.297,P<0.001?,that is,the changes of 6MWD in two groups were different before and after intervention.With the increase of hospitalization time,the 6MWD of control group decreased,while that of exercise group showed an upward trend.8.Activity of daily living in two groups:After 7 days of intervention,the MBI score of the control group increased from 85.73±5.94 to 92.43±5.13,with an average increase of 6.70±4.33.In the exercise group,the MBI score increased from85.83±5.50 to 97.33±2.82,with an average increase of 11.50±4.42.There was interaction between time and treatment?F=18.662,P<0.001?,that is,the changes of MBI in two groups were different before and after intervention.With the increase of hospitalization time,the MBI scores of both groups showed an upward trend,but the range of increase in exercise group was significantly higher than that in control group.9.The quality of life in two groups:After 7 days of intervention,the CAT score of the control group decreased from 28.23±2.39 to 19.17±3.25,with an average decrease of 9.07±2.82.In the exercise group,the CAT score decreased from 28.27±3.32 to 14.37±2.45,with an average decrease of 13.90±2.63.There was interaction between time and treatment?F=47.203,P<0.001?,that is,the changes of CAT in two groups were different before and after intervention.With the increase of hospitalization time,the CAT scores of the two groups showed a decreasing trend.But the decrease value of exercise group was significantly higher than that of control group.?conclusion?1.As the length of hospital stay increases,the muscle strength of the lower limbs of AECOPD patients will gradually decrease.Resistance training of the quadriceps muscle can enhance the muscle strength of the lower limbs.2.With the increase of hospitalization time,the pulmonary function of patients with AECOPD decreased progressively,while the quadriceps resistance training could improve the pulmonary function of the patients by stimulating respiration to exercise the lung and respiratory muscles.3.As the length of hospital stay increases,the exercise capacity of AECOPD patients will gradually decline,and the quadriceps resistance training can improve the patient's exercise capacity by improving the lower limb muscle strength and lung function of the patient.4.When AECOPD patients felt the benefits of quadriceps resistance training,their ability and confidence in activities are enhanced,their mentality and behavior are also more positive,thus the ability of daily living was improved.5.The quadriceps resistance training can improve the patient's quality of life by changing the patient's objective symptoms and subjective psychology.