Терапевтический архив (Mar 2012)
PHYSICAL TRAINING IS A UNIVERSAL METHOD OF PULMONARY REHABILITATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Abstract
Aim. To study systemic effects of chronic obstructive pulmonary disease (COPD) of stage III—IV and to assess their response to pulmonary rehabilitation method physical training (PT). Material and methods. The study enrolled 112 patients aged 46-72 years (mean age 64.3 years) with severe and extremely severe COPD. Of them, 57 patients received standard pharmacotherapy, exercise training and training with respiratory trainers. The control group of 55 patients received only pharmacotherapy. At the start and in the end of the study the following parameters were examined: 6-min walk, inspiratory and expiratory muscles performance (Pi, Pe), functional changes in the lungs, quality of life by MOS SF-36 questionnaire, depressive alterations by CES-D questionnaire, markers of systemic inflammation (TNF-alpha, IL-6, IL-1beta, C-reactive protein, testosterone). Results. At the start of the study all the examinees had low exercise tolerance according to 6-min walk test (266,7 м), inspiratory and expiratory muscles performance (Pi 54,8 cm of water, Pe 75,3 cm of water). Patients from the PT group improved the above parameters: pulmonary function, 6-min walk by 80 m, Pi — to 77.2 cm, Pe — to 89.8 cm, functional residual capacity reduced by 14%, residual pulmonary volume by 30%, CRP by 8.1 mg/l, IL-6 by 8.3 pkg/ml, depression regressed, testosterone rose. Patients from the control group improved the above parameters insignificantly. Conclusion. PT is a universal method of pulmonary rehabilitation having a positive action on various COPD systemic effects.
