| 秦芳,马甜甜,于子夫,冷晓轩,曹新燕,刘西花.阈值压力负荷呼吸肌训练对脑卒中患者肺功能影响的Meta分析[J].中国康复,2025,40(7):422-430 |
| 阈值压力负荷呼吸肌训练对脑卒中患者肺功能影响的Meta分析 |
| Impact of threshold respiratory muscle training on pulmonary function in stroke patients: a meta-analysis |
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| DOI：10.3870/zgkf.2025.07.008 |
| 中文关键词: 脑卒中 阈值压力负荷呼吸肌训练 肺功能 Meta分析 |
| 英文关键词: stroke threshold respiratory muscle training pulmonary function Meta-analysis |
| 基金项目:国家自然科学基金（81802239） |
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| 中文摘要: |
| 目的：评价阈值压力负荷呼吸肌训练（TIMT）对脑卒中患者呼吸功能、运动功能的干预效果，并探讨最佳训练方案。方法：系统检索2024年9月之前中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Cochrane Library、Embase、PubMed和Web of Science发表的相关文献。使用Cochrane偏倚风险评估工具和物理治疗证据数据库（PEDro）量表对纳入文献进行质量评价，使用RevMan 5.3进行数据分析。结果：共纳入16篇文献，845例患者。结果表明，TIMT可以显著改善最大吸气压（MIP）、最大呼气压（MEP）、用力肺活量（FVC）、呼气峰流速（PEF）、膈肌增厚率、膈肌移动度和运动耐力（P<0.01，0.05），但对1秒用力呼气容积（FEV1）的作用不明显。病程亚组分析结果显示：亚急性期进行TIMT对于MEP、FEV1、PEF和运动耐力的恢复更有优势；干预参数亚组分析显示，中等强度TIMT：20 min/d，6~12周，总干预时间≤600 min对MIP的改善更有效（P<0.05）；3~4周，总干预时间≥720 min对MEP的改善更有效（P<0.05）。结论：与常规治疗或假刺激相比，TIMT显著改善了脑卒中患者呼吸功能和运动功能，且在脑卒中发病3个月内干预效果最好。最佳训练方案应根据病情和耐受程度选择合适的训练强度，20 min/d，5~6次/周，至少持续6周。 |
| 英文摘要: |
| Objective: To evaluate the effects of threshold respiratory muscle training on the respiratory function and motor function of stroke patients, and explore the optimal training program. Methods: The relevant literatures published in CNKI, Wanfang, VIP, CBM, Cochrane Library, Embase, PubMed and Web of Science were systematically searched before September 2024. The Cochrane bias risk assessment tool and PEDro scale were used to evaluate the quality of the included literature. The RevMan 5.3 was used for data analysis. Results: A total of 16 articles were included, involving 845 patients. The results indicated that TIMT could significantly improve MIP, MEP, FVC, PEF, diaphragmatic thickening rate, diaphragmatic mobility and physical endurance（P<0.01，0.05）, but the improvement in FEV1 was not significant . Subgroup analysis of disease duration showed that TIMT performed in the subacute phase was more advantageous for recovery of MEP, FEV1, PEF, and physical endurance. Subgroup analysis of intervention parameters showed that moderate intensity , 20 min/d, 6-12 weeks, and total intervention time of ≤600 min were more effective in improving MIP and had statistically significant differences compared with the control group (P<0.05). 3-4 weeks and total intervention time of ≥720 min were more effective in improving MEP and had statistically significant differences compared with the control group (P<0.05). Conclusion: Compared with conventional treatment or sham stimulation, TIMT significantly improved the respiratory and motor fun-ctions of stroke patients, with the best intervention effects observed within three months after stroke onset. The optimal training regimen is to choose the appropriate training intensity based on the patient’s condition, 20 min per day, 5-6 times per week, for at least 6 weeks. |
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