{"title":"分级运动康复增强AECOPD患者膈肌功能和运动耐量的随机对照试验。","authors":"Hongmin Ran, Yue Chen, Lijuan Zhang, Dandan Fu, Yan Wang, Nana Yang, Rong Liu, Luwen Luo, Lina Ma, Jimei Luo, Chuanli Cheng, Hui Zeng","doi":"10.1038/s41598-025-09224-3","DOIUrl":null,"url":null,"abstract":"<p><p>To evaluate the improvement effect of graded exercise rehabilitation on diaphragm function, exercise function, and respiratory performance in AECOPD patients. 68 AECOPD patients admitted to the Respiratory and Critical Care Department of a tertiary hospital in Zunyi City. Patients were randomly divided into a study group and a control group (each group 34 patients), and then according to the grading criteria, patients in each group were divided into 3 levels, for a total of 6 groups. The control group used conventional rehabilitation, while the study group used graded exercise rehabilitation. Bedside ultrasound was used to monitor the changes in diaphragm function (DE, DTei, DTee, DTF), 6MWT, CAT score, mMRC questionnaire, non-invasive mechanical ventilation time, and hospital stay between two groups of patients before and after rehabilitation. Compared with before the rehabilitation intervention, the study group showed significant improvement in diaphragm movement compared to the control group (P < 0.05). The end-inspiratory, end-expiratory, and diaphragm thickening scores all improved compared to before, and the differences were statistically significant (P < 0.05); The 6MWT and CAT scores of the study group were significantly higher than those of the control group after the intervention, and the difference was statistically significant (P < 0.05); Compared with the control group, the study group had significantly less mechanical ventilation time and hospitalization time, and the difference was statistically significant (both P < 0.05); The total incidence of MV related complications in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). There were no actual compression injuries, aspiration, deep vein thrombosis, atelectasis, etc. in either group; The mMRC questionnaire did not show statistical significance (P > 0.05), but there was improvement before the intervention. Graded exercise rehabilitation can effectively improve the overall diaphragm function of patients, and has a positive effect on enhancing exercise quality and endurance; Bedside ultrasound can dynamically and real-time observe the diaphragm movement status of AECOPD patients, objectively and directly evaluate the recovery of respiratory muscle function, and has important clinical value.</p>","PeriodicalId":21811,"journal":{"name":"Scientific Reports","volume":"15 1","pages":"28510"},"PeriodicalIF":3.9000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325577/pdf/","citationCount":"0","resultStr":"{\"title\":\"A randomized controlled trial of graded exercise rehabilitation enhances diaphragm function and exercise tolerance in patients with AECOPD.\",\"authors\":\"Hongmin Ran, Yue Chen, Lijuan Zhang, Dandan Fu, Yan Wang, Nana Yang, Rong Liu, Luwen Luo, Lina Ma, Jimei Luo, Chuanli Cheng, Hui Zeng\",\"doi\":\"10.1038/s41598-025-09224-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To evaluate the improvement effect of graded exercise rehabilitation on diaphragm function, exercise function, and respiratory performance in AECOPD patients. 68 AECOPD patients admitted to the Respiratory and Critical Care Department of a tertiary hospital in Zunyi City. Patients were randomly divided into a study group and a control group (each group 34 patients), and then according to the grading criteria, patients in each group were divided into 3 levels, for a total of 6 groups. The control group used conventional rehabilitation, while the study group used graded exercise rehabilitation. Bedside ultrasound was used to monitor the changes in diaphragm function (DE, DTei, DTee, DTF), 6MWT, CAT score, mMRC questionnaire, non-invasive mechanical ventilation time, and hospital stay between two groups of patients before and after rehabilitation. Compared with before the rehabilitation intervention, the study group showed significant improvement in diaphragm movement compared to the control group (P < 0.05). The end-inspiratory, end-expiratory, and diaphragm thickening scores all improved compared to before, and the differences were statistically significant (P < 0.05); The 6MWT and CAT scores of the study group were significantly higher than those of the control group after the intervention, and the difference was statistically significant (P < 0.05); Compared with the control group, the study group had significantly less mechanical ventilation time and hospitalization time, and the difference was statistically significant (both P < 0.05); The total incidence of MV related complications in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). There were no actual compression injuries, aspiration, deep vein thrombosis, atelectasis, etc. in either group; The mMRC questionnaire did not show statistical significance (P > 0.05), but there was improvement before the intervention. Graded exercise rehabilitation can effectively improve the overall diaphragm function of patients, and has a positive effect on enhancing exercise quality and endurance; Bedside ultrasound can dynamically and real-time observe the diaphragm movement status of AECOPD patients, objectively and directly evaluate the recovery of respiratory muscle function, and has important clinical value.</p>\",\"PeriodicalId\":21811,\"journal\":{\"name\":\"Scientific Reports\",\"volume\":\"15 1\",\"pages\":\"28510\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325577/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scientific Reports\",\"FirstCategoryId\":\"103\",\"ListUrlMain\":\"https://doi.org/10.1038/s41598-025-09224-3\",\"RegionNum\":2,\"RegionCategory\":\"综合性期刊\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MULTIDISCIPLINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scientific Reports","FirstCategoryId":"103","ListUrlMain":"https://doi.org/10.1038/s41598-025-09224-3","RegionNum":2,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
A randomized controlled trial of graded exercise rehabilitation enhances diaphragm function and exercise tolerance in patients with AECOPD.
To evaluate the improvement effect of graded exercise rehabilitation on diaphragm function, exercise function, and respiratory performance in AECOPD patients. 68 AECOPD patients admitted to the Respiratory and Critical Care Department of a tertiary hospital in Zunyi City. Patients were randomly divided into a study group and a control group (each group 34 patients), and then according to the grading criteria, patients in each group were divided into 3 levels, for a total of 6 groups. The control group used conventional rehabilitation, while the study group used graded exercise rehabilitation. Bedside ultrasound was used to monitor the changes in diaphragm function (DE, DTei, DTee, DTF), 6MWT, CAT score, mMRC questionnaire, non-invasive mechanical ventilation time, and hospital stay between two groups of patients before and after rehabilitation. Compared with before the rehabilitation intervention, the study group showed significant improvement in diaphragm movement compared to the control group (P < 0.05). The end-inspiratory, end-expiratory, and diaphragm thickening scores all improved compared to before, and the differences were statistically significant (P < 0.05); The 6MWT and CAT scores of the study group were significantly higher than those of the control group after the intervention, and the difference was statistically significant (P < 0.05); Compared with the control group, the study group had significantly less mechanical ventilation time and hospitalization time, and the difference was statistically significant (both P < 0.05); The total incidence of MV related complications in the study group was lower than that in the control group, and the difference was statistically significant (P < 0.05). There were no actual compression injuries, aspiration, deep vein thrombosis, atelectasis, etc. in either group; The mMRC questionnaire did not show statistical significance (P > 0.05), but there was improvement before the intervention. Graded exercise rehabilitation can effectively improve the overall diaphragm function of patients, and has a positive effect on enhancing exercise quality and endurance; Bedside ultrasound can dynamically and real-time observe the diaphragm movement status of AECOPD patients, objectively and directly evaluate the recovery of respiratory muscle function, and has important clinical value.
期刊介绍:
We publish original research from all areas of the natural sciences, psychology, medicine and engineering. You can learn more about what we publish by browsing our specific scientific subject areas below or explore Scientific Reports by browsing all articles and collections.
Scientific Reports has a 2-year impact factor: 4.380 (2021), and is the 6th most-cited journal in the world, with more than 540,000 citations in 2020 (Clarivate Analytics, 2021).
•Engineering
Engineering covers all aspects of engineering, technology, and applied science. It plays a crucial role in the development of technologies to address some of the world''s biggest challenges, helping to save lives and improve the way we live.
•Physical sciences
Physical sciences are those academic disciplines that aim to uncover the underlying laws of nature — often written in the language of mathematics. It is a collective term for areas of study including astronomy, chemistry, materials science and physics.
•Earth and environmental sciences
Earth and environmental sciences cover all aspects of Earth and planetary science and broadly encompass solid Earth processes, surface and atmospheric dynamics, Earth system history, climate and climate change, marine and freshwater systems, and ecology. It also considers the interactions between humans and these systems.
•Biological sciences
Biological sciences encompass all the divisions of natural sciences examining various aspects of vital processes. The concept includes anatomy, physiology, cell biology, biochemistry and biophysics, and covers all organisms from microorganisms, animals to plants.
•Health sciences
The health sciences study health, disease and healthcare. This field of study aims to develop knowledge, interventions and technology for use in healthcare to improve the treatment of patients.