间断性抗阻锻炼在老年慢性阻塞性肺疾病患者中实施的效果评价

doi:10.3761/j.issn.0254-1769.2025.15.001

摘要/Abstract

摘要：

目的探讨间断性抗阻锻炼在老年慢性阻塞性肺疾病患者运动康复中的实施效果，为改善其生活质量提供参考。方法 2024年10—12月，便利选取平顶山市某三级甲等医院收治的96例老年慢性阻塞性肺疾病患者为研究对象，采用随机数字表法将其分为试验组和对照组（各48例）。试验组在常规肺康复的基础上实施间断性抗阻锻炼方案，对照组实施常规肺康复护理，干预时长3个月。比较干预前后两组的肺功能、运动耐力、生活质量、运动依从性。结果最终试验组纳入46例，对照组纳入47例。试验组干预3个月时肺功能优于对照组（P<0.05），试验组干预1个月、3个月时的运动依从性得分均高于对照组（P<0.001）；重复测量方差分析显示，两组干预前、干预1个月、3个月时的运动耐力、生活质量比较，时间与组间存在交互效应（P<0.05），简单效应分析显示，试验组干预3个月时的运动耐力优于对照组（P<0.05），试验组干预1个月、3个月时的生活质量优于对照组（P<0.05）。结论间断性抗阻锻炼可有效改善老年慢性阻塞性肺疾病患者的肺功能，提升其运动耐力及运动依从性，提高生活质量。

关键词: 老年人, 肺疾病，慢性阻塞性, 间断性运动, 抗阻锻炼, 运动康复, 康复护理

Abstract:

Objective Exploring the application effect of fragmented resistance exercise in the exercise rehabilitation of elderly patients with chronic obstructive pulmonary disease，providing references for improving their quality of life. Methods From October to December 2024，96 elderly patients with chronic obstructive pulmonary disease admitted to a tertiary hospital in Pingdingshan city were conveniently selected as the research subjects. They were randomly divided into an experimental group and a control group（all n=48） using a random number table method. The experimental group received a fragmented resistance exercise program on the basis of routine pulmonary rehabilitation，while the control group received routine pulmonary rehabilitation nursing care for a duration of 3 months. The lung function，exercise endurance，quality of life，and exercise compliance were compared between the 2 groups before and after intervention. Results The experimental group ultimately included 46 cases, while the control group ultimately included 47 cases. The lung function of the experimental group was better than that of the control group after 3 months of intervention（P<0.05），and the exercise compliance scores of the experimental group were higher than those of the control group after 1 and 3 months of intervention（P<0.001）. Repeated measures ANOVA showed that there was an interaction effect（P<0.05） in the comparison of exercise endurance and quality of life between the 2 groups. Simple effects analysis showed that the experimental group had better exercise endurance after 3 months of intervention than the control group（P<0.05），and better quality of life after 1 and 3 months of intervention than the control group（P<0.05）. Conclusion Fragmented resistance exercise can effectively improve lung function，enhance exercise endurance and compliance，and improve quality of life in elderly patients with chronic obstructive pulmonary disease.

Key words: Aged, Pulmonary Disease，Chronic Obstructive, Fragmented Exercise, Resistance Exercise, Exercise Rehabilitation, Rehabilitation Nursing

范莹莹, 吕鹏鹏, 陈学昂, 张俊梅, 赵瑞, 张士变. 间断性抗阻锻炼在老年慢性阻塞性肺疾病患者中实施的效果评价[J]. 中华护理杂志, 2025, 60(15): 1797-1803.

FAN Yingying, LÜ Pengpeng, CHEN Xueang, ZHANG Junmei, ZHAO Rui, ZHANG Shibian. Application of fragmented resistance exercise in exercise rehabilitation of elderly patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2025, 60(15): 1797-1803.

图/表 5

表1 老年慢阻肺患者间断性抗阻锻炼干预方案

Table 1 Fragmented resistance exercise program for elderly patients with COPD

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general information between 2 groups of patients[cases（percentage，%）]

表3 干预前后两组肺功能的比较[M（P25，P75）]

Table 3 Comparison of lung functions between 2 groups before and after intervention[M（P25，P75）]

表4 干预前、干预1个月、3个月两组运动耐力的比较（m，$\bar{x} \pm s$）

Table 4 Comparison of exercise endurance between 2 groups before intervention， a month， and 3 months after intervention（m，$\bar{x} \pm s$）

表5 干预前、干预1个月、3个月两组生活质量的比较（分，$\bar{x} \pm s$）

Table 5 Comparison of quality of life between 2 groups before intervention，a month， and 3 months after intervention（scores，$\bar{x} \pm s$）

参考文献 23

[1]	Xu JX, Ji ZL, Zhang P, et al. Disease burden of COPD in the Chinese population:a systematic review[J]. Ther Adv Respir Dis, 2023,17:17534666231218899.
[2]	Kahnert K, Jörres RA, Behr J, et al. The diagnosis and treatment of COPD and its comorbidities[J]. Dtsch Arztebl Int, 2023, 120(25):434-444.
[3]	胡娇娇, 王建宁, 龚翠颖, 等. 慢性阻塞性肺疾病患者体力活动现状及干预措施的研究进展[J]. 中国护理管理, 2022, 22(10):1573-1577.
	Hu JJ, Wang JN, Gong CY, et al. Research progress on the current situation of physical activity and intervention measures in patients with chronic obstructive pulmonary disease[J]. Chin Nurs Manag, 2022, 22(10):1573-1577.
[4]	沈蓝君, 程云. 稳定期慢性阻塞性肺疾病患者肺康复依从性的研究进展[J]. 中华护理杂志, 2020, 55(5):710-715. DOI
	Shen LJ, Cheng Y. Research progress on pulmonary rehabilitation compliance in patients with stable COPD[J]. Chin J Nurs, 2020, 55(5):710-715.
[5]	张紫薇, 杨婧, 李文, 等. 9种运动方式对COPD患者肺康复影响的网状Meta分析[J]. 护理学杂志, 2023, 38(2):85-91.
	Zhang ZW, Yang J, Li W, et al. Network meta-analysis of nine exercise training modalities in pulmonary rehabilitation for COPD patients[J]. J Nurs Sci, 2023, 38(2):85-91.
[6]	陈小瑜, 吴红霞, 赵倩, 等. 慢性阻塞性肺疾病患者抗阻运动的最佳证据总结[J]. 中华护理杂志, 2022, 57(17):2088-2094. DOI
	Chen XY, Wu HX, Zhao Q, et al. Summary of best evidence of the resistance training in patients with chronic obstructive pulmonary disease[J]. Chin J Nurs, 2022, 57(17):2088-2094. DOI
[7]	石宇, 杜静, 郝梓良, 等. 老年人肌肉力量训练中居家零食式抗阻运动的研究进展[J]. 护理学杂志, 2024, 39(19):116-120.
	Shi Y, Du J, Hao ZL, et al. Research progress of home-based resistance exercise snacks for muscle strength training in the elderly[J]. J Nurs Sci, 2024, 39(19):116-120.
[8]	Nuzzo JL, Pinto MD, Kirk BJC, et al. Resistance exercise minimal dose strategies for increasing muscle strength in the general population:an overview[J]. Sports Med, 2024, 54(5):1139-1162.
[9]	Jones MD, Clifford BK, Stamatakis E, et al. Exercise snacks and other forms of intermittent physical activity for improving health in adults and older adults:a scoping review of epidemiological,experimental and qualitative studies[J]. Sports Med, 2024, 54(4):813-835.
[10]	中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南(2021年修订版)[J]. 中华结核和呼吸杂志, 2021, 44(3):170-205.
	Chronic Obstructive Pulmonary Disease Group of the Respiratory Medicine Branch of the Chinese Medical Association,Chronic Obstructive Pulmonary Disease Working Committee of the Respiratory Medicine Branch of the Chinese Medical Association. Guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease(revised 2021 edition)[J]. Chin J Tub Res Med, 2021, 44(3):170-205.
[11]	Perkin OJ, McGuigan PM, Stokes KA. Exercise snacking to im-prove muscle function in healthy older adults:a pilot study[J]. J Aging Res, 2019,2019:7516939.
[12]	魏莉莉, 刘海. 慢性阻塞性肺疾病临床康复循证实践指南[J]. 中国康复理论与实践, 2021, 27(1):15-26. DOI
	Wei LL, Liu H. Evidence-based practice guidelines for clinical rehabilitation of chronic obstructive pulmonary disease[J]. Chin J Rehabil Theory Pract, 2021, 27(1):15-26.
[13]	Garvey C, Bayles MP, Hamm LF, et al. Pulmonary rehabilitation exercise prescription in chronic obstructive pulmonary disease:review of selected guidelines:an official statement from the American association of cardiovascular and pulmonary rehabilitation[J]. J Cardiopulm Rehabil Prev, 2016, 36(2):75-83.
[14]	柴晶晶, 柳涛, 蔡柏蔷. 慢性阻塞性肺疾病评估测试中文版临床应用意义的评价[J]. 中华结核和呼吸杂志, 2011, 34(4):256-258.
	Chai JJ, Liu T, Cai BQ. Evaluation of clinical significance of Chronic Obstructive Pulmonary Disease Assessment Test[J]. Chin J Tuberc Respir Dis, 2011, 34(4):256-258.
[15]	巫雨轩, 余鑫源, 罗新楚, 等. 运动依从性量表汉化及其在癌症病人中的信效度检验[J]. 护理研究, 2024, 38(21):3799-3805.
	Wu YX, Yu XY, Luo XC, et al. Translation of the Exercise Adherence Rating Scale and its reliability and validity test in cancer patients[J]. Chin Nurs Res, 2024, 38(21):3799-3805.
[16]	张义静, 李娟, 孙丽, 等. 慢性阻塞性肺疾病患者早期简易肺康复方案的构建及应用[J]. 中华护理杂志, 2020, 55(5):690-695. DOI
	Zhang YJ, Li J, Sun L, et al. Construction of an early simple pulmonary rehabilitation programme for patients with COPD and its evaluation of effectiveness[J]. Chin J Nurs, 2020, 55(5):690-695. DOI
[17]	张一虹, 许胜. 进阶式抗阻运动结合呼吸康复锻炼对老年COPD稳定期患者肺功能、运动耐力和生活质量的影响[J]. 中国老年学杂志, 2024, 44(13):3116-3119.
	Zhang YH, Xu S. Effects of advanced resistance exercise combined with respiratory rehabilitation exercise on lung function,exercise endurance and quality of life of elderly COPD patients in stable stage[J]. Chin J Gerontol, 2024, 44(13):3116-3119.
[18]	郝莹, 陈卓. 抗阻运动提升老年人下肢肌肉力量及功能状态的网状Meta分析[J]. 中国循证医学杂志, 2024, 24(2):175-182.
	Hao Y, Chen Z. Resistance exercise on lower limb muscle strength and functional status enhancement in aging:a network meta-analysis[J]. Chin J Evid Based Med, 2024, 24(2):175-182.
[19]	Islam HJ, Gibala MP, Little J, 等. 零食式锻炼与心脏代谢健康[J]. 中国运动医学杂志, 2023, 42(9):677-681.
	Islam HJ, Gibala MP, Little J, et al. Snack style exercise and cardiac metabolic health[J]. Chin J Sports Med, 2023, 42(9):677-681.
[20]	谭春苗, 姜芬, 王小环, 等. 多组分运动训练方案对老年COPD病人四肢骨骼肌功能的影响[J]. 护理研究, 2023, 37(22):4106-4110.
	Tan CM, Jiang F, Wang XH, et al. Effect of multi-component exercise training program on appendicular skeletal muscle function in elderly patients with COPD[J]. Chin Nurs Res, 2023, 37(22):4106-4110.
[21]	Xiong T, Bai XY, Wei XY, et al. Exercise rehabilitation and chronic respiratory diseases:effects,mechanisms,and therapeutic benefits[J]. Int J Chron Obstruct Pulmon Dis, 2023,18:1251-1266.
[22]	Fyfe JJ, Dalla Via J, Jansons P, et al. Feasibility and acceptability of a remotely delivered,home-based,pragmatic resistance ‘exercise snacking’ intervention in community-dwelling older adults:a pilot randomised controlled trial[J]. BMC Geriatr, 2022, 22(1):521.
[23]	Jansons P, Fyfe JJ, Dalla Via JD, et al. Barriers and enablers associated with participation in a home-based pragmatic exercise snacking program in older adults delivered and monitored by Amazon Alexa:a qualitative study[J]. Aging Clin Exp Res, 2023, 35(3):561-569.