监督下的运动训练方案对成年囊性纤维化患者身体成分的改善。

Improvement in body composition following a supervised exercise-training program of adult patients with cystic fibrosis.

机构信息

Université de Lille, CHU Lille, centre de ressource et de compétence pour la mucoviscidose, service de pneumologie et immuno-allergologie, hôpital Calmette, Lille, 59000, France.

出版信息

Respir Med Res. 2019 May;75:5-9. doi: 10.1016/j.resmer.2019.04.001. Epub 2019 Apr 13.

DOI:10.1016/j.resmer.2019.04.001

PMID:31235455

Abstract

OBJECTIVES

Maintenance of optimal nutritional status is a crucial issue for cystic fibrosis (CF) patients. Here, we evaluate the effects of an 8-week exercise training (ET) program on body composition in CF patients.

METHODS

This prospective pilot observational study was conducted in adult CF subjects in stable condition following their annual check-up. The ET program consisted of three sessions per week and included aerobic training (≥30min), muscle strengthening, circuit training, and relaxation. Exercise tolerance (6-minute walk test, 6MWT), pulmonary function, quadriceps isometric strength, and body composition (bioelectrical impedance analysis of fat-free mass [FFM], fat mass, and body cell mass) were analyzed before and immediately after the ET program. A control group of CF patients who preferred not to participate in the ET program received the same evaluations.

RESULTS

A total of 43 CF patients were enrolled and offered the ET program; 28 accepted (aged 28±5 years, forced expiratory volume in 1s [FEV] 48.8±19% predicted) and 15 declined the ET program but agreed to be part of the control group (matched for age and CF severity: 30.8±9 years, FEV 51.8±16.5%). Pulmonary function was unchanged at the end of the ET program, but significant improvements were observed in 6MWT distance (from 520±96m to 562±105m, P<0.001) and muscle strength (331±141N to 379±168N, P<0.001). Although mean body mass index did not change, the ET group showed significantly increased FFM (43.85±8kg to 44.5±9.2kg, P=0.03) and a trend towards increased body cell mass (21.4±6 to 22.1±6.6kg, P=0.06). All other parameters were unchanged by ET. There were no significant correlations between the increase in FFM and the improvements in either 6MWT distance or muscle strength. The CF control group exhibited no significant changes in any parameters between evaluations.

CONCLUSIONS

ET significantly improved FFM, but not body mass index, in CF patients. The results illustrate the superiority of bioimpedancemetry for assessing changes in body composition and reveal the importance of ET for improving not only exercise tolerance but also nutritional status in these patients.

摘要

目的

维持最佳营养状态是囊性纤维化（CF）患者的关键问题。在这里，我们评估了 8 周运动训练（ET）方案对 CF 患者身体成分的影响。

方法

这是一项前瞻性试点观察性研究，在 CF 患者年度检查后稳定时进行。ET 方案包括每周三次，包括有氧运动（≥30 分钟）、肌肉强化、循环训练和放松。在 ET 方案前后，分别分析运动耐量（6 分钟步行测试，6MWT）、肺功能、股四头肌等长力量和身体成分（去脂体重[FFM]、体脂肪和细胞内液的生物电阻抗分析）。未参加 ET 方案的 CF 患者对照组接受了相同的评估。

结果

共有 43 名 CF 患者被纳入并提供 ET 方案；28 名患者接受了治疗（年龄 28±5 岁，第 1 秒用力呼气量[FEV]为预测值的 48.8±19%），15 名患者拒绝了 ET 方案，但同意成为对照组的一部分（年龄和 CF 严重程度匹配：30.8±9 岁，FEV 为预测值的 51.8±16.5%）。ET 方案结束时，肺功能无变化，但 6MWT 距离（从 520±96m 增加到 562±105m，P<0.001）和肌肉力量（从 331±141N 增加到 379±168N，P<0.001）显著提高。虽然平均体重指数没有变化，但 ET 组的 FFM（从 43.85±8kg 增加到 44.5±9.2kg，P=0.03）和细胞内液质量（从 21.4±6kg 增加到 22.1±6.6kg，P=0.06）有显著增加。ET 对所有其他参数均无显著影响。FFM 的增加与 6MWT 距离或肌肉力量的改善之间没有显著相关性。CF 对照组在两次评估之间没有任何参数的显著变化。