Effect of progressive resistance training based on HAPA model on the health behavior and exercise endurance of elderly patients with chronic obstructive pulmonary emphysema

doi:10.3877/cma.j.issn.1674-6902.2021.01.007

Abstract

Abstract:

Objective

To explore the effect of progressive resistance training based on HAPA model on the health behavior and exercise endurance of elderly patients with chronic obstructive pulmonary emphysema.

Method

Select 98 elderly patients with chronic obstructive pulmonary emphysema admitted to our hospital from January 2018 to January 2020, and divide them into observation group 63 cases and control group 35 cases. The control group adopted progressive resistance training for intervention, and the observation group adopted a healthy action process model (HAPA)on the basis of the control group to intervene. The lung function index levels, St. George′s Respiratory Questionnaire (SGRQ) and health behavior scores were compared between the two groups before and after intervention. , Exercise endurance, self-efficacy score (GSES) and other changes.

Result

After the intervention, the lung function indexes such as FVC(2.83±0.65) L, FEV₁(2.15±0.43)L, and FEV₁/FVC (0.76±0.12)% in the observation group were significantly higher than those in the control group (2.39±0.57)L, (1.73±0.45)L, (0.71±0.11)% (P<0.05). After the intervention, the observation group′s CAT score (12.41±2.33) score was lower than that of the control group (17.25±2.12), while the 6MWD (208.22±46.35) m was farther than the control group (173.43±46.29), and the difference reached statistical significance Significance (P<0.05). After the intervention, the SGRQ scores of the observation group such as the symptom part score (33.57±3.24), the activity part score (44.28±3.36), and the influence part score (31.26±2.57) were significantly lower than those of the control group (45.35±3.43). (52.41±3.27) points, (39.45±3.23) points (P<0.05). After the intervention, the physical activity, interpersonal relationship, stress management, mental health, nutritional status, health responsibility and other health behavior scores of the two groups of patients were higher than those of the control group (P<0.05). After the intervention, the total scores of dyspnea management, physical activity, safety behaviors, emotional fluctuations, environment and temperature, and GSES of the two groups were significantly higher than before the intervention, and the GSES scores of the observation group were higher than those of the control group (P<0.05).

Conclusion

Progressive resistance training based on the HAPA model has a positive effect on the healthy behavior and exercise endurance of elderly patients with chronic obstructive pulmonary emphysema, not only can significantly improve their lung function, promote their quality of life, but also improve their healthy behavior And exercise endurance and self-efficacy, have high clinical application value.

Key words: Health action process approach, Progressive resistance training, Chronic obstructive pulmonary emphysema, Health behavior, Exercise endurance

Zhiping Huang, Yumei Lao, Dandan Xiao. Effect of progressive resistance training based on HAPA model on the health behavior and exercise endurance of elderly patients with chronic obstructive pulmonary emphysema[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(01): 37-42.

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References 31

1	任成山，王关嵩，钱桂生. 慢性阻塞性肺疾病的成因及其治疗的困惑与希望[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(2): 127-141.
2	刘卫庭，姚　宇. 早期肺康复对慢性阻塞性肺疾病急性加重期患者肺功能及运动耐力的影响[J]. 中华物理医学与康复杂志，2019, 41(3): 213-216.
3	Irene Coppolino, Paolo Ruggeri, Francesco Nucera, et al. Role of stem cells in the pathogenesis of chronic obstructive pulmonary disease and pulmonary emphysema[J]. COPD, 2018, 15(5): 536-556.
4	Burcu Yormaz, Hakan Cebeci, Farise Yllmaz, et al. Bone mineral density in emphysema and chronic bronchitis phenotypes in hospitalized male chronic obstructive pulmonary disease patients[J]. Clin Respir J, 2020, 14(1): 47-53.
5	齐　飞，肖金玲. 多学科协作护理模式对老年COPD患者运动耐力和负性情绪的影响[J]. 重庆医学，2019, 48(03): 154-157.
6	Benjamin M Smith, Dennis Jensen, Marc Brosseau, et al. Impact of pulmonary emphysema on exercise capacity and its physiological determinants in chronic obstructive pulmonary disease[J]. Sci Rep, 2018, 8(1): 15745.
7	钱　会，张孝飞，唐　超. 噻托溴铵联合沙美特罗替卡松对慢性阻塞性肺疾病病人肺功能、血气分析、运动耐力的影响[J]. 内蒙古医科大学学报，2019, 41(3): 301-303.
8	Isabelle Opitz, Silvia Ulrich. Pulmonary hypertension in chronic obstructive pulmonary disease and emphysema patients: prevalence, therapeutic options and pulmonary circulatory effects of lung volume reduction surgery[J]. J Thorac Dis, 2018, 10(Suppl 23): S2763-S2774.
9	邱亚娟，龙晓东，罗　洪，等. 太极拳对老年慢性阻塞性肺病患者肺功能和体力状况的影响[J]. 中国老年学杂志，2018, 38(1): 151-153.
10	Yoshiaki Kinoshita, Kentaro Watanabe, Hiroshi Ishii, et al. Distribution of emphysema and fibrosis in idiopathic pulmonary fibrosis with coexisting emphysema[J]. Histopathology, 2019, 74(7): 1103-1108.
11	毛立伟，陆　甘，王　磊. 有氧运动联合低水平抗阻训练对老年慢性阻塞性肺病患者肺功能与运动能力影响的观察[J]. 中国康复医学杂志，2018, 33(8): 54-59.
12	施晓雷，夏　艺，范　丽，等. 慢性阻塞性肺疾病患者肺气肿改变对气道重塑与气流受限相关性的影响[J]. 临床放射学杂志，2018, 37(6): 931-935.
13	Piotr Damiański, Piotr Kuna, Michał Panek. Generalized emphysema and chronic obstructive pulmonary disease in a farmer, non-smoker-the more we seek, the more we find[J]. Pol Merkur Lekarski, 2019, 47(278): 70-71.
14	虎瑞娟，苏桂香，侯　超. 慢性阻塞性肺疾病患者采用噻托溴胺联合呼吸操训练对其肺通气功能、生活质量以及运动耐力的影响[J]. 临床肺科杂志，2018, 23(4): 704-706.
15	Joseph Balnis, Tanner C Korponay, Catherine E Vincent, et al. IL-13-driven pulmonary emphysema leads to skeletal muscle dysfunction attenuated by endurance exercise[J]. J Appl Physiol, 2020, 128(1): 134-148.
16	喻　晴，沈其晓，韩丽莹，等. 慢性阻塞性肺疾病患者肺气肿空间分布对肺功能及临床严重程度的影响[J]. 中国医学影像技术，2018, 34(5): 692-696.
17	Meng Wang, Carrie Pistenmaa Aaron, Jaime Madrigano. Association between long-term exposure to ambient air pollution and change in quantitatively assessed emphysema and lung function[J]. JAMA, 2019, 322(6): 546-556.
18	齐亚飞，郑则广. 短期强化锻炼在慢性阻塞性肺疾病患者肺康复中的作用[J]. 中华结核和呼吸杂志，2018, 41(11): 899-902.
19	孙青玲，朱智玲，许寿霞，等. 基于项目管理的老年COPD患者医院-家庭过渡期运动管理对患者呼吸功能和运动耐力的影响[J]. 中华现代护理杂志，2020, 26(4): 491-495.
20	Andreas M Fischer, Akos Varga-Szemes, Marly van Assen, et al. Comparison of artificial intelligence-based fully automatic chest CT emphysema quantification to pulmonary function testing[J]. AJR Am J Roentgenol, 2020, 214(5): 1065-1071.
21	Mariaelena Occhipinti, Matteo Paoletti, Francesca Bigazzi, et al. Emphysematous and nonemphysematous gas trapping in chronic obstructive pulmonary disease: quantitative CT findings and pulmonary function[J]. Radiology, 2018, 287(2): 683-692.
22	刘　燕，李　红，张换春，等. 分级运动肺康复训练对慢性阻塞性肺疾病患者运动耐力及生存质量的影响[J]. 中国煤炭工业医学杂志，2018, 21(1): 34-38.
23	冯晓丽，姜　轶，巫道琳，等. 缩唇腹式呼吸联合阻力呼吸训练器对老年慢性阻塞性肺病稳定期患者康复效果和生活质量的影响[J]. 实用医院临床杂志，2018, 15(2): 129-132.
24	Sara J Abdallah, Benjamin M Smith, Mark A Ware, et al. Effect of vaporized cannabis on exertional breathlessness and exercise endurance in advanced chronic obstructive pulmonary disease. a randomized controlled trial[J]. Ann Am Thorac Soc, 2018, 15(10): 1146-1158.
25	白延平，刘智娜，李海军，等. 适量抗阻运动对慢性心功能不全患者血清PTH, DA, ALD水平和心功能，运动耐力与生活质量的影响[J]. 临床误诊误治，2020, 293(1): 41-46.
26	Simen A Steindal, Henny Torheim, Trine Oksholm, et al. Effectiveness of nursing interventions for breathlessness in people with chronic obstructive pulmonary disease: A systematic review and meta-analysis[J]. J Adv Nur, 2019, 75(5): 927-945.
27	黄子叶，韩　媛，王艳玲. 抗阻运动对COPD患者运动耐力，肺功能和生活质量影响的Meta分析[J]. 中华现代护理杂志，2019, 25(14): 1726-1731.
28	张海云，何英姿，张　萍，等. 腹式呼吸、有氧训练联合抗阻运动在老年稳定期COPD患者肺功能康复中的应用[J]. 川北医学院学报，2019, 34(2): 110-113.
29	梁　丰，霍文璟，欧阳刚，等. 不同运动方式训练对慢性肾脏病患者运动功能的影响[J]. 中国康复理论与实践，2018, 24(2): 208-213.
30	臧　玉，赵晓霞，朱利月，等. 优化肺康复训练对慢性阻塞性肺疾病稳定期患者的临床疗效[J]. 中国慢性病预防与控制，2019, 27(6): 464-467.
31	Lingyun Tian, Ying Zhang, Li Li, et al. The efficacy of mindfulness-based interventions for patients with COPD: a systematic review and meta-analysis protocol[J]. BMJ Open, 2019, 9(5): e026061.

组　别	例数	FVC(L)		FEV₁(L)		FEV₁/FVC(%)
组　别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	1.67±0.45	2.83±0.65^a	1.05±0.31	2.15±0.43^a	0.63±0.19	0.76±0.12^a
对照组	35	1.69±0.41	2.39±0.57^a	1.07±0.32	1.73±0.45^a	0.63±0.18	0.71±0.11^a
t值		0.246	3.794	0.341	5.128	0.000	2.301
P值		0.806	0.000	0.734	0.000	1.000	0.023

组　别	例数	FVC(L)		FEV₁(L)		FEV₁/FVC(%)
组　别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	1.67±0.45	2.83±0.65^a	1.05±0.31	2.15±0.43^a	0.63±0.19	0.76±0.12^a
对照组	35	1.69±0.41	2.39±0.57^a	1.07±0.32	1.73±0.45^a	0.63±0.18	0.71±0.11^a
t值		0.246	3.794	0.341	5.128	0.000	2.301
P值		0.806	0.000	0.734	0.000	1.000	0.023

组　别	例数	CAT评分(分)		6MWD(m)
组　别	例数	干预前	干预后	干预前	干预后
观察组	63	20.34±4.12	12.41±2.33^a	135.47±49．62	208.22±46．35^a
对照组	35	20.11±4.23	17.25±2.12^a	138.53±49．44	173.43±46．29^a
t值		0.295	11.500	0.330	4.016
P值		0.768	0.000	0.742	0.000

组　别	例数	CAT评分(分)		6MWD(m)
组　别	例数	干预前	干预后	干预前	干预后
观察组	63	20.34±4.12	12.41±2.33^a	135.47±49．62	208.22±46．35^a
对照组	35	20.11±4.23	17.25±2.12^a	138.53±49．44	173.43±46．29^a
t值		0.295	11.500	0.330	4.016
P值		0.768	0.000	0.742	0.000

组　别	例数	症状部分		活动部分		影响部分
组　别	例数	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	51.46±3.52	33.57±3.24^a	62.31±3.45	44.28±3.36^a	45.39±3.25	31.26±2.57^a
对照组	35	50.62±3.48	45.35±3.43^a	61.72±3.24	52.41±3.27^a	45.12±3.14	39.45±3.23^a
t值		1.697	24.967	1.247	17.340	0.597	19.842
P值		0.091	0.000	0.214	0.000	0.551	0.000

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