星期四, 5月 01, 2008

電腦遊戲有助於慢性阻塞性肺病患者呼吸更順暢

Computer Game Helps COPD Patients Breathe Better

原文:15 Apr 2008 2008年4月15日
根據新的研究,慢性阻塞性肺疾病( COPD )病患,經訓練玩利用呼氣控制的電腦遊戲,可能獲得更好地控制他們的呼吸。

"COPD is a double-edged sword: the incapacitating lung condition can cause such serious shortness of breath that every-day physical activity, such as walking a flight of stairs, becomes unduly burdensome-and yet one of the few effective symptomatic treatments for COPD is the very thing that its victims dread most: exercise," said leading researcher Eileen G. Collins, Ph.D., of the Edward Hines Jr. VA Hospital in Hines, Illinois and UIC.
「慢性阻塞性肺病是一把雙刃劍:功能不夠的肺可能會導致嚴重的呼吸急促,以致於每天的活動,例如上樓梯,成為過於沉重的負荷。而其中的幾個有效的症狀治療:運動,也是慢性阻塞性肺疾患者非常恐懼的。」領導這項研究的Eileen G. Collins博士如是說。

"This computerized program is still in the research stages, but shows promise for future use in pulmonary rehabilitation programs."
「這個電腦程式仍是在研究階段,但顯示的令人滿意的結果,以供未來使用在肺復健計劃」 。

The results of this randomized, controlled study appeared in the April 15 issue of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
此結果隨機對照研究發表在4月15日,美國胸腔學會所發表的美國呼吸和急重病醫學雜誌。

COPD patients with the greatest disability are also those most likely to be unable to exercise long enough to reap the benefits rehabilitation can offer them.
慢性阻塞性肺疾病患者有嚴重的功能低下,這也是最可能的讓他們無法運動夠長的時間來獲得復健治療的好處。

"One of the key mechanisms of shortness of breath and exercise impairment in these patients," Dr. Collins said, "is their inability to fully exhale air when active."
「其中一個重要的機制,氣促及運動障礙,在這些患者中, 」Collins博士說: 「是他們在活動時無法充分呼出的空氣」 。
This phenomenon causes trapping of air in the lungs-ie, dynamic hyperinflation-and diminishes the patient's breathing efficiency.
這種現象造成空氣"困"在肺部-即,動態過度充氣-削弱了病人的呼吸效率。

Dr. Collins and colleagues designed a randomized, controlled trial, the first of its kind, to test whether this computer program could decrease the extent of air trapping during exercise and thus improve the results of rehabilitation in COPD patients.
Collins博士和同事設計了一個隨機對照試驗,以測試是這個電腦程式是否可以減少空氣俘困在肺部的量,從而改善慢性阻塞性肺疾病患者復健治療的成效。

"Our primary goal was to determine if patients with COPD would achieve longer exercise duration if they were engaged in ventilation feedback, in addition to the regular exercise program over either ventilation feedback or exercise alone," said Dr. Collins.
「我們的首要目標是要研究,在呼吸回饋幫助之下,慢性阻塞性肺病患者是否可以達到更長的運動時間,而這個是加在經常性的訓練運動之上的」柯林斯博士說。

A total of 64 patients were randomized to three groups- exercise alone, exercise plus ventilation feedback (VF) or VF alone.
共64例病患隨機分為三組,運動,運動加呼吸回饋(VF)或僅呼吸回饋。

VF patients had their breathing monitored by a computer program which provided them with real-time biofeedback and set individualized goals, presented graphically on a screen in front of them.
VF這一組的病患,電腦程式會監測他們呼吸,同時提供即時回饋,並為他們設置個性化的目標,顯示在他們面前的螢幕上。

Patients could see their current speed and depth of breathing in relation to the set goal, encouraging them to inhale more slowly and exhale more completely in order to achieve the goal.
病人可以看到他們目前呼吸的速度和深度,及和設定目標間的關係,這個可以鼓勵他們吸更慢和呼出更多空氣,以達成設定的目標。

At baseline, the groups all performed similarly in exercise tolerance tests.
在一開始,各組的運動耐力都類似。

Comparing all the groups, those that underwent a regimen of exercise and ventilation feedback showed significant improvements in exercise duration, and those who underwent exercise alone fared much better than those who only received ventilation feedback.
比較各組,那些接受運動加呼吸回饋的病患,有顯著改善他們運動的時間,而那些只接受運動訓練的病患,表現僅優於呼吸回饋的病患。

Because of the multiple comparisons between groups, the exercise-plus-ventilation feedback group did not attain statistically significant improvements over the exercise-only group, but the results indicated a strong trend in that direction.
利用各群體之間的多重比較,接受運動加呼吸回饋的病患組和只接受運動訓練的病患組之間的差異,並未達到統計學上顯著的改善,但結果仍顯示了這一個趨勢。

Exercise-induced hyperinflation was also reduced in patients randomized to exercise-plus-ventilation feedback over either program by itself.
接受運動加呼吸回饋的病患組,在運動誘發的過度充氣這一項上也減少了。

Duration of exercise tolerance in the exercise-plus-ventilation feedback group also showed a significant trend toward improvement.
在這次研究中,接受運動加呼吸回饋的病患組,運動的時間也顯示改善的趨勢。

If patients can be taught to translate these breathing techniques from the computer game to activities of daily living, they could potentially greatly improve their quality of life.
如果病人可以這些呼吸技術,從電腦遊戲帶到日常生活活動,他們可能會大大改善他們的生活品質。

"We are conducting a follow-up clinical trial to compare computerized breathing feedback with other unique methods of pulmonary rehabilitation," said Dr. Collins. 「我們正進行後續的臨床試驗,以比較電腦呼吸的反饋,與其他獨特的肺部復健方法 」Collins博士如是說。

Published in the American Thoracic Society's peer-reviewed journal, the American Journal of Respiratory and Critical Care Medicine.
發表在美國胸腔學會審查的雜誌,美國呼吸和急重病醫學雜誌。

Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine.
美國胸腔學會是世界上領先的醫療協會,成立於1905年,致力於推展胸腔暨重症照護和睡眠醫學。

The Society has more than 18,000 members who prevent and fight respiratory disease around the globe, through research, education, patient care and advocacy.
這個組織已經有超過1萬8千個會員,他們在世界各地,透過研究,教育,病人照護服務和宣傳工作來預防和治療呼吸系統疾病,。

American Thoracic Society 美國胸腔學會


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