早期太極拳運動對慢性阻塞性肺疾住院病患之運動耐力、焦慮憂鬱及生活品質的長期成效

Long-term effects of early Tai Chi on exercise tolerance, anxiety, depression, and quality of life in hospitalized patients with chronic obstructive pulmonary disease

10.6288/TJPH.201802_37(1).106122

沈雪珍(Hsueh-Chen Shen)；郭素娥(Su-Er Guo)；張家豪(Chia-Hao Chang)；楊聰明(Tsung-Ming Yang)；蔡昆道(Kuen-Daw Tsai)

早期運動 ； 慢性阻塞性肺疾病 ； 太極拳 ； 運動耐力 ； 生物標誌物 ； 早期運動 ； 慢性阻塞性肺疾病 ； 太極拳 ； 運動耐力 ； 生物標誌物

台灣公共衛生雜誌

37卷1期（2018 / 02 / 15）

91 - 108

繁體中文

目標：早期運動有助於慢性阻塞性肺疾病急性發作（Acute Exacerbation of Chronic Obstructive Pulmonary Disease, AECOPD）的住院病患快速回復，但未有研究探討早期太極拳運動的長期成效，故本研究旨在檢測AECOPD住院病患接受早期太極拳運動訓練在運動耐力、焦慮憂鬱、生活品質與生物標誌物的長期成效。方法：本研究採類實驗設計，立意取樣自雲嘉三間醫院，共31人參與此研究（實驗組，n=17及常規照護的對照組，n=14）。收集6次資料，分別是介入前、出院日、出院後1週、1、3及6個月。運用廣義估計方程式分析太極拳運動成效。結果：實驗組比對照組在出院後1週（p=0.008）及第6個月（p=0.012）有較佳的運動耐力表現；實驗組比對照組在出院後第3個月生活品質明顯改善（p=0.040）；實驗組與對照組相比，實驗組在出院後第3個月第六型介白質（Interleukin-6, IL-6）和C-反應蛋白（C-reactive protein, CRP）的改善幅度，分別減少15.67（pg/ml）（p=0.017）與17.46（ug/ml）（p=0.013），獲得顯著成效。然而在焦慮憂鬱、YKL-40和LCN2的分析上，兩組未達顯著差異。結論：住院期間介入早期太極拳運動可增進病患之運動耐力、生活品質及降低發炎反應且安全可行。此研究結果可供臨床醫護人員做為日後推動住院COPD病患早期運動的實證基礎。

Objectives: Early sustained exercise can help patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) to quickly return to a steady state; however, to the best of our knowledge, no previous studies have examined the long-term effects of early Tai- Chi or Tai Chi as a bridge between early exercise during hospitalization and exercise at home. The aim of this study was to examine the effects of early Tai Chi on exercise tolerance, anxiety, depression, health-related quality of life and biomarkers in hospitalized patients with AECOPD. Methods: A quasi-experimental study was conducted. A purposive sampling of 31 patients with AECOPD (experimental group n=17 and control group n=14) was selected from hospitals in the Yunlin-Chiayi area. Data were collected during pre-intervention, at discharge, and one week, one month, three months or six months after discharge. Generalized estimating equations were used to examine the effects of the Tai Chi training intervention. Results: The experimental group had better exercise tolerance than did the control group one week after discharge (p=0.008) and six months after discharge (p=0.012). The experimental group had a better quality of life than the control group three months after discharge (p=0.040). The experimental group had decreased biomarker levels (Interleukin-6, p=0.017 and C-reactive protein, p=0.013) more than the control group three months after hospitalization. Anxiety, depression, and other biomarkers (YKL-40 and LCN2) failed to find statistical significance. Conclusions: Early Tai Chi helped promote early exercise in patients with AECOPD.

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