Physical training for cystic fibrosis

 

Abstract

Background

Physical training may form an important part of the care package for people with cystic fibrosis.

Objectives

To determine whether a prescribed regimen of physical training produces improvement or prevents deterioration in physiological and clinical outcomes in cystic fibrosis compared to no training.

Search methods

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.

Date of the most recent search: 29 November 2010.

Selection criteria

All randomised and quasi-randomised controlled clinical trials in which a prescribed regimen of physical training is compared to no physical training in people with cystic fibrosis.

Data collection and analysis

Two authors independently selected studies for inclusion, assessed methodological quality and extracted data.

Main results

Of the 28 studies identified, seven studies which included 231 participants, met the inclusion criteria. This review does provide some limited evidence from both short- and long-term studies that aerobic or anaerobic physical training has a positive effect on primary outcomes (exercise capacity, strength and lung function) but improvements are not consistent between studies.

Authors' conclusions

Conclusions about the efficacy of physical training in cystic fibrosis are limited by the small size, short duration and incomplete reporting of most of the studies included in this review. Physical training is already part of the care package offered to most people with cystic fibrosis and there is a lack of evidence to actively discourage this. The benefits obtained from including physical training in a package of care may be influenced by the type of training programme. Further research is needed to assess comprehensively the benefits of exercise programmes in people with cystic fibrosis and the relative benefits of the addition of aerobic versus anaerobic versus a combination of both types of physical training to the care of people with cystic fibrosis.

 

Plain language summary

Physical training to improve exercise capacity in people with cystic fibrosis

The progress of lung disease in cystic fibrosis leads to abnormal breathing during exercise. This limits people exercising, which in turn affects health and body image. Physical training is designed to improve physical, heart and muscle strength through aerobic and anaerobic activity. Aerobic exercise involves training for a length of time such as distance cycling or running. Anaerobic exercise involves training intensely for a short time such as weight training or sprinting. A lack of regular physical training may lead to more severe lung disease and a reduced ability to perform day-to-day tasks. The side effects of exercise include dehydration, damage to muscles and bone fractures in those with low bone mineral density. This review includes seven studies with 231 participants. Due to different study designs, we were not able to combine any data. Some studies were short-term and did not show differences between treatments. However, it is not likely that training for less than one month would be beneficial. There is some evidence that physical training produces benefits and that these are influenced by the type of training programme. There are not enough studies in this review to compare aerobic training to anaerobic training or to a mixture of these two. The review provides some evidence that the benefits of training are maintained after training has ceased, but it is not clear for how long. Physical training is already part of the care package offered to most people with CF and there is no evidence to discourage this.

 

摘要

背景

囊狀纖維化患者的體能訓練

體能訓練可能成為囊狀纖維化患者照護計畫中重要的一部份。

目標

為了確定處方體能訓練與無任何訓練之下相比，是否能對生理及臨床表現帶來改善或避免惡化。

搜尋策略

我們搜尋了 Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register，其中包含綜合電子資料庫、相關期刊以及學術會議摘要等的參考資料。最近的搜尋日期是2007年9月。

選擇標準

所有有處方體能訓練與無體能訓練之囊狀纖維化患者之隨機與半隨機臨床對照試驗。

資料收集與分析

兩位作者獨自選取納入之研究，並且評估研究方法的品質與擷取數據。

主要結論

總共瀏覽了26項研究，其中7個研究總共包含231位試驗者符合納入的條件。這篇回顧提出有限的證據指出在這些長期與短期研究中，有氧與無氧體能訓練對於初步結果有正面的影響(包含運動耐受力、強度以及肺功能)，但這些結果在這些研究中並不是完全一致的。

作者結論

這篇回顧中所引用有關體能訓練對囊狀纖維化患者之效能的研究規模不大、時間不長，以及報告不夠完整，因此結論是有限的。體能訓練已是多數囊狀纖維化患者的照護計畫中之一部份，目前並沒有積極反對的證據。將體能訓練納入照護計劃的優點取決於訓練項目的種類。我們還需要更進一步的研究去綜合評估囊狀纖維化患者照護計畫中體能訓練的優點，此外還有有氧運動、無氧運動以及結合兩者之運動計畫的比較。

翻譯人

本摘要由臺灣大學附設醫院林珮璇翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

體能訓練計畫結合了有氧與無氧訓練，可能可以提高囊狀纖維化患者的運動能力，並且對健康有其他助益。 囊狀纖維化患者肺部疾病的進展會導致運動中有不正常的呼吸。這會造成患者喘不過氣並且限制了患者的運動行為，進而對健康與身體形象有影響。體能訓練是一項規律的強而有力的活動，它的目的是要提高生理、心臟，和/或肌力。這篇研究回顧發現短期以及長期的訓練能有助益，並且這些進步情形甚至在訓練結束後仍能持續。訓練的形式(有氧或無氧)會對結果有影響。