Effektivität eines sensomotorischen Krafttrainings im Rahmen einer ambulanten pneumologischen Rehabilitation bei COPD-Patienten: eine randomisierte kontrollierte Studie

Zusammenfassung

Ziel der Studie Einen Eckpfeiler der pneumologischen Rehabilitation (PR) von Patienten mit einer chronisch obstruktiven Lungenerkrankung (COPD) stellt das körperliche Training dar. Die Komponenten eines erfolgreichen Trainings sind aber noch nicht abschließend untersucht. Es wurde eine randomisierte kontrollierte Studie durchgeführt, um die Effektivität eines sensomotorischen Trainings (SMT) im Vergleich zu einem konventionellen Krafttraining (KT) auf den Zugewinn an Leistungsfähigkeit zu untersuchen.

Patienten und Methoden 43 COPD-Patienten wurden randomisiert und trainierten entweder in der Interventionsgruppe (SMT = 30 Minuten SMT pro Tag) oder in der Kontrollgruppe (KT = 30 Minuten KT pro Tag). Das SMT wurde als Zirkeltraining mit 5 Stationen durchgeführt. Der primäre Endpunkt war die Differenz zwischen T1 (Beginn der PR) und T2 (Ende der PR) im 5-Times Sit-to-Stand-Test (5-STST) im Intergruppenvergleich. Sekundäre Endpunkte waren die Intra- und Intergruppenvergleiche zu T1 und T2 im 6-Minuten-Gehtest (6-MWT), COPD-Assessmenttest (CAT), St. George Respiratory Questionnaire (SGRQ), Hospital-Anxiety-and-Depression Scale (HADS) und der Lungenfunktion.

Ergebnisse Im 5-STST zeigt sich zwischen den Gruppen kein signifikanter Unterschied. Ebenso im 6-MWT, SGRQ, CAT, HADS und in der Lungenfunktion. Im Intragruppenvergleich zwischen T1 und T2 zeigten sich in beiden Gruppen signifikante Unterschiede im 5-STST, 6-MWT, SGRQ, CAT und HADS. Die Unterschiede in der Lungenfunktion waren weder im Inter- noch im Intragruppenvergleich signifikant.

Schlussfolgerung Die Verbesserungen der körperlichen Leistungsfähigkeit bei COPD-Patienten im Rahmen einer PR sind mit einem SMT ebenso gut erreichbar wie mit einem konventionellen Krafttraining. Weitere Studien sind erforderlich, um den Stellenwert des SMT im Hinblick auf die posturale Kontrolle zu definieren.

Abstract

Objective Exercise training provides a cornerstone of pulmonary rehabilitation (PR) in COPD-patients. However, the components of the training are not yet fully investigated. We conducted a randomized controlled trial to investigate the effectiveness of a sensory-motoric training (SMT) in comparison to a conventional strength training (KT) according to the physical performance.

Patients and Methods: 43 COPD patients were randomized and participated either in the intervention group (SMT = 30 minutes SMT per day) or in the control group (KT = 30 minutes KT per day). The SMT was performed as circuit training with five stations. The primary endpoint was the difference between T1 (start of the PR) and T2 (end of the PR) in 5-Times Sit-to-stand test (5-STST) in the intergroup comparison. Secondary endpoints were the intra- and intergroup comparisons of T1 and T2 in the 6-Minute Walk Test (6-MWT), COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), Hospital Anxiety- and Depression Scale (HADS) and in lung function.

Results No significant differences were seen in the results of the 5-STST between the groups. Likewise, in the 6-MWT, SGRQ, CAT, HADS and lung function. The intragroup comparison between T1 and T2 showed significant differences in 5-STST, 6-MWT, SGRQ, CAT and HADS in both groups. The differences in lung function were not significantly, neither in the inter- nor in the intragroup comparison.

Conclusion Similarly to a conventional strength training improvements in exercise capacity could be achieved with a SMT during PR in COPD patients. Further studies are necessary to define the role of the SMT in regards to postural control.

Schlüsselwörter

sensomotorisches Krafttraining - COPD - Sit-to-Stand-Test - 6-Minuten-Gehtest - ambulante pneumologische Rehabilitation

Keywords

senso-motoric intervention - COPD - Sit-to-stand test - 6-minute walk test - outpatient pulmonary rehabilitation

^* M. Spielmanns und K. Müller sind gleichberechtigte Erstautoren

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