Exercise tolerance of chronic respiratory insufficiency

本研究の目的は，自転車エルゴメーターを用いて，健常者と，呼吸不全患者の運動能力の相違点を捉えることである． 対象者は，健常者4例，呼吸不全患者8例，計12例である．運動負荷は，多段階運動負荷で，それぞれExhaustion時に達するまで個人別に与えた．運動負荷中止の判定は，酸素飽和度（SaO2）が80％以下，予測年齢最大心拍数以上，及び自覚症のあった場合とした． その結果，呼吸不全患者は，健常者に比べ，Exhaustion時の一回換気量，分時換気量，酸素摂取量，二酸化炭素排出量，酸素摂取率，METS，体重あたりの酸素摂取量，酸素脈値が低いことが解った． この原因として，呼吸不全患者は，運動負荷に対して一回換気量が増加できず，呼吸効率が低下していることが考えられた．そのため，我々理学療法士が患者に対し指導することは，一回換気量を増加し，過剰な呼吸数を減少させ，呼吸効率の上昇を図ることであることが示唆された．Exercise tests measured with a bicycle ergometer were used to study the difference in exercise tolerance for patients with chronic respiratory insufficiency and healthy persons. Twelve subjects, eight patients and four healthy controls, exercised with a bicycle ergomater under a multi-step test condition until exhaustion. Exercise was discontinued when any manifestation of subjective symptoms (levels less than 80% of SaO2 or more than the age maximum heart rate) were observed. Results show that the exercise level of the patients at exhaustion was lower than that of the healthy controls, This is because of decreased tidal volume and minute ventilation against the exercise and the decrease in respiration efficiency. It is in order important for their physiotherapists to give directions to these patients so as to increase their tidal volumes control excessive respiration rates and improve respiration efficiency