12주 운동이 만성폐쇄성 폐질환자의 심폐기능과 근기능에 미치는 영향 = The Effect of 12 Week Exercise Training on Cardiopulmonary and Muscular Function in Chronic Obstructed Pulmonary Disease Patients

다국어 초록 (Multilingual Abstract)

[INTRODUCTION] The purpose of this study was to verify effects of 12 weeks exercise on cardiopulmonary and muscular function in chronic obstructed pulmonary disease(COPD) patients. [METHOD] Subjects, who voluntarily participated in this study, were 31 chronic obstructed pulmonary disease patients men aged in the range of 40-80 years old. They were assigned to the mild group(=17) and the severe group(=14) to disease severity(FEV1). All subjects were carried out aerobic and resistance exercise programs for 40 to 60 minutes a day, five times per week in the period of 12weeks. The aerobic exercise was carried out walking exercise and its intensity was increased step by step in the range of 60-70%VO2max. The resistance exercise was carried out elastic-band exercise and weight-bearing exercise. Resistance exercise intensity was increased step by step to the muscular function test results. Statistical analyses were performed using paired t-tests within group and analysis of covariance(ANCOVA) to compare means between two groups. [RESULT] There were no differences of VO2max of two groups between pre and post tests, but there was a significant difference(p=.001) of exercise effect between groups in ANCOVA. Significant lower values of HRmax(p=.029) of severe group and dyspnea scale(p=.044) of mild group between pre and post tests were founded, but there was significant difference of dyspnea scale(p=.013) only between groups. Improvement of leg fatigue scale(p=.010) in the severe group between pre and post tests but no difference between groups(p=.013). Treadmill walking endurance of two groups(p=.000) were enhanced and significantly different between groups(p=.025). Upper limbs muscular function(mild group; p=.004, severe group; p=.005) and lower limbs muscular function(mild group: p=.001, severe group: p=.010) were all enhanced in two groups. There was a marked improvement of the lower limbs muscular function of mild group(p=.046) in between groups comparison. [CONCLUSION] It was concluded that exercise training is effective to COPD patients and it is suggested that it is possibile its effect is different to disease severity(FEV1) in cardiopulmonary function and muscular function.

국문 초록 (Abstract)

[서론] 이 연구의 목적은 12주 운동이 만성폐쇄성 폐질환자의 심폐기능과 근기능에 미치는 영향을 구명하는데 있다. [방법] 연구 대상은 만성폐쇄성 폐질환을 진단 받은 40-80세 남성 31명으로서 이들을 COPD 질환의 중증도에 따라 경증집단(n=17)과 중증집단(n=14)으로 구분하였다. 운동프로그램은 60-70%VO2max 강도의 걷기운동과 근력운동을 병행하여 하루 40-60분, 주 5회, 12주 동안 실시하였다. 운동 프로그램 적용 직전 및 12주 운동 후에 심폐기능과 근기능을 측정하였다. 심폐기능은 운동부하검사(최대산소섭취량, 최대심박수, 호흡곤란정도, 다리피로정도)와 오래걷기검사를 측정하였고, 근기능은 아령들기와 앉았다가일어서기를 검사를 실시하였다. 집단별 사전사후 검사의 평균차 검증을 위하여 대응 t-검정을 실시하였고, 집단간 12주 운동효과의 차이를 검증하기 위하여 공변량분석(ANCOVA)을 실시하였다. [결과] 최대산소섭취량은 집단별 사전사후검사결과의 차이는 없었으나 공변량분석결과 집단간 운동효과의 차이가 나타났다. 사전사후검사결과 최대심박수는 중증집단에서, 호흡곤란척도는 경증집단에서 유의한 감소를 보였으며 집단간 차이는 호흡곤란척도만 나타났다. 다리피로척도는 사전사후거사결과 중증집단에서 유의한 감소를 보였고 집단간 차이는 없었다. 오래걷기시간은 경증집단과 중증집단 모두 사전사후검사결과의 차이가 발생하였으나 집단간 차이도 있었다. 아령들기와 앉았다가일어서기 모두 사전사후검사결과 유의한 차이가 발생하였으나 앉았다가일어서기에서만 집단간 차이를 보였다. [결론] 운동은 만성폐쇄성 폐질환의 심폐기능과 근기능을 향상시키는데 효과가 있었고, 이 연구에서 적용한 운동 프로그램의 경우 심폐기능이 경증집단보다는 중증집단에서 더 좋은 향상을 가져왔으나 근기능에서는 경증집단에서 더 나은 효과를 보임으로써 향후 만성폐쇄성 폐질환자의 운동프로그램 개발에 있어서 질환의 중증도를 고려할 필요가 있다고 판단된다.

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