登階運動訓練對阻塞型睡眠呼吸中止症候群患者心肺耐力與睡眠狀況之成效

Effectiveness of Stair Stepping Exercise Training on Cardiopulmonary Endurance and Sleep Condition in Patients with Obstructive Sleep Apnea Syndrome

本研究主要目的在探討登階運動對阻塞性睡眠呼吸中止症候群患者心肺耐力與睡眠狀況之成效。採單組重複測量之類實驗性設計，收案標準為經用睡眠多項式生理檢查(polysomnography)診斷其呼吸中止／不全指數(AHI)＞15/hr，氧氣低飽和指數(oxygen desaturation index, ODI)＞10/hr，年齡19歲以上，願意參與本研究計畫者。共收胸腔內科門診15位阻塞性睡眠呼吸中止症候群患者，在家施行登階運動八週。於收案第一天登階運動開始前（前測）、實施登階運動後第四週最後一天、第八週最後一天測量下列參數：用三分鐘登階測驗評估心肺耐力，參數包括心肺體適能指數、總耗氧量；睡眠狀況參數包括Epworth日間嗜睡量表、匹茲堡睡眠品質量表及睡眠多項式生理檢查(polysomnography)。研究結果顯示，在調整了年齡、性別、BMI及抽菸包年等效應後，達統計上顯著性差異的參數包括：心肺體適能指數(p= .009)、總耗氧量(p< .001)、Epworth日間嗜睡量表分數(p< .03)，匹茲堡睡眠品質量表分數(p< .001)。其他參數的進步量太小，未達顯著性差異。結論為規律運動訓練對改善阻塞性睡眠呼吸中止症候群患者的心肺耐力和睡眠狀況可能扮演重要的角色。

This study seeks to verify improvements of the stair stepping exercise training on cardiopulmonary endurance and sleep condition in patients with obstructive sleep apnea syndrome (OSAS). The quasiexperimental, one group repeated-measures study design was used. Patients meeting the following criteria were invited to participate in this study: being diagnosed with AHI (apnea-hyponea index)>15/hr and ODI (oxygen desaturation index)>10/hr by polysomnography, aged 19 or older. Fifteen patients with OSAS treated in the outpatient department of Chest Medicine were recruited. Each patient performed stair stepping exercise training daily for eight weeks at home. Outcome measures included cardiopulmonary endurance assessed by the three minutes step test, in which including cardiorespiratory fitness index and gross oxygen consumption (VO2), and sleep condition assessed by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and polysomnography. Data were recorded just prior to the stair stepping exercise at Day 1 as baseline, at the end of the fourth week, and at the end of the eighth week. Results of this study showed that after adjustment for the effect of sex, age, body mass and smoking pack-year, cardiorespiratory fitness index (p= .009); gross oxygen consumption (VO2) (p< .001), Epworth Sleepiness Scale (p< .03), and Pittsburgh Sleep Quality Index (p< .001) were significantly improved. Differences in the effect of stair stepping exercise for other outcome variables were either minimal or not statistically significant. Eight weeks of stair stepping exercise training could be useful in increasing cardiopulmonary endurance and improving sleep condition on patients with OSAS.