Materials and methods
Pulmonary rehabilitation program
1.Rehabilitation evaluation
(1)Pulmonary capacity: we used the Jaeger MS-PFT examiner from YAEGEA company in Germany. The participants were rested over 15 minutes in recumbent position, all the procedures were performed under normal pulmonary examination methods and the quality was controlled following the principles made by the American Thoracic Society (ATS). Each of the participants took the pulmonary capacity examination and the diastolic examination. The examination mainly tested FEV1, FEV1/FVC%, FEV1%Pred, FVC(L), MVV. After first round of examination, the participants were given salbutamol aerosol five times, and the second round examination started 20 minutes later.
(2)CPET examination: we used the COSMED PFTERGO cardiopulmonary exercising examiner from Italy and the Ergoline bicycle, the test included three phases.
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Breathing exercise: abdominal respiration, half-closed lip respiration, respiratory muscle exercise; 2. Aerobic exercise: relaxed gymnastics, walking, bicycling; 3. Strength training: elastic strap, dumbbell; coordinate exercise: 24-type shadowboxing. Exercise intensity: we set up the target work load as the 60-80% of the maximum VO2 of cardiopulmonary test, taking the personal tiredness into account. Feeling somewhat hard and sweat slightly is the optimal results. Exercise time and frequency: the total exercise time for each episode should be managed between 30-45 minutes, including aerobatic exercise for 20-30minutes. We prepared the participants with joint stretching for 5 minutes prior the exercise and another 5 minutes after the training for recovery. 10 minutes for shadowboxing three times a week. 10-15 minutes for muscle strength exercise twice a week.
Exercise frequency: everyday, but the participants must maintain doing the exercise twice a week in the hospital and finish the rest at home or in the community under the instructions of exercise