推拿结合抗阻运动对骨骼肌衰减症患者日常生活活动能力的影响

Effects of Chinese massage and resistance exercise on ADL in elderly Chinese sarcopenic men

目的:探讨推拿或/和抗阻运动对骨骼肌衰减症男性患者骨骼肌质量、肌力、步速及日常活动能力的影响,为推拿及运动防治老年人骨骼肌衰减症提供科学依据。方法:按照亚洲肌少症工作组确定的骨骼肌衰减症诊断标准筛选符合标准的骨骼肌衰减症老年男性志愿者24例,并随机平均分为4组:对照组(C)、推拿组(M)、抗阻运动组(R)、推拿结合抗阻运动组(MR)。M组受试者接受推拿功法易筋经(20min)和推拿手法(20min)干预;R组受试者分别进行60%—80%1RM、3组/次、组间歇3—5min的板凳深蹲(20min)和弹力带练习(20min);MR组受试者交替进行推拿干预和抗阻运动练习。干预频率为3次/周,为期8周,8周前后分别测量受试者四肢骨骼肌质量、肌力、步速及Barthel指数,并进行统计分析。结果:1组内比较发现:C组仅步速显著下降;M组和R组握力、步速和Barthel指数显著提高,四肢骨骼肌质量指数(appendicular skeletal muscle mass,ASMI)值小幅提升但无差异显著性;MR组四项测量指标均显著升高。2组间比较发现:与C组相比,M组仅步速显著提高,R组除ASMI值外均显著提高,MR组四项测量指标均显著升高;与M组相比,MR组四项测量指标均显著升高;与R组相比,MR组仅Barthel指数显著提高。结论:推拿结合抗阻运动能有效提升骨骼肌衰减症患者骨骼肌质量、肌力、步行能力及整体活动能力,且其改善效果优于单纯进行推拿或抗阻运动干预,是值得推荐的治疗骨骼肌衰减症的有效手段之一。

Objective： To investigate the effects of Chinese massage and/or exercise on skeletal muscle mass, strength and walking ability in elderly Chinese man with sarcopenia. Method： A total of 24 men aged over 60 years who were defined as sarcopenia according to the AWGS were randomly assigned into four groups： control group（C）, Chinese massage（M） group, resistance exercise（R） group, and Chinese massage and resistance exercise group（MR）. The M group received a 40min Chinese massage inter- vention program including YiJinJing and massage manipulation.The R group attended a 40rain resistance exer- cise program which consists of bench squat and Thera-Band training. The MR group received Chinese massage program and resistance exercise program alternately. All programs were carried out three times a week and for 8 weeks. Interview data and sarcopenic measurements, such as muscle mass appendicular skeletal muscle mass （ASMI）, strength handgrip strength（HS）, gait speed（GS） and Barthel Index（BI）, were collected before and after the 8-week intervention. Result： ①Within the groups, there were no significant difference in the ASMI, HS and BI, while a significant- ly decreased GS in the C group. There were significant increases in the HS, GS and BI in both the M and R group, but the ASMI just had a slight improvement with no significant difference. All four indicators had significant increase in the MR group. ②Among the groups, there were significant increases in the GS of M group, in the HS, GS,BI of R group, and in all four indicators of MR group when compared with that of the C group. There were also significant increase in all four indicators of the MR group when compared with that of the M group. It was interesting to see that only the BI had a significant increase in the MR group when compared with that in the R group, Conclusion： The combination of Chinese massage and resistance exercise has a beneficial effect on physical function measured by gait speed, muscle mass and strength in sarcopenic man, which can promote the activi- ties of daily living.