积极临床干预对老年性肌肉减少症患者下肢肌力及功能性活动的影响

Effect of active clinical interventions on muscle strength and physical function of lower extremities of patients with sarcopenia

目的探讨积极临床干预对老年性肌肉减少症(简称肌少症)患者的下肢肌力及功能性活动的影响。方法选择2015-06至2016-01亚洲工作组关于亚洲肌少症诊断共识标准的109例老年性肌少症的患者,通过有针对性地治疗原发病、运动指导、营养支持及维生素D治疗6个月后,比较治疗前后患者的下肢肌群(髂腰肌、股四头肌、腘绳肌)肌力和下肢活动能力、平衡功能。应用便携手持式肌力测定仪FET3测定肌力,采用单腿站立测试(one leg standing test,OLS),计时直立行走测试(timed up and go test,TUGT),Berg平衡量表(Berg balance scale,BBS),功能性步态测试(functional gait assessment,FGA)测定下肢功能。结果干预后,双下肢肌力变化均无统计学差异(P<0.05),而患者的OLS[左侧(3.42±1.84)s,右侧(3.23±1.82)s]较干预前延长,而TUGT[(12.20±7.30)s]较干预前缩短,BBS[(49.52±27.17)分]和FGA[(17.91±9.86)分]评分均较干预前增大,差异均有统计学意义(P<0.05)。结论通过积极治疗原发病、运动指导、营养支持及维生素D治疗,可明显改善老年性肌少症患者的下肢活动功能状态。

Objective To study the clinical value of nutrition treatment combined with exercise and Vit D in treating sarcopenia.Methods One hundred and nine patients with sarcopenia treated in our hospital from June 2015 to January 2016 were included in this study. The patients’ strength of iliopsoas, quadriceps, hamstrings and tibialisanterior, and their scores of One Leg Stranding Test Berg Balance Scale, Functional Gait Assessment and Timed Up and Go Test were analyzed after six months of treatment.Results After intervention, there was no significant change in lower extremity muscle strength （P〈 0.05）, but patients’ OLS [（3.42±1.84） s in the left side, and （3.23±1.82） s in the right side] was extended, TUGT[（12.20±7.30） s] was shortened, BBS [（49.52±27.17） score] and FGA [（17.91±9.86）score] were increased. The differences were statistically significant （P〈0.05）.Conclusions Clinical therapy can obviously increase the physical function in lower extremities in patients with sarcopenia.