核心力量训练对绝经后骨质疏松症患者跌倒风险相关因素及骨密度的影响

Effects of core strength training on related factors of fall risk and bone mineral density of patients with postmenopausal osteoporosis

目的探讨核心力量训练(core strength training,CST)对绝经后骨质疏松症患者跌倒风险相关因素及骨密度(bone mineral density,BMD)的影响。方法选取绝经后骨质疏松症患者44例,按随机数字表法分为CST组和对照组各22例。2组均采用常规药物治疗,CST组在此基础上进行CST,每周训练3次,每次60min,共训练24周。治疗前后对2组进行平衡功能评定系统评估、计时起立行走测试、30s座椅站立试验、Tinetti步态评分、腰背疼痛程度评分及BMD检测。结果治疗后,2组睁、闭眼模式下的压力中心X轴、压力中心Y轴、覆盖90%椭圆区域面积及功能表面区域的轨迹长度(length in function of surface,LFS)指数均低于治疗前,且CST组睁、闭眼模式下的压力中心X轴、压力中心Y轴、覆盖90%椭圆区域面积及LFS指数均低于对照组(P<0.05)。2组计时起立行走测试(timed up and go test,TUGT)评定和视觉模拟评分法(Visual Analogue Scale,VAS)评分低于治疗前,30sCST评定、Tinetti步态评分高于治疗前,且CST组TUGT评定和VAS评分低于对照组,30sCST评定、Tinetti步态评分高于对照组(P<0.05)。治疗后,2组腰椎L2~4和股骨颈BMD高于治疗前,且CST组腰椎L2~4和股骨颈BMD高于对照组(P<0.05)。结论 CST能有效改善绝经后骨质疏松症患者平衡功能、下肢肌力、步态功能及疼痛程度等跌倒风险相关因素,提高BMD,为临床绝经后骨质疏松症及其跌倒的防治提供了一种新的思路。

Objective To explore the effects of core strength training(CST)on related factors of fall risk and bone mineral density(BMD)of patients with postmenopausal osteoporosis.Methods Forty-four patients with postmenopausal osteoporosis were enrolled in the study.According to the random number table,the patients were divided into CST group(n=22)and control group(n = 22).Patients in both groups received conventional drug treatment.Meanwhile,patients in the CST group were given core strength training 60 minutes three times a week for 24 weeks.All patients were assessed with the balance function assessment system,the timed up and go test,the 30-second chair stand test,the Tinetti gait score,the degree of lower back pain score and the BMD examination before and after the treatment.Results After the treatment,the center of press X-axis、center of press Y-axis、coverage of 90% ellipse area and length in function of surface(LFS)index results at eyes opened and closed mode in two groups were lower than those before the treatment,and the center of press X-axis、center of press Yaxis、coverage of 90% ellipse area and LFS index results at eyes opened and closed mode in the CST group were lower than those in the control group(P<0.05).After the treatment,the timed up and go test(TUGT)and Visual Analogue Scale(VAS)results in two groups were lower than those before the treatment,the 30 sCST and Tinetti gait score results in two groups were higher than those before the treatment,and the TUGT and VAS results in the CST group were lower than those in the control group,the 30 sCST and Tinetti gait score results in the CST group were higher than those in the control group(P<0.05).After the treatment,the lumbar vertebra(L2-4)and femoral neck BMD results in two groups were higher than those before the treatment,and the lumbar vertebra(L2-4)and femoral neck BMD results in the CST group were higher than those in the control group(P<0.05).Conclusion CST can effectively improve the related factors of fall risk including the balance function,the strength of lower limbs,the gait function,the pain degree and enhance the BMD in patients with postmenopausal osteoporosis,which provide a new thought for the prevention and treatment of postmenopausal osteoporosis.