生物肌电反馈肌肉强化治疗对高龄糖尿病患者下肢肌群改善的影响

Effect of electromyographie biofeedback therapy improves lower limb muscles in elderly diabetic patients

目的研究生物肌电反馈肌肉强化治疗对高龄2型糖尿病(T2DM)患者血糖指标、胰岛素抵抗指数(IRI)及下肢肌肉能力的影响。方法选取高龄T2DM患者77例,随机分为反馈强化治疗组(26例)、单纯抗阻组(27例)、常规治疗组(24例)3组。反馈强化治疗组给予常规治疗+生物肌电反馈肌肉强化治疗;单纯抗阻组给予常规治疗+弹力带抗阻训练;常规治疗组仅给予常规糖尿病药物治疗。检测并分析比较3组患者治疗开始前(T0)及治疗4周(T4)、8周(T8)、12周(T12)后对3组患者的空腹血糖、IRI、糖化血红蛋白A1C(HbA1c)、峰力矩值(PT)、双下肢骨骼肌质量、6m步行速度、生存质量评分。结果与T0时比较,反馈强化组及单纯抗阻组T8、T12时空腹血糖及IRI值均明显降低,T12时该两组HbA1C值均明显降低(均P<0.05);与单纯抗阻组比较,反馈强化组T12时空腹血糖及HbA1c值明显降低、T8时IRI值明显降低(均P<0.05)。3组患者T8、T12时PT值、双下肢骨骼肌质量、6m步行速度组间比较差异均有统计学意义(均P<0.05);反馈强化组及单纯抗阻组T8、T12时PT值、双下肢骨骼肌质量及6m步行速度较治疗前均明显增加(均P<0.05)。3组患者在治疗前后各个时间点的生存质量评分比较差异均无统计学意义(均P>0.05)。结论生物肌电反馈肌肉强化治疗可以改善高龄T2DM患者的血糖指标和下肢肌肉能力,预防和延缓T2DM肌少症的发生。

Objective To study the effects of electromyographie biofeedback therapy on lower limb muscles in elderly patients with type 2 diabetes mellitus(T2DM). Methods Seventy seven elderly diabetic patients were randomly divided into the biofeedback-enhanced group, simple resistance movement group and conventional treatment group. The biofeedbackenhanced group was given conventional treatment plus electromyographie biofeedback muscle strengthening training;the simple resistance movement group was given conventional treatment plus elastic band resistance training;the conventional treatment group was given conventional anti-diabetic drug. The blood glucose index, insulin sensitivity index, muscle index and quality of life of the three groups were tested before and 4 weeks, 8 weeks, and 12 weeks after treatment. Results After 8 weeks and 12 weeks of intervention, the blood glucose index and insulin sensitivity index in biofeedback-enhanced group and the simple resistance movement group decreased significantly(both P<0.05), while the indexes in the biofeedback-enhanced group were better than those in simple resistance movement group(P<0.05). In the biofeedback-enhanced group and the simple resistance movement group, the peak quadriceps torque(PT), the mass of lower limbs and the speed of 6 m walking after intervention for 8 weeks were significantly enhanced(all P<0.05);while the biofeedback-enhanced group was better than the simple resistance movement group(P<0.05). There was no significant difference in the quality of life scores in three groups at all time points before and after intervention(all P>0.05). Conclusion Electromyographie biofeedback muscle strengthening training can improve blood glucose index and lower limb muscle capacity, and prevent or delay the occurrence of sarcopenia in elderly T2DM patients.