下肢抗阻运动训练对慢性阻塞性肺疾病急性加重期患者骨密度的影响

Effect of Lower Limbs Resistance Exercise Training on Bone Mineral Density of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨下肢抗阻运动训练对慢性阻塞性肺疾病急性加重期患者(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)骨密度的影响。方法2019年2月至2020年1月,便利抽样法选取在邛崃市某医院就诊并住院的AECOPD患者77名为研究对象,采用抛硬币法将其随机分为对照组(39例)和观察组(38例)。对照组患者给予常规有氧运动指导,而观察组患者实施下肢抗阻运动训练,干预时间为12周。于入院第2天、干预12周后测量两组患者骨密度(T值)及1次最大阻力(1 repetition maximum,1RM)。结果干预前,两组患者的T值和1RM水平的差异均无统计学意义(均P>0.05)。干预后,观察组患者T值及1RM较干预前增大(均P<0.05),而对照组患者干预后T值及1RM较干预前的差异均无统计学意义(均P>0.05)。观察组患者的T值及1RM水平均优于对照组,差异均有统计学意义(均P<0.05)。干预前后两组患者T值及1RM,测量时间与干预方法均存在交互作用(均P<0.05),观察组患者T值及1RM上升优于对照组。结论下肢抗阻运动训练较有氧运动更能显著提高AECOPD患者的下肢肌力、骨密度,改善其骨质疏松状况。

Objective To investigate the effect of lower limbs resistance exercise training on bone mineral density of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Seventy-seven patients with AECOPD were randomly divided into an observation group(n=38)and a control group(n=39)by convenience sampling method.The control group was given conventional aerobic walking exercise guidance and intervention.The group implemented lower limb resistance exercise training with an intervention time of 12 weeks.Bone mineral density(T value)and muscle force(1RM)of the two groups were measured on the second day of admission and 12 weeks after intervention.Results There was no statistically difference between the two groups before intervention(all P>0.05).After intervention,the T value and 1RM increased in the intervention group(all P<0.05),while the T value and 1RM decreased in the control group(all P>0.05).The T value and 1RM in the intervention group were better than those in the control group,and the difference was statistically significant in both groups(all P<0.05).There was an interaction between the measurement time and the intervention method(all P<0.05)before and after the intervention of T value and 1RM in the two groups.The difference between the two groups showed that the T value and 1RM of the intervention group increased better than the control group.Conclusions Lower extremity resistance exercise training can significantly enhance the lower extremity muscle strength and density,and improve osteoporosis in patients with chronic obstructive pulmonary disease during the acute exacerbation phase than aerobic exercise.