不同运动训练强度对不完全性SCI患者痉挛程度和BDNF浓度的影响

Effects of different intensities of exercises on spasticity and concentration of serum brain-derived neurotrophic factor in patients with incomplete spinal cord injury

目的:观察不同运动强度对不完全性脊髓损伤(SCI)患者下肢痉挛程度和血清脑源性神经营养因子(BDNF表达的影响。方法:60例不完全性SCI患者,随机分成A、B、C 3组,每组各20例。A组为常规康复治疗对照组;B组为低运动强度训练组:在常规康复治疗的基础之上,加用MOTOmed智能运动训练仪对下肢进行低强度运动训练;C组为高运动强度训练组:在常规康复治疗的基础之上,加用MOTOmed智能运动训练仪对下肢进行高强度运动训练。在治疗前和治疗4周后,对痉挛程度采用改良Ashworth痉挛评分法(MAS)和改良Tardieu量表(MTS)进行评定。采用Elisa法检测对患者治疗前后血清中BDNF浓度进行分析。并对运动训练强度、痉挛改善程度与血清BDNF浓度增长率进行相关性分析。结果:A、B、C 3组患者AMS和MTS在治疗后较治疗前均降低(P<0.05);治疗后C组患者AMS和MTS明显低于A组(P<0.05)。治疗后,B、C组血清BDNF浓度较治疗前增加(P<0.05);C组较A组和B组血清BDNF浓度明显增高(P<0.05)。MAS和MTS降低等级数与血清BDNF浓度增长率之间均存在正相关性。结论:运动训练,尤其是高强度运动训练,有助于改善不完全性SCI患者下肢的痉挛状态,增加血清中BDNF的含量,且运动训练强度、痉挛改善程度与血清BDNF含量增长率之间存在正相关性。

Objective:To observe the effects of different exercise intensities on the levels of lower limb spasticity and the expression of serum brain-derived neurotrophic factor(BDNF)in patients with incomplete spinal cord injury(SCI).Methods:A total of 60 patients with incomplete SCI were randomly divided into 3 groups with 20 cases each.Group A was defined as a control group that was treated with conventional rehabilitation.Group B received low-intensity exercise training to the lower limbs of patients using MOTOmed intelligent training based on the conventional rehabilitation.Group C was given high-intensity training to the lower limbs of patients using MOTOmed intelligent training based on conventional rehabilitation.Spasticity of the lower limbs was assessed by Modified Ashworth Scale(MAS)and Modified Tardieu Scale(MTS)at pre-intervention and the end of 4 weeks’therapeutic exercises when the concentration of BDNF in the serum was meanwhile tested and analyzed by ELISA.We also conducted correlation analysis among the intensity of exercise,the decrease of spasticity and the growth rate of serum BDNF concentrations.Results:The spasticity level of the lower limbs(AMS and MTS scores)in all three groups decreased after treatment as compared with that before treatment(P<0.05).After intervention,spasticity level(AMS and MTS scores)in group C was significantly lower than that in group A(P<0.05).Serum concentrations of BDNF in groups A and B after 4 weeks of treatment were increased as compared with those before treatment(P<0.05).The serum BDNF concentration after treatment in group C was significantly higher than that in groups A and B(P<0.05).There was a positive correlation between exercise intensity,the decrease of spasticity(MAS and MTS scores)and the increased rate of serum BDNF concentrations.Conclusions:Performing exercise,especially inhigh-intensity mode,could improve the spasticity of the lower limbs in patients with incomplete SCI.The content of serum BDNF can also be increased.Moreover,there is a positive correlation between the intensity of exercise,the decrease of spasticity and the increased rate of serum BDNF concentrations.