发散式体外冲击波联合抗阻运动治疗老年原发性肌肉减少症

Radial extracorporeal shockwave combined with resistance exercise for treating senile primary sarcopenia

背景:老年原发性肌肉减少症有多种治疗手段,但均因其局限性而在临床推广受限,寻找安全、患者依从性好的治疗手段很有必要。目的:探索发散式体外冲击波疗法联合抗阻运动对老年原发性肌肉减少症的临床疗效。方法:收集2021年2-8月于锦州医科大学附属第一医院就诊的40例老年原发性肌肉减少症患者,通过计算机随机数字表法分为对照组、治疗组,每组20例。两组均采用抗阻运动,治疗组在抗阻运动基础上增加发散式体外冲击波治疗,记录两组患者治疗前及治疗4,8周后的四肢骨骼肌质量指数、步行速度、伸膝肌力、大腿周径、血清胰岛素生长因子1质量浓度,并对数据进行统计分析。结果与结论:①对照组的骨骼肌质量指数、步行速度、伸膝肌力、大腿周径、血清胰岛素生长因子1质量浓度等指标在不同时间点差异均有显著性意义(P<0.05);②治疗组的骨骼肌质量指数、步行速度、伸膝肌力、大腿周径、血清胰岛素生长因子1浓度等指标在不同时间点差异均有显著性意义(P<0.05);③治疗4,8周后,治疗组的伸膝肌力、血清胰岛素生长因子1质量浓度的改善程度均优于对照组(P<0.05);④治疗8周后,治疗组大腿周径的改善程度优于对照组(P<0.05);⑤提示与抗阻训练相比,发散式体外冲击波结合抗阻训练更能促进肌肉质量与功能的恢复,延缓老年原发性肌肉减少症的发生与发展。

BACKGROUND:Various treatment methods for senile primary sarcopenia have been developed,but all of them are restrictedly used in clinical practice due to their limitations.Therefore,it is necessary to find a safe treatment with good patient compliance.OBJECTIVE:To explore the clinical effect of radial extracorporeal shockwave therapy combined with resistance exercise on senile primary sarcopenia.METHODS:Forty elderly patients with primary sarcopenia admitted in the First Affiliated Hospital of Jinzhou Medical University from February to August 2021 were collected and randomly divided into control group and treatment group with 20 cases in each group.Both two groups were subjected to resistance exercise.The treatment group was treated with radial extracorporeal shockwave therapy based on resistance exercise.Skeletal muscle index,walking speed,knee extension muscle strength,thigh circumference,and serum insulin growth factor-1 level were recorded before treatment and after 4 weeks and 8 weeks of treatment.All data were statistically analyzed.RESULTS AND CONCLUSION:Significant differences were found in skeletal muscle index,walking speed,knee extensor strength,thigh circumference and serum insulin growth factor-1 level in both control and treatment groups at different time points(P<0.05).After 4 and 8 weeks of treatment,knee extensor strength and serum insulin growth factor-1 level were significantly better in the treatment group than the control group(P<0.05).After 8 weeks of treatment,the circumference of the thigh was significantly improved in the treatment group compared with the control group(P<0.05).These findings indicate that compared with resistance training alone,radial extracorporeal shockwave therapy combined with resistance training can better promote the recovery of muscle quality and function and delay the occurrence and development of senile primary sarcopenia.