低强度运动控制训练对老年共病患者下肢肌肉衰减的影响

Effect of low-intensity exercise control training on attenuation of lower limb muscles in elderly patients with comorbidities

目的 探究低强度运动控制训练对老年共病患者下肢肌肉衰减的临床疗效和安全性,为老年共病患者延缓肌肉衰减提供新方法。方法 选择2019年1月—2020年10月于复旦大学附属华东医院康复医学科进行康复训练的老年共病患者40例,采用随机数字表法分为试验组(n=20)和对照组(n=20)。2组在接受所患共病常规治疗的同时,给予健康宣教和训练指导,试验组加用为期4周和每周5次的低强度运动控制训练。训练过程中,记录患者每次训练前后心率、血压、总工作量、总时间和训练过程中的自我感觉运动强度。在干预前后,2组分别进行30 s坐站测试,作为下肢肌力的评价指标。结果 与干预前比较,试验组干预后30 s坐站测试结果的次数明显增加(P<0.05),而对照组则没有明显变化(P>0.05),提示试验组患者下肢肌力改善优于对照组。低强度运动控制训练前后老年共病患者的平均心率差、平均收缩压差和平均舒张压差无明显变化,差异均无统计学意义(P>0.05),提示所有患者均无心脑血管等不良事件发生。试验组各项目第1~4周平均功率变化率逐渐增加,第2~4周平均功率变化率均明显高于同项目第1周(P<0.05)。低强度运动控制训练前后患者自我感觉运动强度无明显变化(P>0.05)。提示低强度运动控制训练可改善老年共病患者的下肢肌肉功率。结论 低强度运动控制训练可改善老年共病患者的下肢肌肉衰减,安全性好,可望成为无法耐受高强度运动负荷的老年共病患者用以延缓肌肉衰减的运动干预方法之一。

Objective To explore the clinical efficacy and safety of low-intensity exercise control training on the attenuation of lower limb muscles in elderly patients with comorbidity,so as to provide a new method for delaying muscle attenuation in elderly patients with comorbidities.Methods From January 2019 to October 2020,40 elderly patients with comorbidities who received rehabilitation training in the Department of Rehabilitation Medicine,Huadong Hospital Affiliated to Fudan University were selected and divided into the experimental group(n=20) and the control group(n=20).While receiving the routine treatment of comorbidity,both groups were given health education and training guidance.In addition,the experimental group received low intensity exercise control training for 4 weeks and 5 times a week.During the training,the heart rate,blood pressure,total workload,total time and self-feeling exercise intensity before and after each training of patients were recorded.Before and after the intervention,the patients underwent 30's sit to stand test as the evaluation index of lower limb muscle strength.Results Compared with pre-intervention,the number of 30's sit to stand test of the experimental group increased significantly after intervention(P0.05),indicating that the improvement of lower limb muscle strength of the patients in the experimental group was better than those in the control group.The mean heart rate difference,mean systolic pressure difference,and mean diastolic pressure difference before and after low-intensity exercise control training did not change significantly,and the difference was not statistically significant(P>0.05),indicating that no patients had adverse events such as cardiovascular and cerebrovascular events.The mean power change rates of each item in the experimental group increased gradually from the first week to the fourth week,and the mean power change rates in the second to the fourth week were significantly higher than those of the same item in the first week(P0.05).It was suggested that low-intensity exercise control training could improve the muscle power of lower limbs in elderly patients with comorbidities.Conclusion Low intensity exercise control training is safe and can improve the attenuation of lower limb muscles of elderly patients with comorbidities.It is expected to become one of an exercise intervention method for elderly patients with comorbidities who cannot tolerate high intensity exercise load to delay muscle attenuation.