全身振动训练对高龄肌少症患者下肢运动功能的影响

Whole body vibration can improve the muscle strength, balance and walking ability of elderly persons with sarcopenia

目的观察侧交替全身振动训练对高龄肌少症患者下肢肌力、平衡及步行能力的影响。方法选取符合标准的高龄肌少症患者40例, 采用随机数字表法将其分为观察组及对照组, 每组20例。2组患者均给予常规康复训练(包括平衡功能训练和下肢肌力训练), 观察组患者在此基础上辅以侧交替全身振动训练(振动频率9~14 Hz, 振幅2~3 mm, 1 min/组, 5组/次, 5次/周)。于训练前、训练8周后评估2组患者下肢肌力、6 m步速、起立-行走计时(TUGT)、压力中心运动椭圆面积以及运动轨迹长度等指标。结果经8周干预后观察组髂腰肌肌力较训练前显著改善(P<0.05), 其余肌群肌力、6 m步速、TUGT计时、运动椭圆面积以及运动轨迹长度均较训练前极显著改善(P<0.01);对照组闭眼运动椭圆面积和睁眼运动轨迹长度均较治疗前显著改善(P<0.05), 股四头肌、胫前肌肌力、6 m步速、TUGT计时、睁眼时运动椭圆面积和闭眼时运动轨迹长度均较治疗前极显著改善(P<0.01)。通过组间比较发现, 干预后观察组双侧股四头肌[(24.35±6.20)kg和(24.38±6.12)kg]、左侧腘绳肌和胫前肌肌力[(24.99±3.78)kg和(24.32±5.42)kg]以及闭眼时运动轨迹长度[(655.85±94.56)mm]均极显著优于对照组水平(P<0.01);右侧腘绳肌和胫前肌肌力[(25.15±5.05)kg和(24.67±5.10)kg]、6 m步速[(0.84±0.17)m/s]、TUGT计时[(15.22±5.69)s]、睁眼及闭眼时运动椭圆面积[(456.30±94.32)mm2和(803.10±79.19)mm2]、睁眼时运动轨迹长度[(404.70±66.18)mm]亦显著优于对照组水平(P<0.05)。结论低频侧交替全身振动训练对高龄肌少症患者下肢肌力、平衡及步行功能均具有显著改善作用, 可作为防治高龄肌少症患者的有效干预手段。

Objective To observe any effect of alternate side whole body vibration on the muscle strength,balance and walking ability of persons with sarcopenia.Methods Forty elderly persons with sarcopenia were randomly divided into an experimental group and a control group,each of 20.Both groups received conventional balance and lower-limb muscle strength training,but the experimental group also received 9-14Hz whole body vibration treatment with an amplitude of 2-3mm,5 one-minute groups a day,5 times a week.Before and after 8 weeks of treatment,both groups′lower limb strength,6m step speed,exercise ellipse area,exercise track length,and Up and Go test(TUGT)time were measured.Results In the experimental group the average bilateral iliopsoas muscle strength and all the other measurements had improved significantly.In the control group,the exercise ellipse area with the eyes closed and the exercise track length with the eyes open and all the other measurements had improved significantly compared with before the training.But all of the experimental group′s outcomes were,on average,significantly better than those of the control group.Conclusion Low frequency vibration training can better improve the muscle strength,balance and walking ability of elderly persons with sarcopenia.It can be used for prevention as well as treatment.