快走运动对肌肉减少症患者步行能力和握力以及血清GDF-8和IGF-1的影响

The effects of fast walking on persons with sarcopenia

目的观察快走运动训练对肌肉减少症患者步行速度、6 min步行距离(6MWT)、握力以及血清生长分化因子-8(GDF-8)、胰岛素样生长因子-1(IGF-1)的影响。方法选取肌肉减少症患者61例入组,按随机数字表法分为观察组(31例)和对照组(30例)。2组患者均给予常规药物治疗,观察组予快走运动(步速100~120步/min,中等强度60%最高心率为靶心率),对照组予常规散步运动(步速70~90步/min,低强度小于50%最高心率为靶心率),每次30 min,每周3次,共治疗12周。分别于治疗前和治疗12周后(治疗后),观察和比较2组患者的握力、步行速度、6MWT、四肢骨骼肌指数(ASMI)以及血清GDF-8、IGF-1的变化。结果治疗前,观察组和对照组患者(男性或女性)握力及ASMI的同性别组间差异均无统计学意义(P>0.05);治疗后,观察组男性和女性患者的握力及ASMI均较组内治疗前明显增高(P<0.05),且明显优于同性别对照组治疗后(P<0.05);但对照组治疗前后的握力及ASMI均无明显变化(P>0.05)。治疗后,观察组和对照组患者的步行速度[(0.62±0.04)和(0.59±0.02)m/s]、6MWT[(223.68±14.51)m和(210.03±6.71)m]及血清IGF-1[(178.39±10.25)和(160.47±5.89)μg/L]均较组内治疗前[观察组(0.57±0.05)m/s、(201.23±7.01)m、(145.00±8.85)μg/L;对照组(0.56±0.02)m/s、(200.13±7.16)m、(144.50±8.69)μg/L]明显增高(P<0.05),且观察组较对照组增高更为明显(P<0.05);但患者治疗前后血清GDF-8比较显示,观察组明显下降(P<0.05),而对照组无明显变化(P>0.05)。结论快走运动可显著增加肌少症患者的握力和ASMI,明显改善患者的步行能力及血清IGF-1和GDF-8水平。

Objective To observe any effect of fast walking on walking speed,6-minute walking test(6MWT)time,and on serum levels of growth differentiation factor-8(GDF-8)and insulin-like growth factor-1(IGF-1)in patients with sarcopenia.Methods A total of 61 sarcopenia patients were randomly divided into an observation group(n=31)and a control group(n=30).Both groups were given conventional drug therapy.In ad-dition,the observation group underwent 30-minutes of walking at 100-120 steps/min(about 60%of maximum heart rate)three times a week for 12 weeks.The control group also walked,but at 70-90 steps/min(less than 50%of maximum heart rate).Grip strength,walking speed,6MWT time,skeletal muscle index(ASMI)and serum GDF-8 and IGF-1 were compared before and after the intervention.Results There were no significant differences in grip strength or ASMI between observation group and control group(comparing males with males and females with females)before the experiment.Afterward,grip strength and ASMI in the observation group had in-creased significantly on average.Both were then significantly higher than the control groups′averages,which had not changed significantly.Average walking speed,6MWT time and serum IGF-1 levels had improved significantly in both groups,but the observation group′s average improvement was significantly greater.A significant decrease the average serum GDF-8 level was observed in the observation group,but not in the control group.Conclusion Fast walking can improve the walking of persons with sarcopenia,raise serum IGF-1 levels,and significantly reduce serum GDF-8.