等速肌力训练对脑卒中偏瘫患者上肢身体成分的影响

doi:10.3969/j.issn.1006-9771.2022.11.005

摘要/Abstract

摘要：

目的研究等速肌力训练后反映脑卒中偏瘫患者肌肉情况的身体成分变化。

方法 2021年1月至2022年4月，南开大学附属北辰医院住院脑卒中偏瘫患者30例，随机分为对照组和等速组，各15例。对照组予常规康复训练，等速组在对照组基础上增加患侧肩、肘关节等速肌力训练，分别于训练前、训练2周、训练4周时测量瘦体质量、患侧上臂肌肉围度、患侧上肢肌肉量、浮肿指数和骨骼肌指数。

结果与对照组相比，等速组训练后浮肿指数均下降(t > 2.536, P < 0.05)；训练4周后，患侧上肢肌肉量增加(t = -2.750, P = 0.010)。

结论脑卒中偏瘫患者增加等速肌力训练，有利于改善患侧上肢水肿和废用性肌萎缩。

关键词: 脑卒中, 偏瘫, 等速肌力训练, 体成分, 肌肉量

Abstract:

Objective To study the changes of body composition indexes reflecting muscle condition for stroke hemiplegic patients after isokinetic strength training.

Methods From January, 2021 to April, 2022, 30 stroke inpatients with hemiplegia in Beichen Hospital of Nankai University were randomly divided into control group (n = 15) and isokinetic group (n = 15). Both groups accepted routine rehabilitation training, while the isokinetic group accepted isokinetic strength training of shoulder and elbow on the affected side in addition. All patients were tested the lean body mass, affected upper arm muscle circumference, affected upper limb muscle mass, edema index, skeletal muscle index before, and two weeks and four weeks after training.

Results Compared with the control group, the edema index decreased in isokinetic group after training (t > 2.536, P < 0.05); the affected upper limb muscle mass increased more in the isokinetic group four weeks after training (t = -2.750, P = 0.010).

Conclusion Isokinetic training can reduce edema and muscular disuse atrophy of the affected side for stroke patients with hemiplegia.

Key words: stroke, hemiplegia, isokinetic strength training, body composition, muscle mass

中图分类号:

R743.3

丁晓晶,王勇军,姜云虎,马金娇,赵健,黄坤,王龙. 等速肌力训练对脑卒中偏瘫患者上肢身体成分的影响[J]. 《中国康复理论与实践》, 2022, 28(11): 1265-1269.

DING Xiaojing,WANG Yongjun,JIANG Yunhu,MA Jinjiao,ZHAO Jian,HUANG Kun,WANG Long. Body composition of upper limbs for hemiplegic patients after isokinetic strength training[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(11): 1265-1269.

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组别	n	性别(男/女)/n	年龄/岁	病程/d	Brunnstrom分期 (Ⅲ/Ⅳ期)/n	MAS分级 (0/Ⅰ/Ⅰ⁺/Ⅱ级)/n
对照组	15	10/5	61.53±9.86	48.20±8.55	8/7	4/5/4/2
等速组	15	11/4	61.00±10.68	47.53±7.14	7/8	5/4/4/2
Z/t值		-0.392	0.142	0.232	-0.359	-0.194
P值		0.695	0.888	0.818	0.720	0.846

组别	n	训练前	训练2周	训练4周	F值	P值
对照组	15	36.56±3.44	36.56±3.29	36.78±3.33	0.032	0.858
等速组	15	36.93±3.99	37.59±3.74	38.69±3.46	1.660	0.205
t值		-0.274	-0.803	-1.543
P值		0.786	0.429	0.134

组别	n	训练前	训练2周	训练4周	F值	P值
对照组	15	20.77±1.32	20.76±1.25	20.90±1.26	0.074	0.787
等速组	15	20.58±1.55	20.82±1.46	21.42±1.45	2.388	0.130
t值		0.367	-0.121	-1.049
P值		0.716	0.905	0.303

组别	n	训练前	训练2周	训练4周	F值	P值
对照组	15	1.78±0.19	1.79±0.19	1.80±0.18	0.031	0.861
等速组	15	1.82±0.21	1.87±0.21	1.98±0.18^a	4.608	0.038
t值		-0.578	-1.302	-2.750
P值		0.568	0.204	0.010

组别	n	训练前	训练2周	训练4周	F值	P值
对照组	15	0.409±0.011	0.405±0.009	0.401±0.007^a	6.171	0.017
等速组	15	0.408±0.014	0.396±0.010^b	0.387±0.007^c,d	24.958	< 0.001
t值		0.340	2.536	4.854
P值		0.736	0.017	< 0.001