营养联合运动干预对脑卒中伴肌少症患者的效果

doi:10.3969/j.issn.1006-9771.2023.05.016

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (5): 595-600.doi: 10.3969/j.issn.1006-9771.2023.05.016

营养联合运动干预对脑卒中伴肌少症患者的效果

薛新宏, 王晓光, 陶徉聿, 李娜, 董静, 薛子娇, 蔡逢雨, 邢凤梅()

华北理工大学附属医院康复医学科，河北唐山市 063000

收稿日期:2022-11-08 修回日期:2023-03-24 出版日期:2023-05-25 发布日期:2023-06-19
通讯作者: 邢凤梅(1964-)，女，汉族，博士，教授，博士研究生导师，主要研究方向：老年人失能预防。E-mail：598461347@qq.com
作者简介:薛新宏(1972-)，女，汉族，河北唐山市人，硕士，主任医师，硕士研究生导师，主要研究方向：神经康复。
基金资助:
河北省医学适用技术跟踪项目(GZ2022063)

Effect of nutrition combined with exercise on stroke patients with sarcopenia

XUE Xinhong, WANG Xiaoguang, TAO Yangyu, LI Na, DONG Jing, XUE Zijiao, CAI Fengyu, XING Fengmei()

Department of Rehabilitation, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, China

Received:2022-11-08 Revised:2023-03-24 Published:2023-05-25 Online:2023-06-19
Contact: XING Fengmei, E-mail: 598461347@qq.com
Supported by:
Hebei Medical Applicable Technology Tracking Project(GZ2022063)

摘要/Abstract

摘要：

目的观察营养联合运动干预方法对脑卒中伴肌少症患者的疗效。

方法 2022年1月至6月，华北理工大学附属医院住院的脑卒中伴肌少症患者60例，随机分为对照组、营养组、运动组和联合组，每组各15例。4组均予常规康复训练，营养组增加营养干预，运动组增加运动干预，联合组增加营养和运动干预，共4周。干预前后采用生物阻抗分析法评估肌肉指数，握力计测量健侧和患侧握力，采用改良Barthel指数(MBI)和Berg平衡量表(BBS)评定日常活动能力和平衡功能。

结果对照组4例、营养组2例、运动组1例、联合组3例脱落。干预后，各组肌肉指数、握力、MBI评分、BBS评分均提高(|t| > 3.004, P < 0.05)，联合组各项指标优于其他3组(P < 0.05)，运动组健侧握力高于营养组(P < 0.05)。

结论联合应用营养和运动干预能有效提高脑卒中伴肌少症患者肌肉质量、握力、日常生活活动能力和平衡功能，联合应用效果更佳。

关键词: 脑卒中, 肌少症, 运动, 营养

Abstract:

Objective To explore the effect of nutrition combined with exercise intervention on stroke patients with sarcopenia.

Methods From January to June, 2022, 60 stroke patients with sarcopenia were randomly divided into control group (n = 15), nutrition group (n = 15), exercise group (n = 15) and combined group (n = 15). All the groups received routine rehabilitation training, while the nutrition group received nutrition intervention, the exercise group received exercise intervention, and the combined group received both the nutrition and exercise intervention, for four weeks. Before and after intervention, the muscle index was measured with bioelectrical impedance analysis, gripping strength of the healthy and the affected side was measured with gripping strength meter, and the patients were assessed with modified Barthel Index (MBI) and Berg Balance Scale (BBS).

Results Four cases in the control group, two in the nutrition group, one in the exercise group, and three in the combined group dropped down. The muscle index, gripping strength, and the scores of MBI and BBS improved in all the groups after intervention (|t| > 3.004, P < 0.05), while all improved more in the combined group than in the other three groups (P< 0.05), and the grip strength of the healthy side was more in the exercise group than in the nutrition group (P< 0.05).

Conclusion Nutrition or exercise intervention alone can improve the muscle quality, grip strength, activities of daily living and balance of stroke patients with sarcopenia, while the combination is more effective.

Key words: stroke, sarcopenia, exercise, nutrition

中图分类号:

R743.3

薛新宏, 王晓光, 陶徉聿, 李娜, 董静, 薛子娇, 蔡逢雨, 邢凤梅. 营养联合运动干预对脑卒中伴肌少症患者的效果[J]. 《中国康复理论与实践》, 2023, 29(5): 595-600.

XUE Xinhong, WANG Xiaoguang, TAO Yangyu, LI Na, DONG Jing, XUE Zijiao, CAI Fengyu, XING Fengmei. Effect of nutrition combined with exercise on stroke patients with sarcopenia[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(5): 595-600.

图/表 5

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组别	n	性别 (男/女)/n	年龄/岁	婚姻状况 (已婚/丧偶)/n	文化程度 (小学及以下/初中/中专或高中/大专及以上)/n	职业性质 (脑力劳动/体力劳动)/n	病变部位 (大脑/脑干/小脑/丘脑)/n
对照组	15	7/8	70.91±2.19	8/7	9/3/3/0	2/13	10/4/0/1
营养组	15	9/6	70.00±6.74	10/5	6/6/3/0	3/12	11/3/1/0
运动组	15	11/4	69.85±6.58	12/3	6/6/2/1	4/11	13/1/1/0
联合组	15	9/6	69.94±6.62	12/3	4/6/4/1	7/8	7/6/2/0
χ²/F值		2.228	0.014	3.317	6.233	4.397	10.269
P值		0.568	0.906	0.375	0.740	0.271	0.218

组别	n	干预前	干预后	t值	P值
对照组	11	7.49±2.40	9.06±3.76	-3.004	0.013
营养组	13	8.84±1.12	11.86±2.76^a	-4.084	0.002
运动组	14	8.96±1.98	13.32±2.51^a	-7.008	< 0.001
联合组	12	9.47±4.03	16.25±3.30^a,b,c	-8.627	< 0.001
F值		1.236	10.957
P值		0.307	< 0.001

组别	n	健侧		患侧		t值^d	P值^d	t值^e	P值^e
组别	n	干预前	干预后	干预前	干预后	t值^d	P值^d	t值^e	P值^e
对照组	11	18.50±11.64	19.85±11.76	2.60±4.97	5.15±5.16	-8.818	< 0.001	-7.824	< 0.001
营养组	13	19.14±12.00	24.49±11.95	5.23±9.69	10.64±9.97^a	-7.706	< 0.001	-18.459	< 0.001
运动组	14	24.67±9.39	30.37±9.96^a,b	4.55±7.47	11.17±7.57^a	-12.165	< 0.001	-15.767	< 0.001
联合组	12	27.02±8.31	33.05±2.60^a,b,c	7.93±7.09	17.69±6.18^a,b,c	-10.642	< 0.001	-15.927	< 0.001
F值		1.943	3.602	0.979	5.319
P值		0.136	0.020	0.411	0.003

组别	n	干预前	干预后	t值	P值
对照组	11	40.00±23.34	45.45±24.43	-6.708	< 0.001
营养组	13	36.92±14.07	61.53±10.48^a	-15.740	< 0.001
运动组	14	44.64±11.51	60.71±9.37^a	-8.446	< 0.001
联合组	12	44.16±12.02	71.66±8.34^a,b,c	-7.201	< 0.001
F值		0.717	6.660
P值		0.547	0.001

组别	n	干预前	干预后	t值	P值
对照组	11	11.27±8.86	17.72±11.10	-5.589	< 0.001
营养组	13	12.76±9.23	27.61±12.03^a	-17.949	< 0.001
运动组	14	11.50±8.94	28.28±12.02^a	-10.100	< 0.001
联合组	12	12.33±8.99	44.50±18.57^a,b,c	-10.610	< 0.001
F值		0.075	7.609
P值		0.973	< 0.001

营养联合运动干预对脑卒中伴肌少症患者的效果

Effect of nutrition combined with exercise on stroke patients with sarcopenia

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