不同强度血流限制训练联合低强度抗阻训练对老年脑卒中衰弱患者运动功能的影响

doi:10.3969/j.issn.1006-9771.2026.05.006

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (5): 561-570.doi: 10.3969/j.issn.1006-9771.2026.05.006

不同强度血流限制训练联合低强度抗阻训练对老年脑卒中衰弱患者运动功能的影响

安咏怡¹, 李雪梅², 常学优², 赵雅宁¹(), 黄海玲², 杨亚东¹

¹ 华北理工大学护理与康复学院，河北唐山市 063210
² 华北理工大学附属医院，河北唐山市 063000

收稿日期:2026-01-04 出版日期:2026-05-25 发布日期:2026-05-26
通讯作者: 赵雅宁，E-mail：993241832@qq.com
作者简介:安咏怡(2000-)，女，汉族，河北唐山市人，硕士研究生，护士，主要研究方向：康复护理。
赵雅宁(1974-)，女，汉族，河北唐山市人，博士，教授，主要研究方向：脑损伤与脑保护。
基金资助:
华北理工大学研究生创新项目(2025S06)

Effect of blood flow restriction training under different intensities combined with low-intensity resistance training on motor function in elderly stroke patients with frailty

AN Yongyi¹, LI Xuemei², CHANG Xueyou², ZHAO Yaning¹(), HUANG Hailing², YANG Yadong¹

¹ School of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei 063210, China
² Affiliated Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, China

Received:2026-01-04 Published:2026-05-25 Online:2026-05-26
Contact: ZHAO Yaning, E-mail: 993241832@qq.com
Supported by:
Graduate Student Innovation Fund of North China University of Science and Technology(2025S06)

摘要/Abstract

摘要：

目的探讨不同强度血流限制训练(BFRT)联合低强度抗阻训练(LIRT)对老年缺血性脑卒中伴衰弱患者运动功能的影响。
方法 2024年8月至2025年8月，华北理工大学附属医院200例缺血性脑卒中伴衰弱老年患者，随机分为对照组、观察1组、观察2组和观察3组，各50例。对照组采用30% 1RM抗阻训练；在此基础上，观察1~3组均分别接受40%动脉闭塞压(AOP)、50% AOP和60% AOP的BFRT，共8周。训练前，训练4周和8周后，采用Fugl-Meyer评定量表上肢部分(FMA-UE)和下肢部分(FMA-LE)、握力测试、10米步行测试(10MWT)和Berg平衡量表(BBS)评估运动功能，采用Fried衰弱表型(FFP)评估衰弱状态，采用改良Ashworth量表(MAS)评估肌张力，测量血压和静息心率。
结果 4组各脱落1例。FMA-UE评分、FMA-LE评分、双手握力、10MWT和BBS评分的组内、组间和交互效应均显著(F>2.745, P<0.05)。训练4周后，观察1~3组的各指标均高于对照组(P<0.05)。训练8周后，观察3组FMA-UE、FMA-LE、左右手握力和BBS评分均优于观察1~2组(P<0.05)，10MWT优于观察1组(P<0.05)。FFP评分的组内效应显著(F=688.360, P<0.001)，组间效应和交互效应均不显著(P>0.05)。MAS评分的组内效应显著(F=7.171, P=0.008)，组间效应和交互效应均不显著(P>0.05)。收缩压、舒张压和静息心率的组内、组间和交互效应均不显著(P>0.05)。
结论 BFRT联合LIRT可安全有效地改善老年缺血性脑卒中衰弱患者的肢体运动功能、握力、步行与平衡能力，60% AOP效果可能更优。

关键词: 脑卒中, 衰弱, 血流限制训练, 抗阻运动, 运动功能

Abstract:

Objective To explore the effect of blood flow restriction training (BFRT) under different intensities combined with low-intensity resistance training (LIRT) on motor function in stroke patients with frailty.
Methods From August, 2024 to August, 2025, 200 elderly ischemic stroke patients with frailty from Affiliated Hospital, North China University of Science and Technology were randomized into control group and observation groups 1, 2 and 3, with 50 cases in each group. All the groups received 30% 1RM resistance training. In addition, the observation groups received BFRT of 40%, 50% and 60% arterial occlusion pressure (AOP), respectively. Before training, and four and eight weeks after training, their motor function was evaluated with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Fugl-Meyer Assessment-Lower Extremities (FMA-LE), grip strength, 10-Metre Walk Test (10MWT) and Berg Balance Scale (BBS); Fried Frailty Phenotype (FFP) was used to assess frailty status; and the score of modified Ashworth Scale (MAS), blood pressure and resting heart rate were recorded.
Results One case dropped out in each group. For the scores of FMA-UE and FMA-LE, the grip strength of both hands, the time of 10MWT and the score of BBS, the main effects of group and time, and interaction effect were all significant (F>2.745, P<0.05); four weeks after training, the above indexes were better in the observation groups than in the control group (P<0.05); eight weeks after training, the scores of FMA-UE and FMA-LE, the grip strength of both hand and the score of BBS were better in the observation group 3 than in the observation groups 1 and 2 (P<0.05), and the time of 10MWT was better in the observation group 3 than in the observation group 1 (P<0.05). For the score of FFP, the main effect of group was significant (F=688.360, P<0.001), however, the effects of time and interaction were not significant (P>0.05). For the score of MAS, the main effect of group was significant (F=7.171, P=0.008), however, the effects of time and interaction were not significant (P>0.05). For the blood pressure and resting heart rate, the main effects of group and time, and interaction effect were not significant (P>0.05).
Conclusion BFRT under different intensities combined with LIRT can safely improve the motor function, grip strength, walking ability in elderly stroke patients, and 60% AOP may be more effective.

Key words: stroke, frailty, blood flow restriction training, resistance exercise, motor function

中图分类号:

R743.3

安咏怡, 李雪梅, 常学优, 赵雅宁, 黄海玲, 杨亚东. 不同强度血流限制训练联合低强度抗阻训练对老年脑卒中衰弱患者运动功能的影响[J]. 《中国康复理论与实践》, 2026, 32(5): 561-570.

AN Yongyi, LI Xuemei, CHANG Xueyou, ZHAO Yaning, HUANG Hailing, YANG Yadong. Effect of blood flow restriction training under different intensities combined with low-intensity resistance training on motor function in elderly stroke patients with frailty[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(5): 561-570.

图/表 8

表1

表2

表3

表4

各组肢体运动功能干预4周和8周的事后LSD差异检验结果"

变量	组别		训练4周后				训练8周后
			平均值差	P值	95%CI		平均值差	P值	95%CI
			平均值差	P值	上限	下限	平均值差	P值	上限	下限
FMA-UE	对照组	观察1组	-2.653	0.045	-0.060	-5.250	-3.776	0.006	-1.090	-6.460
	对照组	观察2组	-3.122	0.019	-0.530	-5.720	-4.265	0.002	-1.580	-6.950
	对照组	观察3组	-4.694	<0.001	-2.100	-7.290	-7.102	<0.001	-4.410	-9.790
	观察1组	观察2组	-0.469	0.722	2.130	-3.070	-0.490	0.720	2.200	-3.180
	观察1组	观察3组	-2.041	0.123	0.560	-4.640	-3.327	0.016	-0.640	-6.010
	观察2组	观察3组	-1.571	0.234	1.020	-4.170	-2.837	0.039	-0.150	-5.520
FMA-LE	对照组	观察1组	-1.559	0.006	-0.320	-2.798	-1.539	0.008	-0.283	-2.795
	对照组	观察2组	-1.731	<0.001	2.935	0.527	-2.200	<0.001	-0.960	-3.441
	对照组	观察3组	-2.102	<0.001	3.497	0.706	-3.592	<0.001	-2.372	-4.812
	观察1组	观察2组	-0.171	0.999	0.884	-1.227	-0.661	0.367	0.319	-1.642
	观察1组	观察3组	-0.542	0.829	1.816	-0.731	-2.052	<0.001	3.007	1.098
	观察2组	观察3组	-0.371	0.963	1.610	-0.868	1.391	<0.001	2.324	0.458
左手握力	对照组	观察1组	-1.762	0.007	-0.481	-3.043	-2.795	<0.001	-1.357	-4.233
	对照组	观察2组	-2.134	0.001	-0.853	-3.416	-3.308	<0.001	-1.870	-4.746
	对照组	观察3组	-2.416	<0.001	-1.134	-3.697	-4.858	<0.001	-3.420	-6.296
	观察1组	观察2组	-0.372	0.567	0.909	-1.653	-0.512	0.483	0.925	-1.950
	观察1组	观察3组	-0.653	0.316	0.627	-1.935	-2.062	0.005	-0.624	-3.500
	观察2组	观察3组	-0.281	0.666	1.000	-1.562	-1.549	0.035	-0.111	-2.987
右手握力	对照组	观察1组	-1.379	0.018	-0.237	-2.522	-2.259	<0.001	-0.933	-3.584
	对照组	观察2组	-1.704	0.004	-0.561	-2.846	-2.820	<0.001	-1.495	-4.145
	对照组	观察3组	-2.522	<0.001	-1.379	-3.664	-4.971	<0.001	-3.646	-6.296
	观察1组	观察2组	-0.324	0.576	0.817	-1.467	-0.561	0.404	0.763	-1.886
	观察1组	观察3组	-1.142	0.050	-0.000	-2.285	-2.712	<0.001	-1.387	-4.037
	观察2组	观察3组	-0.818	0.159	0.324	-1.960	-2.150	0.002	-0.825	-3.475
10MWT	对照组	观察1组	1.845	0.046	3.661	0.296	2.814	0.001	4.508	1.120
	对照组	观察2组	2.072	0.026	3.887	0.256	3.163	<0.001	4.857	1.469
	对照组	观察3组	2.396	0.010	4.212	0.580	4.723	<0.001	6.417	3.029
	观察1组	观察2组	0.226	0.806	2.042	-1.589	0.348	0.685	2.042	-1.344
	观察1组	观察3组	0.550	0.550	2.366	-1.265	1.908	0.027	3.602	0.215
	观察2组	观察3组	0.324	0.725	2.140	-1.491	1.560	0.071	3.253	-0.133
BBS	对照组	观察1组	-2.796	0.029	-0.300	-5.300	-3.204	0.016	-0.610	-5.800
	对照组	观察2组	-3.163	0.013	-0.660	-5.660	-3.776	0.005	-1.180	-6.370
	对照组	观察3组	-3.694	0.004	-1.190	-6.190	-6.571	<0.001	-3.980	-9.170
	观察1组	观察2组	-0.367	0.772	2.130	-2.870	-0.571	0.664	2.020	-3.170
	观察1组	观察3组	-0.898	0.480	1.600	-3.400	-3.367	0.011	-0.770	-5.960
	观察2组	观察3组	-0.531	0.676	1.970	-3.030	-2.796	0.035	-0.200	-5.390

表4

表5

表6

表7

表8

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组别	n	性别 (男/女)/n	年龄/岁	病程/d	体质量指数 /(kg·m^-2)	并发症/n	病变部位 (LACI/POCI/PACI)/n
对照组	50	25/25	66.88±5.11	15.10±1.16	25.58±3.99	1.16±0.46	29/3/18
观察1组	50	27/23	66.44±4.94	15.30±1.12	25.23±2.96	1.32±0.62	24/6/20
观察2组	50	25/25	66.86±5.48	15.60±1.12	24.39±3.74	1.34±0.71	27/6/17
观察3组	50	22/28	68.78±5.09	15.28±0.94	24.53±3.17	1.08±0.69	24/5/21
χ²/F值		1.020	2.054	1.790	1.315	1.977	2.419
P值		0.796	0.108	0.150	0.271	0.119	0.877

项目	组别	n	训练前		训练4周后		训练8周后
项目	组别	n	均值	标准差	均值	标准差	均值	标准差
FMA-UE	对照组	49	39.69	5.65	41.02	5.83	42.78	6.04
	观察1组	49	40.04	6.11	43.67	6.51	46.55	6.99
	观察2组	49	40.49	6.66	44.14	6.64	47.04	6.76
	观察3组	49	41.98	6.15	45.71	7.00	49.88	7.12
FMA-LE	对照组	49	21.86	2.19	23.24	2.51	24.75	2.69
	观察1组	49	22.24	1.84	24.80	2.02	26.28	1.84
	观察2组	49	22.06	2.02	24.97	1.86	26.95	1.77
	观察3组	49	22.37	2.02	25.34	2.62	28.34	1.66
左手握力/磅	对照组	49	18.34	2.57	19.88	2.67	21.63	2.75
	观察1组	49	18.37	2.01	21.64	2.51	24.42	3.18
	观察2组	49	18.38	2.39	22.01	3.51	24.94	3.62
	观察3组	49	18.56	2.78	22.29	3.94	26.49	4.60
右手握力/磅	对照组	49	19.05	1.55	20.57	1.93	22.34	2.47
	观察1组	49	18.70	2.21	21.95	2.67	24.60	3.15
	观察2组	49	18.64	2.29	22.28	3.56	25.16	3.53
	观察3组	49	19.47	2.19	23.10	3.04	27.31	3.95
10MWT/s	对照组	49	22.54	4.59	21.38	4.69	19.84	4.83
	观察1组	49	22.21	4.34	19.54	4.19	17.03	4.21
	观察2组	49	22.39	5.37	19.31	4.70	16.68	4.35
	观察3组	49	22.27	5.18	18.99	4.61	15.12	3.50
BBS	对照组	49	28.82	6.13	30.14	6.05	31.78	6.57
	观察1组	49	29.31	5.56	32.94	6.76	34.98	6.74
	观察2组	49	29.71	5.41	33.31	5.81	35.55	6.07
	观察3组	49	30.27	6.00	33.84	6.42	38.35	6.63

变量	效应	平方和	自由度	均方	F值	P值
FMA-UE	组内	3540.881	2	2284.553	658.586	<0.001
	组间	1638.726	3	546.242	4.534	0.004
	组内×组间	310.724	3	103.575	25.324	<0.001
FMA-LE	组内	1948.585	2	1123.572	891.002	<0.001
	组间	326.040	3	108.680	9.649	<0.001
	组内×组间	134.659	3	44.886	20.525	<0.001
左手握力	组内	3476.875	2	2017.410	731.418	<0.001
	组间	492.177	3	164.059	6.654	<0.001
	组内×组间	278.766	3	92.922	27.944	<0.001
右手握力	组内	3392.556	2	1956.360	766.863	<0.001
	组间	517.981	3	172.660	8.985	<0.001
	组内×组间	268.829	3	89.610	29.147	<0.001
10MWT	组内	2635.592	2	1815.156	660.360	<0.001
	组间	484.152	3	161.384	2.745	0.044
	组内×组间	252.637	3	84.212	26.199	<0.001
BBS	组内	3120.718	2	1986.226	752.209	<0.001
	组间	1163.347	3	387.782	3.490	0.017
	组内×组间	360.724	6	76.529	28.983	<0.001

效应	平方和	自由度	均方	F值	P值
组内	201.796	2	117.056	688.360	<0.001
组间	3.946	3	1.315	1.709	0.167
组内×组间	0.585	6	0.113	0.665	0.591

项目	组别	n	训练前		训练后
项目	组别	n	均值	标准差	均值	标准差
MAS	对照组	49	0.06	0.24	0.02	0.02
	观察1组	49	0.04	0.20	0.02	0.14
	观察2组	49	0.10	0.30	0.04	0.20
	观察3组	49	0.08	0.27	0.06	0.24
收缩压/mmHg	对照组	49	130.59	12.66	130.51	12.13
	观察1组	49	130.63	10.81	130.88	10.27
	观察2组	49	132.22	11.75	132.08	12.10
	观察3组	49	132.51	13.26	132.73	11.82
舒张压/mmHg	对照组	49	79.08	9.44	78.45	9.60
	观察1组	49	76.35	10.52	76.37	9.72
	观察2组	49	77.20	9.11	75.90	9.41
	观察3组	49	78.39	10.06	78.43	9.84
静息心率/min^-1	对照组	49	71.53	7.27	71.39	7.43
	观察1组	49	72.14	6.25	71.49	6.39
	观察2组	49	71.39	7.62	72.55	8.15
	观察3组	49	73.67	9.49	73.33	9.52

不同强度血流限制训练联合低强度抗阻训练对老年脑卒中衰弱患者运动功能的影响

Effect of blood flow restriction training under different intensities combined with low-intensity resistance training on motor function in elderly stroke patients with frailty

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变量	效应	平方和	自由度	均方	F值	P值
MAS	组内	0.125	1	0.125	7.171	0.008
	组间	0.130	3	0.043	0.513	0.674
	组内×组间	0.028	3	0.009	0.537	0.658
SBP	组内	0.367	1	0.367	0.121	0.728
	组间	307.735	3	102.578	0.367	0.777
	组内×组间	3.000	3	1.000	0.330	0.804
DBP	组内	21.592	1	21.592	2.323	0.129
	组间	453.816	3	151.272	0.841	0.473
	组内×组间	30.061	3	10.020	1.078	0.360
RHR	组内	0.003	1	0.003	0.000	0.993
	组间	238.967	3	79.656	0.885	0.450
	组内×组间	47.048	3	15.683	0.469	0.704

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组别	n	训练前		训练4周后		训练8周后
组别	n	均值	标准差	均值	标准差	均值	标准差
对照组	49	3.67	0.47	2.57	0.54	2.43	0.57
观察1组	49	3.59	0.49	2.51	0.58	2.24	0.59
观察2组	49	3.61	0.60	2.47	0.68	2.22	0.65
观察3组	49	3.49	0.50	2.41	0.64	2.08	0.73