《中国康复理论与实践》

中国康复理论与实践 >

2019 , Vol. 25 >Issue 12: 1463 - 1468

DOI: https://doi.org/10.3969/j.issn.1006-9771.2019.12.016

临床研究

综合康复训练对老年慢性肾脏病并发肌少症的效果

  • 张勃 ,
  • 吴春薇 ,
  • 桂沛君 ,
  • 马清 ,
  • 张通 ,
  • 谢瑛
展开
  • 1. 首都医科大学康复医学院，北京市100068
    2.首都医科大学附属北京友谊医院 康复医学科，北京市 100050
    3.首都医科大学附属北京友谊医院，老年医学科，北京市100050
    4.中国康复研究中心北京博爱医院神经康复科，北京市 100068
张勃(1972-)，女，汉族，辽宁沈阳市人，副主任技师，主要研究方向：脏器康复、老年康复。

收稿日期: 2019-08-05

  修回日期: 2019-09-27

  网络出版日期: 2019-12-26

基金资助

1.北京市215高层次卫生技术人才学科骨干培训计划项目(No. 2015-3-004)；2.首都医科大学附属北京友谊医院科研启动基金项目(No. Z2018061230015)

收起

Effect of Structured Exercise Training on Old Patients with Chronic Kidney Disease Complicated with Sarcopenia

  • ZHANG Bo ,
  • WU Chun-wei ,
  • GUI Pei-jun ,
  • MA Qing ,
  • ZHANG Tong ,
  • XIE Ying
Expand
  • 1.Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
    2. Department of Physical Medicine and Rehabilitation Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
    3. Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
    4.Department of Neurology, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China

Received date: 2019-08-05

  Revised date: 2019-09-27

  Online published: 2019-12-26

Supported by

Supported by Program of the High-level technical Talents in Beijing Health System (No. 2015-3-004) and Research Foundation of Beijing Friendship Hospital, Capital Medical University (No. Z2018061230015)

Fold

摘要

目的 观察低中强度有氧运动联合抗阻运动对老年慢性肾脏病并发肌少症患者的临床疗效。 方法 选取2018年至2019年在本院老年科就诊的慢性肾脏病并发肌少症的老年患者11例，在常规内科治疗的基础上给予低中强度有氧运动联合抗阻运动干预。每运动单元包括有氧运动30~50 min联合抗阻运动20~30 min，每周3次，连续12周。运动前，运动24 h、6周和12周后，测量相关指标。 结果 与运动前比较，首次运动24 h后及6周和12周后，各项血脂和肾功能指标无明显变化(P > 0.05)。与运动前比较，运动6周后座椅前伸试验距离改善(P < 0.05)；运动12周后，四肢骨骼肌质量指数、握力指数、6米步速、峰值摄氧量(VO2peak)、睁眼单腿站立时间、座椅前伸试验距离均改善(P < 0.05)。与运动6周后比较，运动12周后，握力指数、6米步速、VO2peak、睁眼单腿站立时间改善(P < 0.05)。 结论 低中强度有氧运动联合抗阻运动综合康复训练对老年慢性肾脏病并发肌少症患者的肾功能无明显影响，但可以提高其肌肉质量、肌肉力量和运动功能。

关键词： 慢性肾脏病; 肌少症; 老年人; 有氧运动; 抗阻运动

本文引用格式

张勃 , 吴春薇 , 桂沛君 , 马清 , 张通 , 谢瑛 . 综合康复训练对老年慢性肾脏病并发肌少症的效果[J]. 中国康复理论与实践, 2019 , 25(12) : 1463 -1468 . DOI: 10.3969/j.issn.1006-9771.2019.12.016

Abstract

Objective To observe the clinical effect of low and medium intensity aerobic exercise combined with resistance exercise on patients with chronic kidney disease (CKD) complicated with sarcopenia. Methods From 2018 to 2019, 11 elderly patients with CKD complicated with sarcopenia were enrolled in this study. All the patients received low and medium intensity aerobic exercise combined with resistance exercise intervention on the basis of regular internal medical treatment. Each exercise section included 30 to 50 minutes of aerobic exercise and 20 to 30 minutes of resistance exercise, and was conducted three times a week for twelve weeks. Before exercise, and 24 hours, six weeks and twelve weeks after exercise, the related indicators were measured. Results No statistical difference in serum lipids and renal function indicators was found 24 hours after exercise, and six and twelve weeks post exercise (P > 0.05). Compared with pre-exercise condition, the reach in seat increased six weeks after exercise (P < 0.05); the appendicular skeletal muscle mass index, the grip strength index, the 6-meter walking speed, the peak oxygen uptake (VO2peak), the one-leg standing time and the reach in seat improved twelve weeks after exercise (P < 0.05). Compared with the results six weeks after exercise, the grip strength index, the 6-meter walking speed, VO2peak and the one-leg standing time improved twelve weeks after exercise (P < 0.05). Conclusion Structured exercise training of low and medium intensity aerobic exercise combined with resistance exercise training would not worsen the renal function of patients with CKD complicated with sarcopenia; however, it could improve the muscle mass, strength and motor function of them.

Key words： chronic kidney disease; sarcopenia; elderly; aerobic training; resistance training

参考文献

1 JhaV, Garcia-GarciaG, IsekiK, et al. Chronic kidney disease: global dimension and perspectives [J]. Lancet, 2013, 382(9888): 260-272.
2 ZhangL, WangF, WangL, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey [J]. Lancet, 2012, 379(9818): 815-822.
3 MoonS J, KimT H, YoonS Y, et al. Relationship between stage of chronic kidney disease and sarcopenia in Korean aged 40 years and older using the Korea National Health and Nutrition Examination Surveys (KNHANES IV-2, 3, and V-1, 2), 2008-2011 [J]. PLoS One, 2015, 10(6): e0130740.
4 StenvinkelP, CarreroJ J, von WaldenF, et al. Muscle wasting in end-stage renal disease promulgates premature death: established, emerging and potential novel treatment strategies [J]. Nephrol Dial Transplant, 2016, 31(7): 1070-1077.
5 HellbergM, HoqluneP, SvenssonP, et al. A decline in measured GFR is associated with a decrease in endurance, strength, balance and fine motor skills [J]. Nephrology (Carlton), 2017, 22(7), 513-519.
6 LeeheyD J, CollinsE, KramerH J, et al. Structured exercise in obese diabetic patients with chronic kidney disease: a randomized controlled trial [J]. Am J Nephrol, 2016, 44(1): 54-62.
7 张国林,郭兰,李河,等. 同步实时测峰值耗氧量与6 min步行试验[J]. 中国康复医学杂志, 2007, 22(7): 596-598.
8 季丽娜,曹力,陈大坤,等. 慢性肾脏疾病运动康复治疗的研究进展[J]. 中华肾脏病杂志, 2006, 22(8): 510-512.
9 张悦,叶志斌,吴兆龙. 运动致急性肾功能衰竭二例[J]. 中华肾脏病杂志, 2005, 21(6): 314.
10 郭琪. 慢性肾脏病的运动疗法[J]. 现代实用医学, 2017, 29(12): 1547-1549.
11 吴学敏,谢欲晓,孙启良,等. 不同负荷跑台运动对实验性自发性高血压慢性肾功能不全大鼠肾功能的影响[J]. 中国康复医学杂志, 2003, 18(2): 75-78.
12 YoshidaK, KawamuraT, XuH L, et al. Effects of exercise training on glomerular structure in fructose-fed spontaneously hypertensive rats [J]. Hypertens Res, 2003, 26(11): 907-914.
13 ChanD, CheemaB S. Progressive resistance training in end-stage renal disease-systematic review [J]. Am J Nephol, 2016, 44(1): 32-45.
14 AfsarB, SiriopolD, AslanG, et al. The impact of exercise on physical function, cardiovascular outcomes and quality of life in chronic kidney disease patients: a systematic review [J]. Int Urol Nephrol, 2018, 50(5): 885-904. DOI: 10.1007/s 11255-018-1790-4.
15 CigarroaI, BarrigaR, MicheasC, et al. [Effects of a resistance training program in patients with chronic kidney disease on hemodialysis] [J]. [in Spanish]. Rev Med Chil, 2016, 144(7): 844-852.
16 vandenW K, van CraenenbroeckA H, van BiesenW, et al. The effects of aerobic exercise on eGFR, blood pressure and VO2peak in patients with chronic kidney disease stages 3-4: asystematic review and meta-nalysis [J]. PLoS One, 2018, 13(9): e0203662. DOI: 10.1371/journal.pone.0203662.
17 WatsonE L, GreeningN J, VianaJ L, et al. Progressive resistance exercise training in CKD: a feasibility study [J]. Am J Kidney Dis, 2015, 66(2): 249-257.
18 Robinson-CohenC, KatzR, MozaffarianD, et al. Physical activity and rapid decline in kidney function among older adults [J]. Arch Intern Med, 2009, 169(22): 2116-2123.
19 HoodM S, LittleJ P, TarnoplskyM A, et al. Low-volume interval training improves muscle oxidative capacity in sedentary adults [J]. Med Sci Sports Exerc, 2011, 43(10): 1849-1856.
20 DomanskiM, CiechanowskiK. Sarcopenia: a major challenge in elderly patients with end-stage renal disease [J]. J Aging Res, 2012, 2012: 754739.
21 SouzaV A, OliveiraD, BarbosaS R, et al. Sarcopenia in patients with chronic kidney disease not yet on dialysis: analysis of the prevalence and associated factors [J]. PLoS One, 2017, 12(4): e0176230.
22 WooJ. Sarcopenia [J]. Clin Geriatr Med, 2017, 33(3): 305-314.
23 RoshanravanB, GamboaJ, WilundK. Baback Roshan Exercise and CKD: skeletal muscle dysfunction and practical application of exercise to prevent and treat physical impairments in CKD [J]. Am J Kidney Dis, 2017, 69(6): 837-852.
24 WatsonE L, GouldD W, WilkinsonT J. et al. Twelve-week combined resistance and aerobic training confers greater benefits than aerobic training alone in nondialysis CKD [J]. Am J Physiol Renal Physiol, 2018, 314(6): F1188-F1196.
25 FarringtonK, CovicA, NistorI, et al. Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR<45?mL/min/1.73 m2): a summary document from the European Renal Best Practice Group [J]. Nephrol Dial Transplant, 2017, 32(1): 9-16.
Options
文章导航

/

〈 〉