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

Abstract

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

CLC Number:

R743.3

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.

Figures/Tables 6

References 23

[1]	朱小云. 等速肌力训练对脑卒中偏瘫患者上肢运动功能及步行能力的影响[D]. 扬州: 扬州大学, 2018.
	ZHU X Y. Effects of isokinetic muscle strength training on upper extremity motor function and walking ability in stroke patients with hemiplegia[D]. Yangzhou: Yangzhou University, 2018.
[2]	尹正录, 朱小云, 范章岭, 等. 等速肌力训练对脑卒中偏瘫患者上肢运动功能及日常生活活动能力的影响[J]. 中国康复理论与实践, 2017, 23(9): 1086-1090.
	YIN Z L, ZHU X Y, FAN Z L, et al. Effects of isokinetic strength training on upper limb motor function and activities of daily living in stroke patients with hemiplegia[J]. Chin J Rehabil Theory Pract, 2017, 23(9): 1086-1090.
[3]	宣磊, 吴建贤, 潘家武. 等速技术在康复医学领域中的研究进展[J]. 中国康复理论与实践, 2019, 25(7): 788-792.
	XUAN L, WU J X, PAN J W. Advance in isokinetic concept for rehabilitation medicine (review)[J]. Chin J Rehabil Theory Pract, 2019, 25(7): 788-792.
[4]	王原原. 等速肌力训练与测试在脑卒中偏瘫患者康复中的研究进展[J]. 中国医疗器械信息, 2019, 25(11): 53-54.
	WANG Y Y. Research progress of isokinetic muscle strength training and testing in rehabilitation of stroke patients with hemiplegia (review)[J]. Chin Med Device Inform, 2019, 25(11): 53-54.
[5]	RABELO M, FACHIN M E. Interrater and test/retest reliabilities of the isokinetic measurements: assessing strength and endurance of the trunk muscles in two different protocols for ablebodied and post-stroke hemiparesis[J]. Top Stroke Rehabil, 2018, 25(6): 424-431.
[6]	EKSTRAND E, LEXELL J, BROARDH C. Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke[J]. J Rehabil Med, 2015, 47(8): 706-713. doi: 10.2340/16501977-1990 pmid: 26181580
[7]	COROIAN F, JOURDAN C, BAKHTI K, et al. Upper limb isokinetic strengthening versus passive mobilization in patients with chronic stroke: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2018, 99(2): 321-328. doi: 10.1016/j.apmr.2017.08.490
[8]	林芳堃. 等速肌力测试训练仪对脑卒中偏瘫患者上肢运动功能及日常生活活动能力的影响[J]. 中国医疗器械信息, 2020, 26(3): 162-163.
	LIN F K. Effect of isokinetic muscle strength test training apparatus on upper extremity motor function and activities of daily living in patients with hemiplegia after stroke[J]. Chin Med Device Inform, 2020, 26(3): 162-163.
[9]	张浩天, 张倩, 朱婷, 等. 等速肌力训练对脑卒中偏瘫患者上肢运动功能康复影响的Meta分析[J]. 中国当代医药, 2021, 28(14): 4-7, 12.
	ZHANG H T, ZHANG Q, ZHU T, et al. Meta-analysis of the effect of isokinetic muscle strength training on upper extremity motor function rehabilitation in stroke patients with hemiplegia[J]. Chin Mod Med, 2021, 28(14): 4-7, 12.
[10]	范利, 杨坚, 张颖, 等. 等速肌力训练对偏瘫患者上肢运动功能恢复的影响[J]. 中国康复, 2017, 32(1): 10-12.
	FAN L, YANG J, ZHANG Y, et al. Effect of isokinetic muscle strength training on upper extremity motor function recovery in hemiplegic patients[J]. Chin J Rehabil, 2017, 32(1): 10-12.
[11]	郭铁成, 卫小梅, 陈小红. 改良Ashworth量表用于痉挛评定的信度研究[J]. 中国康复医学杂志, 2008, 23(10): 906-909.
	GUO T C, WEI X M, CHEN X H. Reliability of modified Ashworth Scale for spasticity assessment[J]. Chin J Rehabil Med, 2008, 23(10): 906-909.
[12]	CHEN L K, WOO J, ASSANTACHAI P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment[J]. J Am Med Dir Assoc, 2020, 21(3): 300-307. doi: 10.1016/j.jamda.2019.12.012
[13]	陈吉海, 史晓兰, 陆冰, 等. 不同年龄组老年肌肉减少症患者的特点分析[J]. 中华老年医学杂志, 2022, 41(4): 388-392.
	CHEN J H, SHI X L, LU B, et al. Characteristics of sarcopenia patients in different age groups[J]. Chin J Geriatr, 2022, 41(4): 388-392.
[14]	王鹏举. 基于生物电阻抗技术的人体成分分析方法研究[D]. 西安: 西安理工大学, 2021.
	WANG P J. Research on human body composition analysis method based on bioelectrical impedance technology[D]. Xi'an: Xi'an University of Technology, 2021.
[15]	杨乐, 张宝, 管石侠, 等. 不同性别不同年龄成年人体成分测量指标的检测分析[J]. 安徽医学, 2019, 40(11): 1276-1279.
	YANG L, ZHANG B, GUAN S X, et al. Detection and analysis of body composition measurement indexes of different sex and age adults[J]. Anhui Med J, 2019, 40(11): 1276-1279.
[16]	郭丽萍, 马志红, 郝燕菲. 北京某三级医院医务人员体脂成分与健康状况分析[J]. 河北医药, 2021, 43(6): 937-940.
	GUO L P, MA Z H, HAO Y F. Body fat composition and health status of medical staff in a tertiary hospital in Beijing[J]. Hebei Med J, 2021, 43(6): 937-940.
[17]	孙曈. 脑卒中肥胖指标与人体成分的相关性分析[D]. 长春: 吉林大学, 2021.
	SUN T. Correlation analysis of obesity index and body composition in patients with stroke[D]. Changchun: Jilin University, 2021.
[18]	杨子艳, 任姗姗, 李冠臻, 等. 老年糖尿病患者相位角与肌肉量减少的相关研究[J]. 中华老年医学杂志, 2022, 41(4): 397-400.
	YANG Z Y, REN S S, LI G Z, et al. Correlation between phase angle and muscle mass loss in elderly diabetic patients[J]. Chin J Geriatr, 2022, 41(4): 397-400.
[19]	周梦洁. 人体成分与代谢综合征的相关性研究[D]. 乌鲁木齐: 新疆医科大学, 2021.
	ZHOU M J. Correlation between body composition and metabolic syndrome[D]. Urumqi: Xinjiang Medical University, 2021.
[20]	袁嘉尧, 林燕平, 林贤灿, 等. 中老年人体成分与骨密度的关系[J]. 中国组织工程研究, 2022, 26(15): 2394-2399.
	YUAN J Y, LIN Y P, LIN X C, et al. Relationship between body composition and bone mineral density in middle-aged and elderly people[J]. Chin J Tissue Engineer Res, 2022, 26(15): 2394-2399.
[21]	张露萍, 周智明, 倪平, 等. 相位角在心力衰竭患者中应用的研究[J]. 心血管康复医学杂志, 2022, 31(1): 122-125.
	ZHANG L P, ZHOU Z M, NI P, et al. Application of phase angle in patients with heart failure[J]. Chin J Cardiovasc Rehabil Med, 2022, 31(1): 122-125.
[22]	张睿, 尚翠侠, 刘哲, 等. 人体成分分析在评估淋巴水肿程度及疗效中的应用[J]. 中国康复医学杂志, 2022, 37(3): 348-351.
	ZHANG R, SHANG C X, LIU Z, et al. The application of body composition analysis in evaluating the degree of lymphedema and therapeutic effect[J]. Chin J Rehabil Med, 2022, 37(3): 348-351.
[23]	李冬辉, 田喜凤, 马偲铭, 等. 天津市社区老年人肌少症患病率调查及影响因素分析[J]. 中国疗养医学, 2022, 31(6): 633-637. doi: 10.13517/j.cnki.ccm.2022.06.022
	LI D H, TIAN X F, MA C M, et al. Investigation of the prevalence rate of myasthenia gravis in the elderly in Tianjin community and analysis of its influencing factors[J]. Chin J Convalescent Med, 2022, 31(6): 633-637. doi: 10.13517/j.cnki.ccm.2022.06.022

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

Body composition of upper limbs for hemiplegic patients after isokinetic strength training

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组别	n	训练前	训练2周	训练4周	F值	P值
对照组	15	5.52±0.47	5.57±0.42	5.65±0.41	0.632	0.431
等速组	15	5.45±0.51	5.61±0.49	5.94±0.49^a	7.370	0.010
t值		0.409	-0.200	-1.766
P值		0.685	0.843	0.088

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