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阻力训练可改善多发性硬化症患者的步态运动学。

Resistance training improves gait kinematics in persons with multiple sclerosis.

作者信息

Gutierrez Gregory M, Chow John W, Tillman Mark D, McCoy Sean C, Castellano Vanessa, White Lesley J

机构信息

Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.

出版信息

Arch Phys Med Rehabil. 2005 Sep;86(9):1824-9. doi: 10.1016/j.apmr.2005.04.008.

Abstract

OBJECTIVE

To evaluate the effects of an 8-week lower-body resistance-training program on walking mechanics in persons with multiple sclerosis (MS).

DESIGN

Repeated-measures design, evaluating gait kinematics before and after an 8-week progressive resistance-training intervention.

SETTING

Biomechanics laboratory and fitness center (with conventional, commercially available resistance-training equipment).

PARTICIPANTS

Eight ambulatory subjects with MS (age, 46.0+/-11.5 y) with Expanded Disability Status Scale scores ranging from 2.5 to 5.5.

INTERVENTION

An 8-week progressive resistance-training program.

MAIN OUTCOME MEASURES

Kinematic gait parameters including knee range of motion, duration of stance, swing, and double-support phases in seconds and as percentages of the stride time, percentage of stride time spent in stance, swing, and double-support phases, step length, foot angle, stride length, velocity, step width, and toe clearance for both the more affected and less affected lower limbs. Isometric strength, 3-minute stepping, fatigue, and self-reported disability were also measured.

RESULTS

After 2 months of resistance training, there were significant increases (P<.05) in percentage of stride time in the swing phase, step length, stride length, and foot angle; and significant decreases (P<.05) in percentage of stride time in the stance and double-support phases, duration of the double-support phase, and toe clearance. Isometric leg strength improved (P<.05) in 2 of the 4 muscle groups tested. Fatigue indices decreased (P=.04), whereas self-reported disability tended to decrease (P=.07) following the training program. Three-minute stepping increased by 8.7%.

CONCLUSIONS

Resistance training may be an effective intervention strategy for improving walking and functional ability in moderately disabled persons with MS.

摘要

目的

评估为期8周的下肢抗阻训练计划对多发性硬化症(MS)患者步行力学的影响。

设计

重复测量设计,评估8周渐进性抗阻训练干预前后的步态运动学。

设置

生物力学实验室和健身中心(配备传统的、市售的抗阻训练设备)。

参与者

8名可独立行走的MS患者(年龄46.0±11.5岁),扩展残疾状态量表评分在2.5至5.5之间。

干预

为期8周的渐进性抗阻训练计划。

主要观察指标

运动步态参数,包括膝关节活动范围、站立期、摆动期和双支撑期的持续时间(以秒为单位,并占步幅时间的百分比)、站立期、摆动期和双支撑期占步幅时间的百分比、步长、足角、步幅长度、速度、步宽以及患侧和未患侧下肢的脚趾离地高度。还测量了等长肌力、3分钟踏步试验、疲劳程度以及自我报告的残疾情况。

结果

经过2个月的抗阻训练后,摆动期占步幅时间的百分比、步长、步幅长度和足角显著增加(P<0.05);站立期和双支撑期占步幅时间的百分比、双支撑期持续时间和脚趾离地高度显著降低(P<0.05)。在测试的4个肌肉群中,有2个肌肉群的等长腿部力量有所改善(P<0.05)。疲劳指数降低(P=0.04),而训练计划后自我报告的残疾情况有下降趋势(P=0.07)。3分钟踏步试验增加了8.7%。

结论

抗阻训练可能是改善中度残疾MS患者步行和功能能力的有效干预策略。

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