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肌萎缩侧索硬化症患者抗阻运动的随机对照试验。

A randomized controlled trial of resistance exercise in individuals with ALS.

作者信息

Bello-Haas V Dal, Florence J M, Kloos A D, Scheirbecker J, Lopate G, Hayes S M, Pioro E P, Mitsumoto H

机构信息

School of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

Neurology. 2007 Jun 5;68(23):2003-7. doi: 10.1212/01.wnl.0000264418.92308.a4.

Abstract

OBJECTIVE

To determine the effects of resistance exercise on function, fatigue, and quality of life in individuals with ALS.

METHODS

Subjects with a diagnosis of clinically definite, probable, or laboratory-supported ALS, forced vital capacity (FVC) of 90% predicted or greater, and an ALS Functional Rating Scale (ALSFRS) score of 30 or greater were randomly assigned to a resistance exercise group that received a home exercise program consisting of daily stretching and resistance exercises three times weekly or to a usual care group, who performed only the daily stretching exercises. ALSFRS, the Fatigue Severity Scale (FSS), and Short Form-36 (SF-36) were completed at baseline and monthly for 6 months. FVC and maximum voluntary isometric contraction (MVIC) were monitored monthly throughout the study.

RESULTS

Of 33 subjects screened, 27 were randomly assigned (resistance = 13; usual care = 14). Eight resistance exercise subjects and 10 usual care subjects completed the trial. At 6 months, the resistance exercise group had significantly higher ALSFRS and SF-36 physical function subscale scores. No adverse events related to the intervention occurred, MVIC and FVC indicated no negative effects, and less decline in leg strength measured by MVIC was found in the resistance exercise group.

CONCLUSION

Our study, although small, showed that the resistance exercise group had significantly better function, as measured by total ALS Functional Rating Scale and upper and lower extremity subscale scores, and quality of life without adverse effects as compared with subjects receiving usual care.

摘要

目的

确定抗阻运动对肌萎缩侧索硬化症(ALS)患者的功能、疲劳及生活质量的影响。

方法

将诊断为临床确诊、很可能或实验室支持的ALS患者,其用力肺活量(FVC)为预测值的90%或更高,且ALS功能评定量表(ALSFRS)得分30分或更高,随机分为抗阻运动组,该组接受一项家庭锻炼计划,包括每周三次的每日伸展和抗阻运动,或分为常规护理组,该组仅进行每日伸展运动。在基线时以及之后6个月每月完成ALSFRS、疲劳严重程度量表(FSS)和简短健康调查问卷(SF-36)。在整个研究过程中每月监测FVC和最大自主等长收缩(MVIC)。

结果

在33名筛查的受试者中,27名被随机分组(抗阻运动组 = 13名;常规护理组 = 14名)。8名抗阻运动组受试者和10名常规护理组受试者完成了试验。在6个月时,抗阻运动组的ALSFRS和SF-36身体功能分量表得分显著更高。未发生与干预相关的不良事件,MVIC和FVC未显示负面影响,并且在抗阻运动组中发现通过MVIC测量的腿部力量下降较少。

结论

我们的研究虽然规模较小,但表明与接受常规护理的受试者相比,抗阻运动组在通过总ALS功能评定量表以及上肢和下肢分量表得分衡量的功能和生活质量方面显著更好,且无不良影响。

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