11至21岁脊髓功能障碍患者的有氧适能和上肢力量与理想体重及超重对照组的比较
Aerobic fitness and upper extremity strength in patients aged 11 to 21 years with spinal cord dysfunction as compared to ideal weight and overweight controls.
作者信息
Widman Lana M, Abresch Richard Ted, Styne Dennis M, McDonald Craig M
机构信息
University of California Davis School of Medicine, Davis, California, USA.
出版信息
J Spinal Cord Med. 2007;30 Suppl 1(Suppl 1):S88-96. doi: 10.1080/10790268.2007.11754611.
OBJECTIVE
To determine whether the aerobic fitness, upper extremity strength, and body composition in groups of adolescents with mobility impairment due to thoracic and upper lumbar spinal cord injury (SCI) or spina bifida (SB) are significantly different from those in groups of adolescents without mobility impairment who are of normal weight (CTRL) or overweight (OW).
SUBJECTS
One hundred fifteen total subjects were evaluated including 59 female (19 SB, 9 SCI, 17 OW, and 14 CTRL) and 56 male (18 SB, 10 SCI, 8 OW, and 20 CTRL) participants aged 11 to 21 years.
METHODS
Aerobic fitness was assessed using a ramp protocol with a magnetically braked arm ergometer. Heart rate and oxygen uptake (VO2) were recorded. Peak isokinetic upper arm and shoulder strength values were determined with a dynamometer. Body composition was estimated using dual energy x-ray absorptiometry (DEXA). Male and female subjects were categorized as overweight if their percent body fat by DEXA exceeded 25% and 30%, respectively. Results were analyzed with an ANOVA using the Bonferroni correction. Significance was accepted at P < 0.05.
RESULTS
The percent body fat of both the male and female SB and SCI subjects was significantly higher than CTRL but was not different than OW. In general, the shoulder extension and flexion strength in both the SB and SCI males and females was significantly lower than that of the CTRL and OW. The SCI and SB subjects had significantly reduced aerobic capacity (VO2/kg) compared to the CTRL subjects but were not different than the OW subjects. During the maximal exercise test, the SB and SCI subjects reached exhaustion at significantly lower workloads than the CTRL and OW subjects.
CONCLUSIONS
Patients age 11 to 21 years with SB and SCI had reduced aerobic capacity that was associated with being overweight and having reduced upper extremity strength. These data suggest that interventions to increase strength and fitness and to manage weight should be recommended in this population.
目的
确定因胸段和上腰段脊髓损伤（SCI）或脊柱裂（SB）导致行动不便的青少年组与体重正常（CTRL）或超重（OW）的无行动不便青少年组在有氧适能、上肢力量和身体成分方面是否存在显著差异。
受试者
共评估了115名受试者，包括59名女性（19名脊柱裂、9名脊髓损伤、17名超重和14名正常体重）和56名男性（18名脊柱裂、10名脊髓损伤、8名超重和20名正常体重），年龄在11至21岁之间。
方法
采用带有磁制动臂式测力计的递增运动方案评估有氧适能。记录心率和摄氧量（VO2）。用测力计测定等速上臂和肩部力量峰值。使用双能X线吸收法（DEXA）估算身体成分。如果男性和女性受试者通过DEXA测得的体脂百分比分别超过25%和30%，则被归类为超重。结果采用方差分析并进行Bonferroni校正。P<0.05时具有统计学意义。
结果
脊柱裂和脊髓损伤的男性和女性受试者的体脂百分比均显著高于正常体重组，但与超重组无差异。总体而言，脊柱裂和脊髓损伤的男性和女性的肩部伸展和屈曲力量均显著低于正常体重组和超重组。与正常体重组受试者相比，脊髓损伤和脊柱裂受试者的有氧能力（VO2/kg）显著降低，但与超重组受试者无差异。在最大运动测试中，脊柱裂和脊髓损伤受试者在显著低于正常体重组和超重组受试者的工作量下达到疲劳。
结论
11至21岁患有脊柱裂和脊髓损伤的患者有氧能力下降，这与超重和上肢力量下降有关。这些数据表明，应建议对该人群进行增强力量和适能以及控制体重的干预措施。
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