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对抗长期卧床导致腰椎功能退化的对策:抗阻运动结合和不结合全身振动。

Countermeasures against lumbar spine deconditioning in prolonged bed rest: resistive exercise with and without whole body vibration.

机构信息

Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Berlin, Germany.

出版信息

J Appl Physiol (1985). 2010 Dec;109(6):1801-11. doi: 10.1152/japplphysiol.00707.2010. Epub 2010 Sep 23.

Abstract

To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise (n = 7), resistive exercise only (n = 8), or no exercise (n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups (P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only (P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen (P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.

摘要

为了评估短期、大负荷抗阻运动,联合或不联合全身振动对腰椎肌肉大小、椎间盘和脊柱形态变化以及长期卧床休息期间腰痛(LBP)发生率的影响,24 名受试者接受了 60 天的头低位卧床休息,并进行了抗阻振动运动(n=7)、仅抗阻运动(n=8)或不运动(n=9;第 2 届柏林卧床研究)。通过矢状面磁共振图像测量椎间盘和脊柱的形状。在旁轴磁共振图像上测量多裂肌、竖脊肌、腰方肌和腰大肌的横截面积(CSA)。通过定期问卷调查评估 LBP 的发生率。这些对策减少了多裂肌、腰椎竖脊肌和腰方肌的 CSA 损失,并且在对策组中观察到腰大肌 CSA 的增加更大(P ≤ 0.004)。全身振动对抗阻运动单独作用于这些肌肉变化的额外影响几乎没有统计学证据。运动组在卧床休息的第一周报告 LBP 的频率更高,但仅在仅抗阻运动组中具有统计学意义(P=0.011 与对照组相比,抗阻振动运动与对照组相比:P=0.56)。对策对脊柱形态变化没有影响(P≥0.22)。结果表明,每周 3 天进行大负荷抗阻运动,联合或不联合全身振动,可以减少腰椎肌肉萎缩,但需要进一步优化对策。

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