补充维生素D和等速训练对重度烧伤儿童肌肉力量、爆发力、瘦体重和步态的影响：一项随机对照试验。
Effect of vitamin D supplementation and isokinetic training on muscle strength, explosive strength, lean body mass and gait in severely burned children: A randomized controlled trial.
作者信息
Ebid Anwar Abdelgayed, El-Shamy Shamekh Mohamed, Amer Maysa Abbas
机构信息
Department of Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Department of Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
出版信息
Burns. 2017 Mar;43(2):357-365. doi: 10.1016/j.burns.2016.08.018. Epub 2016 Oct 27.
OBJECTIVE
To determine the effects of vitamin D (VD) supplementation and isokinetic training on muscle strength, explosive strength (counter movement jump) (ES), lean body mass (LBM) and gait parameters in severe pediatric burn.
METHODS
Forty-eight burned children with circumferential lower extremity burns covering 40-55% of the total body surface area (TBSA), aged 10-16 years (Mean±SD 13.01±1.75), were randomized into the standard of care (n=16), isokinetic (n=17) and VD (n=15) groups. Unburned children (n=20) served as matched controls. All burned children received 12 weeks of routine physical therapy program (RPTP). In addition, the isokinetic group received isokinetic training for the quadriceps dominant limb 3 times per week at angular velocity 150°/s, and the VD group received the isokinetic training plus an oral daily dose of vitamin D 1000 IU (Cholecalciferol). The primary measures, assessed at baseline and 12 weeks, included quadriceps strength by isokinetic dynamometer, ES, LBM by dual-energy X-ray absorptiometry (DEXA) and gait parameters by GAITRite system.
RESULTS
The VD and isokinetic groups showed significant improvement in quadriceps strength, ES, LBM and gait parameters compared with the standard of care, and VD group show significant improvement in the VD level as compared with the other groups. The outcome measures (and percent of improvement where applicable) for the VD, isokinetic and standard of care are as follows: quadriceps strength, 85.25±0.93Nm (85%), 64.25±0.93 (36%) and 51.88±1.31Nm (12%); stride length, 94.00±2.69 (7%), 110.60±2.87 (25%) and 139.56±2.57 (60%); step length, 67.26±2.45 (72%), 55.25±2.49 (43%) and 43.76±1.34 (18%); velocity, 133.94±1.65 (82%), 99.94±1.65 (35%) and 80.11±1.91 (9%); and cadence, 140.63±1.36 (68%), 132.63±1.36 (58%) and 90.35±1.32 (9%), VD level 43.33±7.48 (75%), 24.77±7.38 (5%) and 25.63±8.39 (4%) respectively.
CONCLUSIONS
VD supplementation combined with exercise training significantly increased muscle strength, ES, LBM, gait and VD level in severely burned children.
目的
确定补充维生素D（VD）和等速训练对重度小儿烧伤患者肌肉力量、爆发力（反向运动跳跃）（ES）、瘦体重（LBM）和步态参数的影响。
方法
48例年龄10 - 16岁（平均±标准差13.01±1.75）、下肢环形烧伤面积占全身表面积（TBSA）40 - 55%的烧伤儿童被随机分为标准治疗组（n = 16）、等速训练组（n = 17）和VD组（n = 15）。20例未烧伤儿童作为匹配对照。所有烧伤儿童均接受为期12周的常规物理治疗方案（RPTP）。此外，等速训练组每周对优势股四头肌进行3次等速训练，角速度为150°/秒，VD组在进行等速训练的同时，每天口服1000 IU维生素D（胆钙化醇）。在基线和12周时评估的主要指标包括：用等速测力计测量股四头肌力量、ES、用双能X线吸收法（DEXA）测量LBM以及用GAITRite系统测量步态参数。
结果
与标准治疗组相比，VD组和等速训练组在股四头肌力量、ES、LBM和步态参数方面有显著改善，且与其他组相比，VD组的VD水平有显著提高。VD组、等速训练组和标准治疗组的结果指标（以及适用时的改善百分比）如下：股四头肌力量分别为85.25±0.93 Nm（85%）、64.25±0.93（36%）和51.88±1.31 Nm（12%）；步长分别为94.00±2.69（7%）、110.60±2.87（25%）和139.56±2.57（60%）；步幅分别为67.26±2.45（72%）、55.25±2.49（43%）和43.76±1.34（18%）；速度分别为133.94±,1.65（82%）、99.94±1.65（35%）和80.11±1.91（9%）；步频分别为140.63±1.36（68%）、132.63±1.36（58%）和90.35±1.32（9%），VD水平分别为43.33±7.48（75%）、24.77±7.38（5%）和25.63±8.39（4%）。
结论
补充VD联合运动训练可显著提高重度烧伤儿童的肌肉力量、ES、LBM、步态和VD水平。
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