Graduate School of Medicine, Nagoya University, Tsurumai, Showa, Nagoya, Japan.
Kajinoki Medical Clinic, Kawai, Kani, Gifu, Japan.
Exp Gerontol. 2017 Nov;98:230-237. doi: 10.1016/j.exger.2017.08.036. Epub 2017 Sep 11.
Older adults requiring long-term care will experience age-associated deterioration of the quality and quantity of skeletal muscle if no interventions are performed. Long-term training is considered a typical intervention method and is effective for improvement of both muscle quantity and physical function. However, how such training affects muscle quality [i.e., fat-to-muscle ratio as determined by echo intensity (EI)] in older adults requiring long-term care remains unclear. The purpose of this study was to investigate the effects of a 12-month physical training intervention on the quality and quantity of skeletal muscle, physical function, and blood chemistry in older adults requiring long-term care. Seventeen older adults requiring long-term care (Tr-group) and 15 healthy older adults (Cont-group) participated in this study. Patients in the Tr-group performed exercises consisting of resistance and endurance training once or twice a week for 12months. The EI and muscle thickness of the thigh were calculated from the rectus femoris and biceps femoris using B-mode transverse ultrasound images. Physical functions (isometric knee extension peak torque, sit-to-stand test, 5-m normal/maximal speed walking, handgrip strength, and timed up and go test) and blood lipid components including adipocytokines were measured at three points, i.e. baseline and 6 and 12months after. The thigh EI was significantly lower after 6months of training than baseline, and it returned to the initial level after 12months of training (baseline, 70.2±8.3a.u.; 6months, 64.1±11.2a.u.; 12months, 72.3±7.2a.u.). The thigh muscle thickness, 5-m maximal speed walking, and knee extension torque were significantly improved after 12months of training (P<0.05). The blood chemistry parameters did not significantly change. These results demonstrate that a 12-month training intervention contributes to improvement of muscle quantity and function with tentative changes in muscle quality but has no effect on blood chemistry in older adults requiring long-term care. We conclude that this type of training has the potential to restore the muscle functional abilities of older adults requiring long-term care.
如果不进行干预，需要长期护理的老年人将经历与年龄相关的骨骼肌质量和数量的恶化。长期训练被认为是一种典型的干预方法，对肌肉数量和身体功能的改善都很有效。然而，这种训练如何影响需要长期护理的老年人的肌肉质量[即，通过回声强度（EI）确定的脂肪与肌肉的比例]尚不清楚。本研究的目的是探讨为期 12 个月的身体训练干预对需要长期护理的老年人的骨骼肌质量和数量、身体功能和血液化学的影响。17 名需要长期护理的老年人（Tr 组）和 15 名健康老年人（Cont 组）参加了这项研究。Tr 组的患者每周进行一次或两次阻力和耐力训练，持续 12 个月。使用 B 型横断超声图像从股直肌和股二头肌计算大腿的 EI 和肌肉厚度。在三个时间点（基线和 6 个月和 12 个月后）测量身体功能（等长膝关节伸展峰值扭矩、坐站测试、5 米正常/最大速度行走、手握力和计时起立行走测试）和包括脂肪细胞因子在内的血脂成分。经过 6 个月的训练后，大腿 EI 明显低于基线，经过 12 个月的训练后恢复到初始水平（基线，70.2±8.3a.u.；6 个月，64.1±11.2a.u.；12 个月，72.3±7.2a.u.）。经过 12 个月的训练后，大腿肌肉厚度、5 米最大速度行走和膝关节伸展扭矩均显著提高（P<0.05）。血液化学参数没有显著变化。这些结果表明，12 个月的训练干预有助于改善肌肉数量和功能，肌肉质量有初步变化，但对需要长期护理的老年人的血液化学没有影响。我们得出结论，这种训练有可能恢复需要长期护理的老年人的肌肉功能能力。
