血流限制阻力训练在有活动能力受限风险的老年人中的应用。
Blood flow restricted resistance training in older adults at risk of mobility limitations.
机构信息
Department of Kinesiology, University of New Hampshire, Durham, NH, United States.
Department of Kinesiology, University of New Hampshire, Durham, NH, United States.
出版信息
Exp Gerontol. 2017 Dec 1;99:138-145. doi: 10.1016/j.exger.2017.10.004. Epub 2017 Oct 5.
UNLABELLED
High-load resistance training (HL) may be contraindicated in older adults due to pre-existing health conditions (e.g. osteoarthritis). Low-load blood flow restricted (BFR) resistance training offers an alternative to HL with potentially similar strength improvement.
PURPOSE
To compare muscle strength, cross-sectional area (CSA), physical function, and quality of life (QOL) following 12-weeks of HL or BFR training in older adults at risk of mobility limitations.
METHODS
Thirty-six males and females (mean: 75.6years 95% confidence interval: [73.4-78.5], 1.67m [1.64-1.70], 74.3kg [69.8-78.8]) were randomly assigned to HL (70% of one repetition maximum [1-RM]) or low-load BFR (30% 1-RM coupled with a vascular restriction) exercise for the knee extensors and flexors twice per week for 12weeks. A control (CON) group performed light upper body resistance and flexibility training. Muscle strength, CSA of the quadriceps, 400-m walking speed, Short Physical Performance Battery (SPPB), and QOL were assessed before, midway and after training.
RESULTS
Within 6-weeks of HL training, increases in all strength measures and CSA were evident and the gains were significantly greater than the CON group (P<0.05). The BFR group had strength increases in leg extension and leg press 1-RM tests, but were significantly lower in leg extension isometric maximum voluntary contraction (MVC) and leg extension 1-RM than the HL group (P<0.01). At 12-weeks HL and BFR training did not differ in MVC (P=0.14). Walking speed increased 4% among all training groups (P<0.01) and no changes were observed for overall SPPB score and QOL (P>0.05).
CONCLUSION
Both training programs resulted in muscle CSA improvements and HL training had more pronounced strength gains than BFR training after 6-weeks and were more similar to BFR after 12-weeks of training. These changes in both groups did not transfer to improvements in QOL, SPPB, and walking speed. Since both programs result in strength and CSA gains, albeit at different rates, future research should consider using a combination of HL and BFR training in older adults with profound muscle weakness and mobility limitations.
未加标签
高负荷阻力训练（HL）可能由于老年人存在健康问题（如骨关节炎）而不适用。低负荷血流限制（BFR）阻力训练提供了一种替代 HL 的方法，可能具有相似的力量改善效果。
目的
比较 12 周 HL 或 BFR 训练后，有发生行动限制风险的老年人的肌肉力量、横截面积（CSA）、身体功能和生活质量（QOL）。
方法
36 名男性和女性（平均年龄：75.6 岁，95%置信区间：[73.4-78.5]，1.67m[1.64-1.70]，74.3kg[69.8-78.8]）被随机分为 HL（70%的 1 次重复最大值[1-RM]）或低负荷 BFR（30%1-RM 结合血管限制）组，每周两次训练膝关节伸肌和屈肌，共 12 周。对照组（CON）进行轻量的上半身阻力和柔韧性训练。在训练前、中途和结束后评估肌肉力量、股四头肌 CSA、400 米步行速度、简短体能状况量表（SPPB）和 QOL。
结果
在 HL 训练的 6 周内，所有力量测量值和 CSA 的增加都很明显，且增益明显大于 CON 组（P<0.05）。BFR 组的腿部伸展和腿部按压 1-RM 测试的力量增加，但腿部伸展等长最大自主收缩（MVC）和腿部伸展 1-RM 的力量比 HL 组显著降低（P<0.01）。在 12 周时，HL 和 BFR 训练的 MVC 无差异（P=0.14）。所有训练组的步行速度均提高了 4%（P<0.01），而 SPPB 总评分和 QOL 无变化（P>0.05）。
结论
两种训练方案均导致肌肉 CSA 增加，HL 训练在 6 周后比 BFR 训练具有更显著的力量增益，且在 12 周后与 BFR 训练更为相似。两组的这些变化都没有转化为 QOL、SPPB 和步行速度的改善。由于两种方案都能以不同的速度产生力量和 CSA 的增加，因此，未来的研究应考虑在肌肉无力和行动受限严重的老年人中使用 HL 和 BFR 联合训练。
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