Rosley Nurhaida, Hasnan Nazirah, Hamzaid Nur Azah, Davis Glen M, Manaf Haidzir
Physiotherapy programme, Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur, Royal College of Medicine Perak, Perak, Malaysia.
Discipline of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Turk J Phys Med Rehabil. 2022 Aug 2;69(1):23-30. doi: 10.5606/tftrd.2023.9418. eCollection 2023 Mar.
This study was conducted to investigate the effects of combined progressive resistance training (PRT) and functional electrical stimulation-evoked leg cycling exercise (FES-LCE) on isometric peak torque and muscle volume in individuals with incomplete spinal cord injury.
In the single-blind, randomized controlled trial performed between April 2015 and August 2016, 28 participants were randomized between two exercise interventions (FES-LCE+PRT and FES-LCE alone), and training was conducted over 12 weeks. The isometric muscle peak torque and muscle volume for both lower limbs were measured at the baseline and after 6 and 12 weeks. Linear mixed-model analysis of variance was performed to test the effects of FES-LCE+PRT versus FES-LCE on each outcome measure over time via an intention-to-treat analysis.
Twenty-three participants (18 males, 5 females; mean age: 33.4±9.7 years; range 21 to 50 years) completed study (10 in the FES-LCE+PRT group, and 13 in the FES-LCE group). The 12-week pre-and posttraining change for left hamstrings' muscle peak torque in the FES-LCE+PRT group (mean difference=4.5±7.9 Nm, 45% change, p<0.05) was consistently higher than that in the FES-LCE group (mean difference=2.4±10.3 Nm, 4% change; p<0.018). The improvement in the right quadriceps muscle's peak torque of the FES-LCE+PRT group (mean difference=19±7.6 Nm, 31% change, p<0.05) was more significant compared to the FES-LCE group. The left muscle volume showed a remarkable increase after 12 weeks in the FES-LCE+PRT group (mean difference=0.3±9.3 L, 7% change, p<0.05).
The combination of PRT and FES-LCE was better in improving lower limb muscle strength and volume in chronic incomplete individuals with spinal cord injury.
本研究旨在探讨联合进行渐进性抗阻训练（PRT）和功能性电刺激诱发腿部循环运动（FES-LCE）对不完全性脊髓损伤患者等长峰值扭矩和肌肉体积的影响。
在2015年4月至2016年8月进行的单盲随机对照试验中，28名参与者被随机分配到两种运动干预组（FES-LCE+PRT组和单纯FES-LCE组），训练为期12周。在基线、6周和12周后测量双下肢的等长肌肉峰值扭矩和肌肉体积。通过意向性分析，采用线性混合模型方差分析来测试FES-LCE+PRT与FES-LCE对各结局指标随时间的影响。
23名参与者（18名男性，5名女性；平均年龄：33.4±9.7岁；范围21至50岁）完成了研究（FES-LCE+PRT组10名，FES-LCE组13名）。FES-LCE+PRT组左腘绳肌肌肉峰值扭矩在12周训练前后的变化（平均差异=4.5±7.9 Nm，变化45%，p<0.05）始终高于FES-LCE组（平均差异=2.4±10.3 Nm，变化4%；p<0.018）。与FES-LCE组相比，FES-LCE+PRT组右股四头肌峰值扭矩的改善（平均差异=19±7.6 Nm，变化31%，p<0.05）更为显著。FES-LCE+PRT组在12周后左肌肉体积有显著增加（平均差异=0.3±9.3 L，变化7%，p<0.05）。
对于慢性不完全性脊髓损伤患者，PRT与FES-LCE联合应用在改善下肢肌肉力量和体积方面效果更佳。
