儿童肝移植后肌少症：制定家庭视频方案以支持肌肉力量和功能——一项基于前后对照的初步研究。

Sarcopenia in Children Post Liver Transplant: Development of a Home-Based Video Program to Support Muscle Strength and Function-A Pre-Post Controlled Pilot Study.

机构信息

Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Canada.

Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.

出版信息

Clin Transplant. 2024 Sep;38(9):e15455. doi: 10.1111/ctr.15455.

DOI:10.1111/ctr.15455

PMID:39254094

Abstract

INTRODUCTION

Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia.

OBJECTIVES

The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child-parent perspectives about RT.

METHODS

Children (6-18 years) post-LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push-ups, sit-to-stand), and PP (6-minute walk test [6MWT], timed-up-and-down-stair test [TUDS]) were measured before and after 12-weeks of RT.

RESULTS

Ten children post-LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM-index (+4.6% LTx vs. a -2.7% HC; p = 0.01) and decreased visceral adipose tissue-index (-18% LTx vs. -0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push-ups (p = 0.04), and greater reduction times for TUDS (-10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle-fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement.

CONCLUSIONS

RT in children post-LTx is feasible and effective. RT in children post-LTx may alleviate adverse outcomes associated with sarcopenia.

摘要

简介

肝移植（LTx）后儿童常发生肌肉减少症。阻力训练（RT）可能对对抗肌肉减少症有效。

目的

本研究旨在测试为期 12 周 RT 方案对骨骼肌量（SMM）、肌肉力量、身体表现（PP）以及儿童和家长对 RT 的看法的可行性和影响。

方法

LTx 后儿童（6-18 岁）和健康对照组（HC）使用阻力带进行渐进式 RT。在进行 12 周 RT 前后，通过 MRI（腹部和大腿）测量 SMM 和脂肪组织，通过握力、俯卧撑、坐站测试测量肌肉力量，通过 6 分钟步行测试（6MWT）和上下楼梯测试（TUDS）测量 PP。

结果

10 名 LTx 后儿童（11.9±3.5 岁）和 13 名 HC（11.7±3.9 岁）参与了研究。与 HC 相比，LTx 儿童的腹部 SM 指数显著增加（+4.6% LTx 比-2.7% HC；p=0.01），内脏脂肪组织指数显著降低（-18% LTx 比-0.8% HC；p=0.04）。大腿 SMI 没有变化。12 周后，6MWT 距离显著增加（LTx；p=0.04），俯卧撑次数增加（p=0.04），TUDS 减少时间增加（-10.6%比+1.7%；p=0.05）。大腿肌肉脂肪含量较高与身体表现较差相关。这些结果受到依从性（≥75%比＜75%）和家庭参与的影响。