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未受影响侧阻力训练对脑卒中患者上肢功能重建和预防肌少症的影响:一项随机对照试验。

The effect of unaffected side resistance training on upper limb function reconstruction and prevention of sarcopenia in stroke patients: a randomized controlled trial.

机构信息

North China University of Science and Technology, School of Clinical Medicine, Tangshan, 063000, China.

The Affiliated Hospital of North China University of Science and Technology, Department of Rehabilitation Medicine, Tangshan, 063000, China.

出版信息

Sci Rep. 2024 Oct 25;14(1):25330. doi: 10.1038/s41598-024-76810-2.

Abstract

Aging has made stroke a top killer and disabler, with post-stroke sarcopenia worsening disability and quality of life. While resistance training benefits the elderly, its impact on stroke patients is understudied. This study evaluates the potential of a 4-week unilateral resistance training (URT) program to prevent sarcopenia in stroke patients. It assesses the impact of URT on hand grip strength (HG), muscle thickness (MT), upper limb functionality, and the psychological status of the patients. The study aims to quantitatively analyze these indicators to inform evidence-based post-stroke rehabilitation practices. This study employed a randomized controlled trial (RCT) involving 77 eligible stroke survivors, equally allocated into a control group (n = 39) and an intervention group (n = 38). The control group received standard rehabilitation, while the intervention group additionally underwent a 4-week URT program. The primary outcomes were unaffected side HG and MT, measuring muscle mass and function. Secondary outcomes included the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) for upper limb functionality and the Hamilton Depression Rating Scale (HAMD) for psychological well-being changes. Statistical analysis showed significant differences (p < 0. 05) in all measured parameters between the intervention and control groups after the 4-week period. Intra-group comparisons also indicated substantial improvements (p < 0. 05). Unilateral resistance training significantly mitigates muscle atrophy in stroke patients, preventing sarcopenia and enhancing upper limb function. It also ameliorates depressive symptoms, improving rehabilitation outcomes and overall quality of life.

摘要

衰老是中风的首要致死和致残因素,中风后肌少症会使残疾和生活质量进一步恶化。尽管抗阻训练对老年人有益,但它对中风患者的影响还研究不足。本研究评估了四周单侧抗阻训练(URT)方案预防中风患者肌少症的潜力。它评估了 URT 对手握力(HG)、肌肉厚度(MT)、上肢功能和患者心理状态的影响。该研究旨在通过定量分析这些指标,为基于证据的中风后康复实践提供信息。

本研究采用随机对照试验(RCT),纳入了 77 名符合条件的中风幸存者,将其平均分为对照组(n=39)和干预组(n=38)。对照组接受标准康复治疗,而干预组在此基础上还进行了四周的 URT 方案。主要结局是未受影响侧的 HG 和 MT,用于衡量肌肉质量和功能。次要结局包括上肢 Fugl-Meyer 评估(FMA-UE)用于上肢功能和汉密尔顿抑郁评定量表(HAMD)用于心理幸福感变化的评估。

统计分析显示,四周后干预组和对照组之间所有测量参数均存在显著差异(p<0.05)。组内比较也表明有明显改善(p<0.05)。单侧抗阻训练可显著减轻中风患者的肌肉萎缩,预防肌少症,增强上肢功能。它还可以改善抑郁症状,提高康复效果和整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a469/11512051/8d41774118a1/41598_2024_76810_Fig1_HTML.jpg

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