Jønsson Anette Bach, Krogh Søren, Lillelund Susanne, Aagaard Per, Kasch Helge, Nielsen Jørgen Feldbæk
Spinal Cord Injury Centre of Western Denmark, Hammel Neurorehabilitation Centre and University Research Clinic, Viborg, Denmark.
Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.
Scand J Med Sci Sports. 2024 Dec;34(12):e14759. doi: 10.1111/sms.14759.
The objective of the present study was to evaluate the efficacy of low-load (LL) blood flow restriction exercise (BFRE) for improving lower limb muscle strength, muscle thickness and physical function in individuals with spinal cord injury (SCI). In a randomized sham-controlled trial, 21 participants (age ≥ 18 years, SCI duration ≥ 1 year, knee extensor strength grade 2-4, ASIA A-D) were randomized to either 45-min LL-BFRE (n = 11) or sham BFRE (n = 10) twice/week for 8 weeks. The exercise protocol consisted of four sets (30 × 15 × 15 × 15 repetitions) of unilateral seated leg extensions and leg curls at 30%-40% of 1RM performed with pneumatic cuffs applied proximally on the trained limb and inflated to 40% of total arterial occlusion pressure (BFRE) or non-inflated (sham exercise). Maximal voluntary isometric quadriceps and hamstring muscle strength, quadriceps muscle thickness, thigh circumference, and physical function were assessed at baseline, after 4 and 8 weeks of training and at 4-week follow-up. No significant between-group differences were found between BFRE and sham exercise in quadriceps or hamstring muscle strength, 10-m walking test, timed up & go, 6-min walking test or the spinal cord independence measure. In contrast, a significant between-group difference favoring BFRE was present for muscle thickness and thigh circumference from baseline to 4-week follow-up (0.76 cm (95% CI: 0.32; 1.20, p = 0.002) and 2.42 cm (0.05; 4.79, p = 0.05), respectively). In conclusion, there was no significant difference in the effect of LL-BFRE and sham exercise on muscle strength and physical function in individuals with SCI. However, significant increases in muscle thickness and thigh circumference were observed in favor of BFRE. Trial Registration: ClinicalTrials.gov identifier: NCT03690700.
本研究的目的是评估低负荷（LL）血流限制运动（BFRE）对改善脊髓损伤（SCI）患者下肢肌肉力量、肌肉厚度和身体功能的疗效。在一项随机假对照试验中，21名参与者（年龄≥18岁，SCI病程≥1年，膝伸肌力量等级为2 - 4级，ASIA A - D级）被随机分为45分钟的LL - BFRE组（n = 11）或假BFRE组（n = 10），每周两次，共8周。运动方案包括四组（30×15×15×15次重复）单侧坐姿腿伸展和腿弯举，在训练肢体近端使用气动袖带，充气至总动脉闭塞压力的40%（BFRE）或不充气（假运动），以1RM的30% - 40%进行。在基线、训练4周和8周后以及4周随访时评估最大自主等长股四头肌和腘绳肌力量、股四头肌肌肉厚度、大腿围度和身体功能。在股四头肌或腘绳肌力量、10米步行测试、计时起立行走测试、6分钟步行测试或脊髓独立性测量方面，BFRE组和假运动组之间未发现显著的组间差异。相比之下，从基线到4周随访，在肌肉厚度和大腿围度方面存在显著的组间差异，有利于BFRE组（分别为0.76厘米（95%CI：0.32；1.20，p = 0.002）和2.42厘米（0.05；4.79，p = 0.05））。总之，LL - BFRE和假运动对SCI患者肌肉力量和身体功能的影响没有显著差异。然而，观察到有利于BFRE组的肌肉厚度和大腿围度显著增加。试验注册：ClinicalTrials.gov标识符：NCT03690700。
