不稳定阻力训练联合高清经颅直流电刺激对老年人本体感觉、平衡及跌倒风险的影响：一项随机对照试验研究

Effects of unstable resistance training combined with high-definition transcranial direct current stimulation on proprioception, balance and fall risks in the elderly: a randomized controlled trial study.

作者信息

Peng Di, Zhang Shengnian, Zhang Yu, Wu Han, Zou Xu, Zhang Guanyue, Ma Yuan, Ma Tongxin, Wang Lejun

机构信息

Key Laboratory of Exercise and Health Sciences of Ministry of Education, School of Exercise and Health, Shanghai University of Sport, Shanghai, China.

出版信息

Exp Gerontol. 2025 Oct 1;209:112843. doi: 10.1016/j.exger.2025.112843. Epub 2025 Jul 22.

DOI:10.1016/j.exger.2025.112843

PMID:40706715

Abstract

OBJECTIVE

This study examined the combined effects of unstable resistance training (URT) and high-definition transcranial direct current stimulation (tDCS) on proprioception, balance, and fall risk in community-dwelling older adults, targeting both central neural drive and peripheral neuromuscular adaptations.

METHOD

Ninety older adults (mean age 66.2 ± 3.3 years) were recruited and randomly assigned to five groups: (1) URT + a-tDCS, (2) URT + s-tDCS, (3) URT, (4) stable resistance training (SRT) and (5) a health education control group (HALE). All participants underwent an 8-week intervention (three sessions per week, 30 min per session). Participants in the URT + a-tDCS group received 2 mA stimulation for 20 min concurrently with URT sessions. Assessments of ankle proprioception, balance and fall risk were conducted at baseline and post-intervention.

RESULT

Eight weeks of URT + a-tDCS significantly improved proprioception at dorsiflexion and plantarflexion, compared with URT + s-tDCS, URT, SRT and baseline (P < 0.05). URT + s-tDCS and URT enhanced proprioception at plantarflexion than baseline (P = 0.033; P = 0.021). Balance measurements (i.e. COP displacement, COP ellipse area and sway velocity index) under stable and unstable surfaces were significantly improved after URT + a-tDCS, compared with other three training modalities and baseline. The fall-risk declined significantly after URT + a-tDCS compared with HALE and baseline (P < 0.05). The change in sway velocity index was positively related to the change in proprioception at plantarflexion after 8-week URT intervention (R = 0.378, P = 0.015).

CONCLUSION

The combined URT and a-tDCS intervention demonstrated synergistic effects, producing statistically significant improvements in proprioceptive acuity and balance parameters among older adults. This integrated intervention offers a promising approach to fall prevention and highlights the importance of targeting both central and peripheral mechanisms in rehabilitation strategies.

摘要

目的

本研究探讨不稳定阻力训练（URT）与高清经颅直流电刺激（tDCS）联合应用对社区居住老年人本体感觉、平衡能力和跌倒风险的综合影响，旨在同时针对中枢神经驱动和外周神经肌肉适应性。

方法

招募90名老年人（平均年龄66.2±3.3岁），随机分为五组：（1）URT+a-tDCS组，（2）URT+s-tDCS组，（3）URT组，（4）稳定阻力训练（SRT）组和（5）健康教育对照组（HALE）。所有参与者均接受为期8周的干预（每周三次，每次30分钟）。URT+a-tDCS组的参与者在进行URT训练时同时接受2毫安的刺激，持续20分钟。在基线和干预后对踝关节本体感觉、平衡能力和跌倒风险进行评估。

结果

与URT+s-tDCS组、URT组、SRT组和基线相比，8周的URT+a-tDCS显著改善了背屈和跖屈时的本体感觉（P<0.05）。URT+s-tDCS组和URT组在跖屈时的本体感觉比基线有所增强（P=0.033；P=0.021）。与其他三种训练方式和基线相比，URT+a-tDCS后在稳定和不稳定表面下的平衡测量（即COP位移、COP椭圆面积和摆动速度指数）有显著改善。与HALE组和基线相比，URT+a-tDCS后跌倒风险显著降低（P<0.05）。8周的URT干预后，摆动速度指数的变化与跖屈时本体感觉的变化呈正相关（R=0.378，P=0.015）。