核心稳定性训练联合早期肌内效贴对脑卒中后本体感觉和平衡功能障碍的影响

目的探讨核心稳定性训练联合肌内效贴对脑卒中病人本体感觉和平衡功能的影响。方法选择2016年4月—2018年6月我院收治的100例脑卒中病人,随机分为观察组与对照组,每组50例。对照组进行核心稳定性训练,观察组在核心稳定性训练的基础上,配合使用肌内效贴。比较两组治疗前后本体感觉[测试执行时间(Time)、多轴平均轨迹差(ATE)]、下肢运动功能、腓肠肌痉挛程度、平衡功能、日常生活能力及总有效率。结果治疗前,两组本体感觉、下肢运动功能、平衡功能、日常生活能力比较,差异均无统计学意义(P>0.05);治疗后,两组本体感觉、下肢运动功能、平衡功能、日常生活能力均明显改善(P<0.05),且观察组改善效果优于对照组(P<0.05);观察组总有效率明显高于对照组(92.00%与66.00%,P<0.05)。结论核心肌群稳定性训练联合肌内效贴能明显改善脑卒中病人的本体感觉、平衡功能、运动功能及日常生活能力,且肌内效贴操作简便、作用明显。     

渐进性抗阻运动对老年人体适能及跌倒风险的干预研究

目的 探讨渐进性抗阻运动对老年人体适能及跌倒风险的影响。方法 选取昆明市某养老机构自理区70岁及以上老年人42例,对其进行12周的渐进性抗阻运动训练,对比干预前后肌肉力量、体质量指数(BMI)、柔韧性、有氧耐力、平衡能力指标及跌倒风险指标的变化情况。结果 12周干预后,老年男性下肢肌肉力量、下肢柔韧性、有氧耐力、平衡能力/跌倒风险均有显著改善(P<0.05),老年女性下肢肌肉力量、下肢柔韧性、平衡功能/跌倒风险有极显著改善(P<0.01),上肢肌肉力量、上肢柔韧性、有氧耐力显著改善(P<0.05)。结论 12周的渐进性抗阻运动可以明显改善老年人的体适能,降低跌倒风险,对预防老年人跌倒有很好的效果。     

核心肌群锻炼提升老年人功能性体能与平衡能力

目的探讨8 w核心肌群锻炼对老年人功能性体能与平衡能力的影响。方法 28位65～70岁南京某区老年人按主观意愿分成实验组14人[平均(65.10±4.08)岁]及控制组14人[平均(65.43±4.66)岁],实验组进行为期8 w的核心肌群锻炼,控制组则不进行任何干预。分别于课程干预前后进行功能性体能测试与平衡能力检测,使用SPSS19.0软件行单因素方差分析。结果实验组接受核心肌群锻炼课程干预后,相较控制组而言,身体质量指数[(体重:△%=-0.43 vs 0.48;体重指数(BMI):△%=-1.75 vs 0.48]、上肢肌力:30 s手臂屈举测试(△%=17.53 vs 0.48)、下肢肌力:30 s坐立测试(△%=19.22 vs 6.81)、有氧耐力:2 min抬膝测试(△%=5.59 vs-6.13)及静态平衡能力等检测项目均有显著差异(P0.05),而下半身柔韧、上半身柔韧及灵敏素质则无显著差异(P0.05)。结论核心肌群锻炼能有效改善老年人的功能性体能与静态平衡能力,故适合推广至老年群体,以促进身体健康、预防跌倒意外事故。     

老年帕金森病伴抑郁患者心理护理联合核心肌群控制训练效果分析

目的探讨对老年帕金森病(PD)伴抑郁患者进行心理护理联合核心肌群控制训练的效果。方法选取在我院住院治疗的老年PD伴抑郁障碍患者68例为干预对象,随机分为干预组36例和对照组32例,对照组患者给予常规护理干预,干预组患者在常规护理干预的基础上,进行心理护理以及核心肌群控制训练。比较两组患者干预前、干预后8周汉密尔顿抑郁量表(HAMD)、Berg平衡量表(BBS)、日常生活活动能力(ADL)量表评分的变化情况。结果干预前,两组患者HAMD各项评分比较差异无统计学意义(P0.05);干预8周后,两组患者HAMD各项评分均显著降低,干预组患者各项评分均显著低于对照组,差异具有统计学意义(P0.05)。干预前,两组患者BBS、ADL评分比较差异无统计学意义(P0.05);干预8周后,两组患者BBS评分显著提高、ADL评分显著降低,干预组患者BBS评分显著高于对照组、ADL评分显著低于对照组,差异具有统计学意义(P0.05)。结论对老年PD伴抑郁患者进行心理护理和核心肌群控制训练,可以显著减轻患者抑郁症状,改善其平衡功能,延缓疾病的进展,提高日常生活能力及生活质量。     

核心肌群训练治疗脑损伤伴平衡障碍及共济失调的疗效观察

目的观察核心肌群训练治疗脑损伤伴平衡障碍及共济失调的疗效。方法选择2010—2012年我院及其他医院神经内科、神经外科收治的脑损伤伴平衡障碍及共济失调患者40例,将其随机分为治疗组(核心肌群训练法+常规治疗)和对照组(常规治疗)。治疗前后采用Fugl-Meyer平衡量表评定平衡功能,日常生活能力(ADL)运用Barthel指数(BI)进行评定。结果治疗后,治疗组Fugl-Meyer和BI评分均高于对照组(P0.05),ADL优于对照组(P0.05)。结论核心肌群训练法对改善脑损伤引起的平衡障碍及共济失调有效,并能提高患者ADL。     

运动康复指导对老年人衰弱状态、生活质量及心理健康的影响

目的研究运动康复指导对老年人衰弱状态、生活质量及心理健康的影响。方法选取的160名老年人作为研究对象,采用随机数字表法将入组老年人分为实验组和对照组,实验组开展为期1年的运动康复指导,对照组未实施针对性运动康复指导,对比两组老年人不同时期的衰弱指数、干预后的生活质量评分(SF-36)和症状自评量表(SCL-90)评分。结果运动干预前两组衰弱指数无明显差异(P0.05),干预后2个月、5个月和12个月后,实验组衰弱指数均显著低于对照组(P0.05);干预后2个月、5个月和12个月后,实验组SF-36评分均显著高于对照组(P0.05);干预后实验组不同维度的SCL-90评分均显著低于对照组(P0.05)。结论针对老年人的衰弱状态采取针对性的运动康复指导措施,不仅能够促进老年人身体功能的提升,还能够有效改善其负性心理状态,对提升老年人生活质量具有积极的意义。     

动态神经肌肉稳定技术对帕金森病患者运动能力、平衡功能及腰椎稳定肌肌肉厚度的影响

目的 探究动态神经肌肉稳定技术对老年帕金森病(PD)患者运动能力、平衡功能及腰椎稳定肌肌肉厚度的影响。方法 老年PD患者90例按照随机数字表法分为对照组与观察组,每组45例,对照组采用常规药物、康复训练,30 min/次,1次/d, 5 d/w,观察组在对照组基础上采用动态肌肉稳定技术治疗,30 min/次,1次/d, 5 d/w,对比两组治疗前后上下肢运动功能评分、平衡功能评分及腰椎稳定肌肌肉厚度。结果 干预后观察组与对照组相比上肢运动能力指标中Brunnstrom、Fugl-meyer上肢(FMA-UE)评分较高,患肘屈曲时肱二头肌、肱三头肌CR值较低;下肢运动能力指标中Fugl-meyer下肢(FMA-LE)评分较高,起立行走测试时间较短,10 min步行测试时间较短,步频较高,左右步长差较低,差异有统计学意义(P<0.05)。干预后观察组与对照组相比稳定极限(LS)较长、多姿态下稳定测试(PS)较短、稳定时间(TS)较短,差异有统计学意义(P<0.05)。干预后观察组与对照组相比腹横肌及多裂肌厚度均较高,差异有统计学意义(P<0.05)。结论 动态神经肌肉稳定...     

核心肌力并太极拳猫步行走锻炼对老年人身体稳定性的效果评价

目的探讨核心肌力与太极拳猫步行走组合锻炼对老年人身体稳定性的影响。方法筛选平衡能力较差的老年人90例,随机分为观察组和对照组,每组45例。对照组进行健步走锻炼;观察组在核心肌力锻炼基础上同时辅以太极拳猫步行走锻炼进行联合干预。分别对两组身体动态和静态平衡能力指标进行检测和比较。结果锻炼后,对照组动态平衡能力指标较锻炼前有明显改善(P0. 05),但静态平衡能力指标差异无统计学意义(P0. 05);观察组锻炼后静态、动态平衡能力指标较锻炼前均有明显改善,且明显优于对照组(均P0. 05)。结论核心肌力与猫步行走组合锻炼,两者间可起到协同干预作用,利于提高老年人的身体稳定性,对提高肢体运动功能及预防跌倒有益。     

温针灸联合绳带捆绑技术对脑卒中后痉挛型偏瘫病人运动耐力及痉挛程度的影响

目的观察温针灸联合绳带捆绑技术对脑卒中后痉挛型偏瘫病人运动耐力及痉挛程度的影响。方法选取2018年1月—2020年1月沧州市人民医院收治的脑卒中后痉挛型偏瘫病人192例,依据随机数字表法分为研究组与对照组,各96例。对照组在常规干预基础上应用绳带捆绑技术,研究组在对照组基础上采取温针灸治疗。比较两组干预前后运动耐力及痉挛程度、运动功能及平衡功能、日常生活活动能力评分、肌张力分级、步速、步宽、步长、起立-行走(TUGT)测试结果和干预满意度。结果干预后,研究组6 min步行距离长于对照组(P<0.05),临床痉挛指数(CSI)量表评分低于对照组(P<0.05);研究组Fugl-Meyer评定量表(FMA)、Berg平衡量表、功能独立行测评(FIM)评分高于对照组(P<0.05);研究组肌张力分级优于对照组(P<0.05);研究组步速、步宽、步长大于对照组(P<0.05)。干预后两组TUGT较干预前缩短(P<0.05),且研究组短于对照组(P<0.05);研究组总满意度(94.79%)高于对照组(84.38%),差异有统计学意义(P<0.05)。结论采取绳带捆绑技术及温针灸对脑卒中后痉挛型偏瘫病人实施干预,可缓解其痉挛状态,恢复肢体功能,增强运动耐力,且病人对干预满意度较高。     

自我调节模式联合健康教育在脑卒中恢复期住院患者护理干预中的应用

目的探讨自我调节模式联合健康教育在脑卒中恢复期住院患者护理干预中的应用价值。方法 2016年11月至2019年3月南京大学医学院附属鼓楼医院收治的脑卒中恢复期患者130例,按照入院顺序进行编号,尾号奇数列为对照组(n=65,行健康教育干预)、尾号偶数列为观察组(n=65,行自我调节模式联合健康教育干预),均干预2个月。使用Berg平衡量表(BBS)及姿态稳定度评价两组干预前后平衡功能;使用Fugl-Meyer运动功能量表(FMA-LE)及日常生活能力量表(ADL)评价两组干预前后运动功能;使用自护能力测评量表(ESCA)评价两组干预前后自护能力;使用综合生活质量评定问卷(GQOLI)评价两组干预前后生活质量。结果平衡功能:两组干预后BBS评分及姿态稳定度均较干预前显著增加,且观察组干预后BBS评分及姿态稳定度显著高于对照组(P0.05);运动功能:两组干预后FMA-LE评分与干预前比较均显著增加,ADL评分与干预前比较均显著减少,且观察组干预后FMA-LE评分显著高于对照组,ADL评分显著低于对照组(P0.05);自护能力:两组干预后自我概念、自护责任感、健康知识水平及自护技能评分均较干预前显著增加,且观察组干预后各维度评分显著高于对照组(P0.05);生活质量:两组干预后心理健康、物质生活、躯体健康及社会功能评分均较干预前显著增加,且观察组干预后各维度评分显著高于对照组(P0.05)。结论自我调节模式联合健康教育可明显改善脑卒中恢复期患者平衡及运动功能,提高其自护能力和生活质量。     

The comparison of resistance and balance exercise on balance and falls efficacy in older females

ObjectivesThe purpose of this study is to compare the effectiveness of resistance and balance exercise in reducing the risk of falls for females 65-years-old or older.DesignThe study was a single blind, controlled trial, conducted over a period of 12-weeks with pre- and post-exercise assessment.Patients and methodsNinety-five participants were randomly assigned to one of three groups: resistance-training group, balance training group, control group. Resistance training group were trained to increase strength of upper, lower. Balance training group were trained to improve balance, coordination and proprioception. Outcome measurement consisted of balance ability, muscle strength, proprioception and fall efficacy.ResultsThe resistance and balance exercise group showed a statistically significant improvement in balance ability compared to the control group (P < 0.01). The resistance exercise group showed significant improvement in muscle strength compared to the balance exercise group (P < 0.01). The balance exercise group showed significant improvement in proprioception compared to the resistance exercise group (P < 0.01). Both resistance and balance exercise showed a significant improvement in fall efficacy than the control group (P < 0.01).ConclusionsWe conclude that the resistance and balance exercise have significant effects on balance ability and falls efficacy in older females.     

多元运动干预对社区老年人衰弱状态的影响

目的探讨多元运动干预对社区老年人衰弱状态的改善效果。方法对沈阳市两个社区老年人进行调查,选取Tilburg衰弱评估量表得分≥5分的老年人106例,将其随机分为试验组和对照组,试验组通过多元运动干预,主要内容为有氧训练、力量训练及柔韧性、平衡性训练,12周后比较多元运动干预对社区老年人衰弱状态的影响。结果试验组老年人衰弱得分低于对照组(P<0.05)。结论多元运动对社区老年人衰弱状态有积极的干预效果。     

不同运动剂量干预对衰弱老年人健康状况的影响

目的探讨不同运动剂量干预对衰弱老年人肌力、体适能及睡眠状况的效果。方法招募符合纳入标准的衰弱老年人88例,随机将其分为对照组、小量中强度组、小量大强度组和大量大强度组,每组22例。对照组无任何针对性身体训练干预,3个干预组按设计方案进行相应的运动量和强度的下肢抗阻运动。分别在干预前、干预12周后评估老年人的下肢肌力、体适能及睡眠状况。结果对照组干预前后下肢肌力、体适能及睡眠状况差异均无统计学意义(P>0.05);小量中强度组、小量大强度组和大量大强度组干预前后各指标均有改善(P<0.05或P<0.01)。小量大强度组和大量大强度组的下肢肌力、6 min步行距离、30 s坐站次数、总睡眠时间均明显优于小量中强度组(P<0.01)。结论抗阻运动可以有效改善衰弱老年人的肌力、体适能和睡眠状况,运动量和运动强度都有利于衰弱老年人肌力、体适能、睡眠指标的改善,但是强度是影响上述健康指标的主要因素。     

Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: A multicenter study in China

BackgroundFrailty, featured by the presence of fatigue, weight loss, decrease in grip strength, decline gait speed and reduced activities substantially increase the risk of falls, disability, hospitalizations, and mortality of older people. Nutritional supplementation and resistance exercise may improve muscle function and reverse frailty status.ObjectiveTo evaluate whether whey protein supplements can improve muscle function of frail older people in addition to resistance exercise.Methods115 community-dwelling older adults who met the Fried's criteria for frailty from four hospitals’ out-patients clinic in Beijing, China completed the study. It's a case–control study which whey protein was used as daily supplementation for 12 weeks for active group and regular resistance exercise for active group and control group. Handgrip strength, gait speed, chair-stand test, balance score, and SPPB score were compared in both groups during the 12-week follow-up.ResultsOverall, 115 subjects were enrolled for study with 66 in active group and 49 in control group. Handgrip strength, gait speed, and chair-stand time were all significantly improved in both groups with significant between-group differences. The active group improved significantly in handgrip strength compared with the control group, which between-group effect (95% confidence interval) for female was 0.107 kg (0.066–0.149), p = 0.008 and for male was 0.89 kg (0.579–1.201), p = 0.007. For chair-stand time, between-group effect (95% confidence interval) was −2.875 s (−3.62 to −2.124), p = 0.004 and for gait speed, between-group effect (95% confidence interval) was 0.109 m/s (0.090 to 0.130), p = 0.003.ConclusionsThe 12-week intervention of whey protein oral nutritional supplement revealed significant improvements in muscle function among the frailty elderly besides aiding with resistance exercise. These results warrant further investigations into the role of a multi-modal supplementation approach which could prevent adverse outcomes among frailty elderly at risk for various disabilities.     

悬吊技术联合Mulligan手法对膝骨关节炎老年人群运动后疼痛的康复效果

目的 探究悬吊技术联合Mulligan手法用于膝骨关节炎老年人运动后膝关节疼痛康复的效果.方法 选取84例单侧膝关节运动后疼痛的膝骨关节炎老年患者,依据随机数字表法分为观察组和对照组,各42例.对照组给予常规物理治疗与悬吊训练治疗,观察组在对照组基础上给予Mulligan技术治疗.比较两组治疗开始前与治疗后视觉模拟评分(VAS)疼痛评分、QOL-BREF评分、LEFS下肢功能评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力.结果 两组治疗后VAS评分明显降低(P<0.05),且观察组VAS评分明显低于对照组(P<0.05).两组治疗后QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力较治疗前明显提高(P<0.05),且治疗后观察组QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力明显高于对照组(P<0.05).结论 对于膝关节运动后疼痛的膝骨关节炎老年患者,悬吊技术联合Mulligan手法,能有效缓解膝关节疼痛、促进膝关节功能恢复,提高患者生活质量.     

Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis: A protocol of a randomized controlled trial

Background:Knee osteoarthritis (KOA) is a chronic degenerative joint disease commonly occurring in middle-aged and elderly people. The main clinical manifestations are joint pain, limited activity, and decreased muscle strength resulting in decreased motor control ability. Exercise therapy is an effective method to enhance muscle strength of lower limbs, while China''s traditional skill Tai Chi (TC) is a combination of activity and inertia, internal and external exercise therapy. In recent years, scholars at home and abroad have found that regular TC can effectively improve patients’ lower limb function and balance ability. The purpose of this study is to explore the effects of TC on lower limb function and balance ability in patients with KOA.Methods:This is a prospective randomized controlled clinical trial. One hundred forty-six cases of KOA patients will be randomly divided into experimental group and control group according to 1:1 ratio, 73 cases in each group, the control group: sodium hyaluronate; experimental group: TC added on the basis of the control group. Both groups will receive standard treatment for 5 weeks and will be followed up for 3 months. Observation indicators include: the western Ontario and McMaster universities osteoarthritis index; hospital for special surgery knee score; balance stability index, liver and kidney function, adverse reaction rate, etc. SPSS 23.0 software will be used for data analysis.Discussion:This study will evaluate the effects of TC on lower limb function and balance ability of patients with KOA. The results of this trial will provide a clinical basis for the selection of exercise therapy for patients with KOA.     

Effects of resistance and aerobic exercise on physical function, bone mineral density, OPG and RANKL in older women

This study compared the effects of a resistance training protocol and a moderate-impact aerobic training protocol on bone mineral density (BMD), physical ability, serum osteoprotegerin (OPG), and receptor activator of nuclear factor kappa B ligand (RANKL) levels. Seventy-one older women were randomly assigned to resistance exercise (RE), aerobic exercise (AE) or a control group (CON). Both interventions were conducted 3 times per week for 8 months. Outcome measures included proximal femur BMD, muscle strength, balance, body composition, serum OPG, and RANKL levels. Potential confounding variables included dietary intake, accelerometer-based physical activity (PA), and molecularly defined lactase nonpersistence. After 8 months, only RE group exhibited increases in BMD at the trochanter (2.9%) and total hip (1.5%), and improved body composition. Both RE and AE groups improved balance. No significant changes were observed in OPG and RANKL levels, and OPG/RANKL ratio. Lactase nonpersistence was not associated with BMD changes. No group differences were observed in baseline values or change in dietary intakes and daily PA. Data suggest that 8 months of RE may be more effective than AE for inducing favourable changes in BMD and muscle strength, whilst both interventions demonstrate to protect against the functional balance control that is strongly related to fall risk.     

AGE,EXERCISE AND THE MUSCULO-SKELETAL SYSTEM

A striking cultural feature of most of Western society is the expectation that the elderly will become progressively more sedentary, increasingly indolent and gradually more febrile until they are eventually unable to cope for themselves. There is the perception that old people do not need to exercise to any great extent, that exercise may be harmful to the elderly and that older people in exercise are most unattractive. Advertising emphasises that exercise is for the young and encourages a belief that the elderly should take life easily as reward for a lifetime's work. Research into musculo-skeletal structure and performance has clearly shown the necessity for high levels of exercise activity through the whole life span. Inactivity is associated with a decline in muscle bulk, strength and endurance; an increase in joint stiffness and a decline in the individual's ability to respond to rapid environment change. All of the above changes are markedly improved by exercise, even in the very elderly. This paper discusses current research into the effect of ageing and exercise on the musculo-skeletal system of the body, and demonstrates the necessity for continued high levels of physical activity into old age.     

Effects of a physical and nutritional intervention program for frail elderly people over age 75. A randomized controlled pilot treatment trial

BACKGROUND AND AIMS: There are few studies published that combine the interventions of physical training and nutrition. The aim of the present study was to describe the impact of a physical and nutritional intervention program for frail community- dwelling elderly people over the age of 75. METHODS: Ninety-six community-dwelling elderly people (58 women) were randomized to four different groups: i) a physical training program (aerobic, muscle strength, balance), ii) a nutritional intervention program (individually targeted advice and group sessions), iii) a combination of these interventions, and iv) a control group. At baseline subjects were screened for physical performance such as muscle strength, balance, mobility and activities of daily living, as well as nutritional aspects such as energy intake, body weight and fat-free mass. These measurements were repeated immediately after the intervention, which lasted for 12 weeks, and after another 6 months. RESULTS: The intention-to-treat analysis indicated significant improvements in lower- extremity muscle strength in both training groups compared with the nutrition group at 1st follow-up. There were small significant changes for some of the balance measurements in the training group without nutrition treatment. The nutrition intervention did not show any significant results. CONCLUSIONS: This study shows the positive effect on lower-extremity muscle strength directly after the intervention. Balance training most probably needs to be more individualized in order to be effective for frail elderly people. Further studies are needed, with larger sample sizes, to investigate the effects of these types of interventions before any further conclusions can be drawn.     

Ankle force and rate of force production increase following high intensity strength training in frail older adults

BACKGROUND AND AIMS: The most common cause of accidental injury and death in people over age 65 results from impacts associated with falling. Balance impaired older adults have poorer balance control than healthy young adults or healthy older adults. Lack of sufficient lower extremity strength and inability to rapidly produce muscle force may contribute to diminished balance control in the elderly. This study evaluated the effect of a 10-week high intensity strength-training program targeting key lower extremity muscles for the purpose of improving postural control in frail older adults. METHODS: Thirteen experimental and fourteen control subjects, all balance impaired older adults were evaluated in response to unexpected platform perturbations that simulated slips. RESULTS: Following strength training the experimental group was significantly stronger than the control group. Mean ankle moments improved in the experimental group following strength training during forward sway (Right: p=0.067, Left: p=0.009) and backward sway (Right: p=0.031, Left: p=0.058). For the backward sway condition the ankle rate of torque production increased significantly in the experimental group (Right: p=0.016, Left: p=0.031). CONCLUSIONS: Enhancement of lower extremity strength contributed to improvements in balance stability demonstrated by greater ankle force production, in response to balance threats.