Biodex等速系统测试老年人膝关节屈伸肌力可靠性的初步研究

目的确定Biodex等速系统测试老年人膝关节伸肌和屈肌等速向心肌肉功能的可靠性。方法使用Biodex System 3型多关节等速系统在2个测试日对20名老年人（年龄71±6岁）的双下肢进行等速向心肌力测试。结果除了屈肌的作功疲劳度值,伸肌和屈肌两次测试的峰力矩、单次最大作功和平均功率值差异均有统计学意义（P〉0．05）。伸肌和屈肌两次重复测试的相关系数在0．40～0．96之间,除屈肌的作功疲劳度值的P值〉O．05,其余各指标的P值均〈0．05,具有相关关系。结论采用Biodex等速系统对老年人膝关节伸肌和屈肌进行的肌肉功能的重复测试之间具有较好的可靠性。同时提示,有必要加强测试程序的标准化、测试前的热身和熟练程序。     

通过简易肌力测试预测社区老年人群身体肌肉含量的模型

目的通过测量社区老年人身体肌肉含量和不同部位的肌力,建立以单独或联合肌力水平为基础的肌肉含量预测模型。方法2019年9~12月在社区招募老年居民140例,分别进行握力、30 s肱二头肌弯举、30 s连续坐立测试和基于Micro FET3手持测力仪测定的股四头肌与腘绳肌最大等长肌力测试,并使用日本TANITA体成分仪测定身体肌肉含量,分析上述肌力指标与肌肉含量的相关性,并建立回归预测模型。结果所有肌力检测指标(握力、30 s肱二头肌弯举测试、30 s连续坐立测试、股四头肌与腘绳肌最大等长肌力)均与身体肌肉含量呈正相关(r=0.207~0.720,P<0.001)。在各肌力测试指标单独预测肌肉含量的多元回归分析中,除30 s连续坐立测试外,其余指标模型均具有统计学意义(r2=0.702~0.761,P<0.001)。多项肌力测试结果联合预测肌肉含量回归方程(r2=0.786,P<0.001)的预测因子包括性别、BMI、非优势手握力、30 s连续坐立测试和股四头肌最大等长肌力。结论身体不同部位简易肌力测试的结果均与身体肌肉含量呈正相关。除30 s连续坐立测试外,每一单项肌力水平均可建立拟合优度较好的肌肉含量预测模型,多项肌力指标联合预测模型效果稍优于单独指标,但优势差别较小。这些结果为评估社区老年人肌肉质量提供了简易的筛查方法,可为后续检查及治疗提供参考依据。     

骨碎补对绝经妇女下肢肌力的影响

绝经妇女因雌激素水平显著下降引发肌肉力量下降,肌力下降是造成骨关节功能减退及骨质疏松重要原因,影响绝经妇女生活质量。而临床中多数患骨性关节炎的绝经妇女经关节腔注射玻璃酸钠仍有关节周围疼痛、乏力表现。近年来,我们加用骨碎补治疗此类患者,效果较好。现报告如下。     

等速肌力训练用于老年脑卒中后下肢功能恢复

目的 观察等速肌力训练用于脑卒中后偏瘫患者下肢运动功能康复的效果.方法 41例老年脑卒中后偏瘫患者随机分为2组,对照组采用常规训练,试验组在常规训练基础上加用等速肌力训练.结果 训练后试验组老年脑卒中患者下肢运动功能与平衡积分明显好于对照组(P＜0.01),试验组膝关节伸屈肌峰力矩较对照组有明显提高(P＜0.01).结论 等速肌力训练对脑卒中后偏瘫患者下肢功能有明显改善.     

老年人下肢肌力测量方法及其研究进展

正目前,我国已步入老龄社会[1],随着人口老龄化速度的加剧,老龄化所带来的公共健康问题也成为政府及研究学者所关注的热门问题。随着年龄的增长,老年人许多器官和系统逐渐退化[2],研究显示[3],从40岁开始肌力以每10年5%的速度退化,65岁以后下肢肌力每年下降1%～2%。老年人下肢肌肉力量与活动能力和姿势稳定性密切相关,下肢肌肉力量对维持身体姿势的稳定具有很重要的作用,肌肉力量薄弱导致人体姿势不稳,增加老年人发生跌倒的危险系数[2,4]。     

老年人的跌倒预防与肌肉力量训练

跌倒是造成65岁以上老年人受伤的主要原因,几乎95%的老年人髋部骨折都是由跌倒造成的,其严重后果是骨折发生的前3个月中的高死亡率,后期的功能活动能力减退和独立生活能力丧失.在我国,目前有老年人1.3亿,至少每年2 000万老年人发生跌倒2500万人次,直接医疗费用超过50亿人民币[1],社会费用高达(600～800)亿人民币[2].     

人造负离子对老年人呼吸肌力量训练效果的影响

目的观察空气中人造负离子含量的高低对老年人呼吸肌力量训练效果的影响。方法在年龄60～75岁的老年人中,筛选呼吸肌力量较差者50例,随机分为观察组和对照组,每组25例。两组在不同健身房内进行功能训练,空气负离子浓度采用空气离子测定仪进行检测;浓度的大小采用空气负离子发生仪进行人造负氧离子干预。对照组锻炼环境的空气负离子含量控制在100个/cm~3左右,而观察组控制在15×104个/cm~3左右。于入选时及经9 w功能康复训练后,分别对两组入选者的呼吸肌力量指标进行检测和比较。结果经9 w训练治疗后,两组训练者的呼吸肌力量指标较治疗前均有不同程度显著改善,差异有统计学意义(P<0. 05),与对照组比较,观察组的改善效果更显著(P<0. 05)。结论空气质量即空气中负离子含量的高低可对呼吸肌力量训练的效果起到明显干预作用,充足的负离子含量更利于呼吸肌力量改善。     

提高下肢肌肉质量，改善消化水平

人到中年很多人开始感觉腿脚不如年轻时那般轻盈，现在甚至有些年轻人也总把“腿脚不灵光了”挂在嘴边；还有些人，尤其是女性朋友下肢非常瘦，看似用点力气就能被掰折，偏偏这样却羡煞旁人，认为这是骨感美，可是，没有肌肉力量的下肢在威胁自己的健康。太多骨感的女性朋友总是有各种身体的问题比如手脚冰凉等．归其原因就是一句话“下肢力量不够”。     

下肢肌力/体重与老年人行走能力的相关性

目的探讨下肢肌力与体重的比值对老年人行走能力的影响。方法筛选70～79周岁的健康老年男性90例,逐一对其下肢肌力、体重及行走能力等指标进行检测,观察下肢肌力、体重及其比值与行走能力的相关性。结果下肢肌力越大行走能力普遍较好,但正相关性不明显(P0.05);体重越大行走能力越差,但相关性也不明显(P0.05);而下肢肌力与体重的比值与行走能力呈密切相关性,比值指数越大行走能力越好(P0.05)。结论老年人锻炼下肢肌力固然重要,而控制体重也是提高行走能力、预防跌倒发生的重要手段。     

老年腹股沟疝患者肌肉质量和力量研究

目的 评价老年腹股沟疝患者的肌肉质量和力量. 方法 拟接受腹股沟疝手术,年龄在70～90岁的男性住院患者30例为研究对象,40～50岁10例男性健康受试者为对照组,进行人体测量、应用生物电阻抗和双能X线扫描的方法测定人体组分、CT扫描腹部和大腿,通过专用软件计算相应肌肉面积. 结果 老年男性腹股沟疝患者握力和小腿围低于对照组;全身肌肉组织总量结果相近,均低于对照组,肢体骨骼肌指数为7.53±0.78,其中Ⅰ类肌减症(男性＜7.01 kg/m2)为22.7％,Ⅱ类(男性＜6.08 kg/m2)为0;CT扫描发现老年组腹壁肌肉和大腿肌肉均少于对照组,但竖脊肌结果两组相近,L3骨骼肌指数≤52.4(男性)为70.0％. 结论 老年腹股沟疝患者肌肉质量和力量低于成年人,肌减症发生率增高.     

等速肌力训练对脑卒中后上肢功能障碍患者上肢运动功能的影响

目的:研究等速肌力训练对脑卒中患者上肢运动功能的影响。方法:2016年1月-2017年10月于我院治疗的90例脑卒中后上肢功能障碍患者被随机均分为常规康复组和联合训练组(在常规康复组基础上接受等速肌力训练),两组均治疗4周。观察比较两组治疗前后Fugl-Meyer运动功能量表(FMA)评分、改良Ashworth量表(MAS)评分、改良Barthel指数(MBI)评分及以角速度60°/s、120°/s伸屈时肘伸肌、肘屈肌峰力矩(PT)、总功(TW)、平均功率(AP)。结果:与治疗前比较,治疗后两组FMA评分、MBI评分、以角速度60°/s、120°/s伸屈时肘伸肌及肘屈肌PT、TW、AP均显著升高(P均=0.001),治疗后两组MAS评分无显著差异(P均>0.05)。与常规康复组比较,联合训练组治疗后FMA评分[(49.28±6.73)分比(56.79±6.24)分]、MBI评分[(59.92±9.33)分比(70.14±9.39)分]、以角速度60°/s、120°/s伸屈时肘伸肌:PT[60°/s(17.25±3.66)N·m比(21.48±4.21)N·m,120°/s(10.74±3.80)N·m比(15.69±4.21)N·m]、TW[60°/s(165.74±20.51)J比(194.67±23.55)J,120°/s(209.67±25.28)J比(258.76±26.72)J]、AP[60°/s(11.28±3.35)W比(15.42±4.14)W,120°/s(11.58±3.65)W比(17.83±3.74)W]升高更显著(P均=0.001),以角速度60°/s、120°/s伸屈时肘屈肌:PT、TW、AP均无显著差异(P均>0.05)。结论:等速肌力训练可显著促进脑卒中后上肢功能障碍患者上肢运动功能的恢复,提高日常生活活动能力。     

高龄男性肌少症患者的活动能力与下肢肌肉质量和肌力的相关性研究

目的 探讨高龄（＞85岁）男性肌少症患者的活动能力与其下肢肌肉质量和下肢肌力的相关性。方法 根据亚洲肌少症工作组（AWGS）纳入和排除标准,入选2014年6月至2015年2月于解放军总医院门诊部查体的87名高龄肌少症男性患者,年龄（89.5±4.4）岁,平均相对骨骼肌肉质量指数（RASMMI）为（6.04±0.62）kg/m2。分别对研究对象进行身体成分测试、握力测试、下肢肌力测试（分别测试髂腰肌、股四头肌、胫前肌及腘绳肌的最大等长肌力）,并研究上述指标与活动能力测试如步速（6min最大步行速度测试）、计时“起立?行走”时间测试（TUGT）、5次起坐时间测试（FTSST）和闭目单腿站立测试的相关性。结果 步速、TUGT、FTSST、闭目单腿站立时间主要与年龄（r＝?0.567,P＝0.018;r＝0.742,P＝0.001;r＝0.632,P＝0.007;r＝?0.489,P＝0.047）、下肢肌肉质量（r＝0.489,P＝0.045;r＝?0.579,P＝0.012;r＝?0.641,P＝0.003;r＝0.476,P＝0.048）和下肢脂肪含量（r＝?0.517,P＝0.032;r＝0.513,P＝0.031;r＝0.528,P＝0.015;r＝?0.533,P＝0.012）相关。步速、TUGT、FTSST、闭目单腿站立时间与髂腰肌肌力（r＝0.313,P＝0.000;r＝?0.887,P＝0.000;r＝?0.666,P＝0.003;r＝0.515,P＝0.035）和与股四头肌肌力（r＝0.251,P＝0.017;r＝?0.775,P＝0.000;r＝?0.612,P＝0.013;r＝0.671,P＝0.002）相关。结论 高龄肌少症老人的活动能力与身体成分及下肢肌力相关程度较高。脂肪含量高而下肢肌肉质量低的老年人活动能力相对差;下肢肌力高的老年人活动能力较好,尤其以股四头肌、髂腰肌肌力为代表。     

Measuring balance, lower extremity strength and gait in the elderly: Construct validation of an instrument

The purpose of the study was to determine the degree to which scores of a modified version of the ‘Timed Get Up and Go’ test (TGUG) were associated with other measures of functional performance. Thirty-seven community-dwelling older women (72.3 ± 5.5 years) volunteered to participate. Subjects were assessed when performing the modified TGUG test. Correlations between the performance-oriented mobility assessment (POMA), single-leg balance, five chair rises, fast and normal gait speed, knee extension and flexion strength, and the modified TGUG were conducted. Total time to perform the modified TGUG test was significantly correlated with normal and fast gait speed (p < 0.05). The Pearson correlation coefficients were −0.841 and −0.748, respectively. The time needed to perform several tasks of the modified TGUG test significantly correlated with five chair rises, and with right knee extensor strength (p < 0.05). Points obtained in the assessment questionnaire correlated significantly to points obtained in the POMA scale (p < 0.05). The Pearson correlation coefficient was 0.795. Based on the strength of the correlations obtained between components of the modified TGUG and the comparison tests, concurrent, criterion validity of the modified TGUG has been established.     

Association of C-reactive protein and muscle strength in the English Longitudinal Study of Ageing

Sarcopenia has been associated with systemic inflammation and a range of other biological risk factors. The purpose of this study was to assess the systemic inflammation–muscle strength relationship in a large representative community-based cohort of older adults, and to determine the independence of this association from other biological and psychosocial risk factors. Participants were 1,926 men and 2,260 women (aged 65.3 ± 9.0 years) from the English Longitudinal Study of Ageing, a study of community dwelling older adults. We assessed hand grip strength and lower body strength (time required to complete five chair stands). Biological measures included C-reactive protein (CRP), fibrinogen, cholesterol, haemoglobin, glycated haemoglobin, adiposity, and blood pressure. Approximately 33% of the sample demonstrated elevated concentrations (≥3 mg/L) of CRP. After adjustments for age, smoking, physical activity, education, inflammatory diseases, and all other biological factors, elevated CRP was associated with poorer hand grip strength and chair stand performance in women but only chair stand performance in men. Low haemoglobin levels were consistently associated with poorer performance on both tests in women and men. These results confirm an independent association between low grade systemic inflammation (as indexed by CRP) and muscle strength that appears to be more robust in women.     

Respiratory muscle strength for discriminating frailty in community-dwelling elderly: a cross-sectional study

ObjectivesTo compare obtained and predicted inspiratory and expiratory muscle strength between frail, pre-frail, and non-frail older people; to examine the association between inspiratory and expiratory muscle strength and frailty in older people; and to determine cut-off points for inspiratory and expiratory muscle strength for discriminating frailty in older people.MethodsA cross-sectional study was conducted with 379 community-dwelling older adults. Frailty was assessed using Fried’s phenotype, while inspiratory and expiratory muscle strength were measured with maximum inspiratory and maximum expiratory pressures. Inferential analyses were performed using paired Student t-tests, one-way analysis of variance (ANOVA) tests, and a multinomial logistic regression model. ROC curves were constructed to establish cut-off points of maximum inspiratory and expiratory pressures for discriminating frailty and pre-frailty.ResultsFrail and pre-frail participants presented significantly lower mean inspiratory and expiratory pressures compared to non-frail participants; values were significantly lower than predicted. Inspiratory and expiratory muscle strength were inversely associated with frailty and pre-frailty. Cut-off points ≥-50cmH₂O and ≤60cmH₂O for maximum inspiratory and expiratory pressures, respectively, were established as optimal discriminators of frailty. The cut-off point ≤65cmH₂O for maximum expiratory pressure was established as a discriminant for the presence of pre-frailty.ConclusionsInspiratory and expiratory muscle strength were lower in frail than in pre-frail older adults, and lower in pre-frail than in non-frail peers. Frailty and pre-frailty were inversely associated with inspiratory and expiratory muscle strength. Cut-off points for inspiratory and expiratory muscle strength may be useful in clinical practice for discriminating frailty and pre-frailty in older adults.     

Association between ultrasound measurements of muscle thickness,pennation angle,echogenicity and skeletal muscle strength in the elderly

The increase of elderly in our society requires simple tools for quantification of sarcopenia in inpatient and outpatient settings. The aim of this study was to compare parameters determined with musculoskeletal ultrasound (M-US) with muscle strength in young and elderly patients. In this prospective, randomised and observer blind study, 26 young (24.2 ± 3.7 years) and 26 old (age 67.8 ± 4.8 years) patients were included. Muscle thickness, pennation angle and echogenicity of all muscles of musculus quadriceps were measured by M-US and correlated with isometric maximum voluntary contraction force (MVC) of musculus quadriceps. Reproducibility of M-US measurements as well as simple and multiple regression models were calculated. Of all measured M-US variables the highest reproducibility was found for measurements of thickness (intraclass correlation coefficients, 85–97 %). Simple regression analysis showed a highly significant correlation of thickness measurements of all muscles of musculus quadriceps with MVC in the elderly and in the young. Multiple regression analysis revealed that thickness of musculus vastus medialis had the best correlation with MVC in the elderly. This study showed that measurement of muscle thickness, especially of musculus vastus medialis, by M-US is a reliable, bedside method for monitoring the extent of sarcopenia.     

Effects of muscle strength and aerobic training on basal serum levels of IGF-1 and cortisol in elderly women

The aim of this study was to compare the effects of muscle strength and aerobic training on the basal serum levels of IGF-1 and cortisol in elderly women. The subjects were divided in three groups as follows. 1. Strength training group (SG) submitted to the weight training called 1-repetition maximum test (1-RM, 75–85%). This group contained 12 subjects of mean age = 66.08 ± 3.37 years; and body mass index (BMI) = 26.0 ± 3.72 kg/m². (2) Aerobic training group (AG) submitted to aquatic exercise; they were 13 subjects of the mean age = 68.69 ± 4.70 years; and BMI = 29.19 ± 2.96 kg/m². (3) A control group (CG) of 10 subjects, of mean age = 68.80 ± 5.41 years; BMI = 29.70 ± 2.82 kg/m². The training periods were 12 weeks, Fasting blood was analyzed to measure IGF-1 and basal cortisol levels (by chemiluminescence method), both at the beginning and the end of the intervention. Student's t-test revealed increased IGF-1 in the SG (p < 0.05) compared to the other two groups. Repeated-measure ANOVA showed also elevated IGF-1 (p < 0.05) in the SG compared to the other groups (AG and CG). There were no differences in cortisol levels. In conclusion, high-intensity training caused changes in IGF-1. This suggests that strength training may provoke anabolic effects in elderly individuals.