基于不同速率抗阻训练的多组分运动干预对老年衰弱患者躯体功能和抑郁状态的影响

Effects of multi-component exercise intervention based on different rates of resistance training on physical function and depression status in elderly patients with frailty

  • 摘要:
    目的 探讨基于不同速率抗阻训练的多组分运动干预(MET)对老年衰弱患者躯体功能和抑郁状态的影响。
    方法 将80例老年病科住院的衰弱患者随机分为对照组(n=40)和研究组(n=40)。对照组进行常规老年衰弱患者的医疗干预,研究组在对照组基础上进行MET。根据随机分配原则将研究组分为高速阻组(n=20)和低速阻组(n=20), 高速阻组按照强度设定的单次重复最大质量(1RM)的75%进行3组抗阻训练,低速阻组按照强度设定的1RM的45%、60%和75%进行3组抗阻训练。比较3组患者干预前后肩关节、髋关节和膝关节的前屈、后伸活动的1RM变化; 比较3组患者干预前后的简易功能状态评估量表(SPPB)、汉密尔顿抑郁量表(HAMD)和简易生活质量量表(SF-12)评分。
    结果 干预后,高速阻组各关节活动1RM高于低速阻组和对照组,低速阻组各关节活动1RM高于对照组,差异均有统计学意义(P < 0.05)。干预后,高速阻组SPPB评分高于低速阻组和对照组,低速阻组SPPB评分高于对照组,高速阻组HAMD评分低于低速阻组和对照组,低速阻组HAMD评分低于对照组,差异均有统计学意义(P < 0.05)。干预后,高速阻组躯体健康总评分(PCS)和心理健康总评分(MCS)评分高于低速阻组和对照组,低速阻组PCS、MCS评分高于对照组,差异均有统计学意义(P < 0.05)。
    结论 MET可以改善老年衰弱患者的躯体功能和抑郁状态,适当提高抗阻训练速率有助于进一步提高MET的积极效果。

     

    Abstract:
    Objective To explore the effects of multi-component exercise intervention (MET) based on different rates of resistance training on physical function and depression status in elderly patients with frailty.
    Methods Eighty hospitalized elderly patients with frailty in the Geriatric Department were randomly divided into control group (n=40) and study group (n=40). The elderly patients with frailty in the control group received routine medical intervention, while those in the study group received MET on the basis of the control group. According to the principle of random allocation, the study group was further divided into high-resistance group (n=20) and low-resistance group (n=20). The high-resistance group performed three sets of resistance training at 75% of the one-repetition maximum (1RM) intensity, while the low-resistance group performed three sets of resistance training at 45%, 60% and 75% of the 1RM intensity. The changes in 1RM of shoulder, hip, and knee flexion and extension activities were compared among the three groups before and after the intervention; the scores of the Short-form Physical Performance Battery (SPPB), the Hamilton Depression Rating Scale (HAMD), and the Short-form Quality of Life with 12 items (SF-12) were also compared among the three groups before and after the intervention.
    Results After the intervention, the 1RM of joint activities in the high-resistance group was significantly higher than that in the low-resistance group and the control group, and the 1RM of joint activities in the low-resistance group was also significantly higher than that in the control group (P < 0.05). After the intervention, the SPPB score in the high-resistance group was significantly higher than that in the low-resistance group and the control group, and the SPPB score in the low-resistance group was also significantly higher than that in the control group (P < 0.05); the HAMD score in the high-resistance group was significantly lower than that in the low-resistance group and the control group, and the HAMD score in the low-resistance group was also significantly lower than that in the control group (P < 0.05). After the intervention, the total Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in the high-resistance group were significantly higher than those in the low-resistance group and the control group, and the PCS and MCS scores in the low-resistance group were also significantly higher than those in the control group (P < 0.05).
    Conclusion MET can improve physical function and depression status in elderly patients with frailty, and appropriate increase of the resistance training rate can further enhance the positive effects of MET.

     

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