低强度抗阻训练对高龄患者平衡功能和抑郁状态的疗效观察

doi:10.16138/j.1673-6087.2021.05.011

摘要/Abstract

摘要：

目的：探讨低强度抗阻训练对老年患者平衡功能和抑郁状态的疗效。方法：选取我院符合入组条件的60例老年患者,通过随机数字表法分为研究组（30例）和对照组（30例）。对照组在常规药物治疗和护理的基础上,每天接受常规运动训练1次,每次30 min,每周训练5 d,持续干预6个月。研究组在常规药物治疗和护理的基础上,每天接受常规运动训练及低强度抗阻训练,每次30 min,每周训练5 d,持续干预6个月。于治疗前1周、治疗3个月、治疗6个月后,使用BioRescue&BioVal全身智能康复系统对治疗前后2组患者重心移动轨迹通过的表面积进行统计,评估2组患者平衡能力;使用老年抑郁量表对治疗前后老年患者情绪状态进行评估。结果：对照组干预6个月后重心移动轨迹表面积评分较干预前1周有改善（P<0.05）,与干预3个月后评分差异无统计学意义（P>0.05）,干预6个月后老年抑郁量表评分较干预前1周有改善（P<0.05）,与干预3个月后评分差异无统计学意义（P>0.05）;研究组干预6个月后重心移动轨迹表面积评分、老年抑郁量表评分较干预前1周、干预3个月后均有改善（均P<0.05）;干预6个月后,研究组重心移动轨迹表面积评分、老年抑郁量表评分与对照组相比差异有统计学意义（P<0.05）。结论：低强度抗阻训练结合常规药物治疗和护理对改善护理医院老年患者的平衡功能及抑郁状态有积极的疗效。

关键词: 低强度抗阻训练, 老年患者, 平衡功能, 抑郁状态

Abstract:

Objective To explore the effect of low-intensity resistance training on balance function and depression in elderly patients in nursing hospital. Methods Totally 60 elderly patients were randomly divided into study group (30 cases) and control group (30 cases). Based on routine drug treatment and nursing, the control group received routine exercise training once a day, 30 min each time, 5 d a week for 6 months, while the study group received both routine exercise training and low-intensity resistance training every day, 30 min each time, 5 d a week, and continuous training for 6 months. One week before treatment, 3 months, and 6 months after treatment, BioRescue & BioVal whole body intelligent rehabilitation system was used to calculate the surface area scores of gravity moving trajectory to evaluate their balance ability for the patients in two groups. In addition, the elderly depression scale was used to evaluate the emotional state of the elderly patients before and after treatment. Results In control group, the surface area score of gravity moving trajectory and geriatric depression scale score after 6 months were improved than those in 1 week before treatment (P<0.05), while both scores after 3 months didn’t show difference (P>0.05). In the study group, compared with 1 week before treatment and 3 months after training, the surface area score of gravity moving trajectory and the geriatric depression scale score were improved after 6 months training (both P<0.05). In addition, two scores after 6 months in study group were better than those in control group (P<0.05). Conclusions Low intensity resistance training combined with conventional drug therapy and nursing has a positive effect on improving balance function and depression state of elderly patients in nursing hospital.

Key words: Low intensity resistance training, Elderly patients, Balance function, Depression state

中图分类号:

R749.4

陈梅, 付丛会, 余小萍, 王刚, 徐英. 低强度抗阻训练对高龄患者平衡功能和抑郁状态的疗效观察[J]. 内科理论与实践, 2021, 16(05): 344-348.

CHEN Mei, FU Conghui, YU Xiaoping, WANG Gang, XU Ying. Effect of low intensity resistance training on balance function and depression state in elderly patients[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(05): 344-348.

图/表 3

参考文献 32

[1]	Cuevas-Trisan R. Balance problems and fall risks in the elderly[J]. Clin Geriatr Med, 2019, 35(2): 173-183. doi: S0749-0690(19)30009-6 pmid: 30929881
[2]	Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention[J]. Age Ageing, 2006, 35 Suppl 2: ii37-ii44.
[3]	Papa EV, Dong X, Hassan M. Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review[J]. Clin Interv Aging, 2017, 12: 955-961. doi: 10.2147/CIA.S104674 URL
[4]	Auvinet B, Touzard C, Montestruc F, et al. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes[J]. J Neuroeng Rehabil, 2017, 14(1): 7. doi: 10.1186/s12984-017-0218-1 URL
[5]	马微波, 刘悦文, 郭琪, 等. 老年人平衡功能障碍的多成因跌倒分析[J]. 中国康复, 2020, 35(10): 547-551.
[6]	Özkal Ö, Kara M, Topuz S, et al. Assessment of core and lower limb muscles for static/dynamic balance in the older people: an ultrasonographic study[J]. Age Ageing, 2019, 48(6): 881-887. doi: 10.1093/ageing/afz079 URL
[7]	Wang S, Blazer DG. Depression and cognition in the elderly[J]. Annu Rev Clin Psychol, 2015, 11(1): 331-360. doi: 10.1146/annurev-clinpsy-032814-112828 URL
[8]	Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review[J]. Int Psychogeriatr, 2010, 22(7): 1025-1039. doi: 10.1017/S1041610210000608 URL
[9]	王雅琦, 吴方, 黄立群, 等. 养老机构老年人抑郁情绪发展轨迹及预测因素分析[J]. 护理学杂志, 2019, 34(18): 1-4.
[10]	Kekäläinen T, Kokko K, Sipilä S, et al. Effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults: randomized controlled trial[J]. Qual Life Res, 2018, 27(2): 455-465. doi: 10.1007/s11136-017-1733-z pmid: 29124498
[11]	Alenazi AM, Alshehri MM, Alothman S, et al. Functional reach, depression scores, and number of medications are associated with number of falls in people with chronic stroke[J]. PM R, 2018, 10(8): 806-816. doi: 10.1016/j.pmrj.2017.12.005 URL
[12]	Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3): 189-198. doi: 10.1016/0022-3956(75)90026-6 pmid: 1202204
[13]	唐丹. 简版老年抑郁量表(GDS-15)在中国老年人中的使用[J]. 中国临床心理学杂志, 2013, 21(3): 402-405.
[14]	Borg G. Psychophysical bases of perceived exertion[J]. Med Sci Sports Exerc, 1982, 14(5): 377-381.
[15]	游永豪, 温爱玲. 人体平衡能力测评方法[J]. 中国康复医学杂志, 2014, 29(11): 1099-1104.
[16]	杨雅琴, 王拥军, 冯涛, 等. 平衡评价量表在临床中的应用[J]. 中国康复理论与实践, 2011, 17(8): 709-712.
[17]	Crandall M, Duncan T, Mallat A, et al. Prevention of fall-related injuries in the elderly: an Eastern Association for the Surgery of Trauma practice management guideline[J]. J Trauma Acute Care Surg, 2016, 81(1): 196-206. doi: 10.1097/TA.0000000000001025 pmid: 26958795
[18]	周明, 彭楠, 朱才兴, 等. 功能性步态评价与Berg平衡量表对社区老年人跌倒风险的预测价值[J]. 中国康复理论与实践, 2013, 19(1): 66-69.
[19]	Phelan EA, Ritchey K. Fall prevention in community-dwelling older adults[J]. Ann Intern Med, 2018, 169(11): ITC81-ITC96. doi: 10.7326/AITC201812040 URL
[20]	Newman AB, Kupelian V, Visser M, et al. Sarcopenia: alternative definitions and associations with lower extremity function[J]. J Am Geriatr Soc, 2003, 51(11): 1602-1609. pmid: 14687390
[21]	江婉婷, 王兴, 王光旭, 等. 抗阻运动对中老年女性下肢肌肉力量及功能干预效果的Meta分析[J]. 首都体育学院学报, 2019, 31(3): 272-280.
[22]	杜丽成, 张晓调, 黄一奔, 等. 慢性阻塞性肺疾病患者姿势控制能力的初步研究[J]. 中国康复医学杂志, 2017, 32(1): 94-96.
[23]	姚舜, 郝玉鹏, 王洪宇, 等. 针刺结合帕维尔康复训练对帕金森病患者运动及平衡功能的影响[J]. 黑龙江中医药, 2017, 46(2): 52-53.
[24]	夏汶, 郑洁皎, 张杰, 等. 低强度有氧训练改善高龄老人平衡能力的临床应用[J]. 老年医学与保健, 2019, 25(1): 63-65.
[25]	竹内孝仁. 神奇的帕维尔康复[M]. 广州: 中山大学出版社, 2015: 13-39.
[26]	谭敏, 胡秀英, 刘祚燕. 老年人平衡功能评估与训练研究新进展[J]. 华西医学, 2019, 34(1): 86-90.
[27]	Borde R, Hortobágyi T, Granacher U. Dose-response relationships of resistance training in healthy old adults[J]. Sports Med, 2015, 45(12): 1693-1720. doi: 10.1007/s40279-015-0385-9 pmid: 26420238
[28]	Lampert MA, Rosso ALP. Depression in elderly women resident in a long-stay nursing home[J]. Dement Neuropsychol, 2015, 9(1): 76-80. doi: 10.1590/S1980-57642015DN91000012 URL
[29]	张军, 赵心阳, 张莹莹, 等. 辽宁省养老机构老年人长期照护需求及影响因素调查[J]. 护理学杂志, 2018, 33(22): 90-92.
[30]	王雅琦, 吴方, 黄立群, 等. 养老机构老年人抑郁情绪发展轨迹及预测因素分析[J]. 护理学杂志, 2019, 34(18): 1-4.
[31]	李鑫, 高雅, 霍玉萌, 等. 抗阻力运动对老年帕金森睡眠障碍病人睡眠质量及情绪状态的影响[J]. 实用老年医学, 2020, 34(5): 493-495.
[32]	孙宇岸. 运动康复对老年人抑郁心理及心率变异性的影响[J]. 中国老年学杂志, 2019, 5(39): 2150-2152.

项目	对照组	研究组	t/χ²	P
年龄（岁）	80.97±8.27	79.37±8.76	-0.460	0.647
男性[n（%）]	14（17）	14（17）	0.000	1.000
BMI（kg/㎡）	22.63±2.94	21.78±3.36	0.736	0.541

时间	对照组	研究组	Z	P
治疗前1周	882.5(303.7,2 288.5)	896.5(285.0,2 436.0)	-0.075	0.942
治疗3个月后	933.0(344.3,2 233.0)¹⁾	1 408.5(490.3,4 293.0)¹⁾	-1.465	0.144
治疗6个月后	1 056.0(340.8,2 988.5)¹⁾	2 528.0(1 130.0,6 099.3)¹⁾²⁾	-2.811	0.005
χ²	15.820	59.899
P	0.000	0.000

时间	对照组	研究组	Z	P
治疗前1周	7.0(6.0,9.8)	7.0(5.0,8.8)	-6.480	0.517
治疗3个月后	6(5.0,9.0)¹⁾	5.5(4.0,7.0)¹⁾	-1.763	0.078
治疗6个月后	5.5(4.0,7.8)¹⁾	4.0(3.0,6.0)¹⁾²⁾	-2.376	0.018
χ²	42.280	41.694
P	0.000	0.000