Application value of comprehensive myopenia training intervention in stroke rehabilitation training and its preventive effect on myopenia
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摘要:
目的 探讨康复训练在脑卒中患者康复中的应用价值及对肌少症的预防作用。 方法 选取2020年7—12月温州医科大学附属第二医院收治的100例脑卒中住院患者，依据随机数字表法分为对照组、观察组，每组50例。对照组给予常规康复训练，观察组给予常规康复训练结合肌少症训练综合干预。比较2组患者的胫前屈肌、肱二头肌厚度与健侧、患侧握力，汉密尔顿焦虑(HAMA)、抑郁量表(HAMD)评分，生活质量量表(SF-36)评分及肌少症发生率。 结果 观察组肌少症发生率为4%，对照组为18%，观察组肌少症发生率低于对照组(P＜0.05)。干预后，骨骼肌超声(M-US)显示对照组胫前屈肌为(1.78±0.36)cm，观察组为(2.06±0.48)cm；对照组肱二头肌为(2.36±0.58)cm，观察组为(2.64±0.63)cm，2组比较差异均有统计学意义(均P＜0.05)。干预后，观察组健侧、患侧握力高于对照组(均P＜0.05)，干预后，观察组HAMA评分为(4.62±0.73)分、HAMD评分为(4.73±0.82)分，均低于对照组[(5.03±0.84)分、(5.19±0.87)分，均P＜0.05]，观察组SF-36各项目评分均高于对照组(均P＜0.05)。 结论 对于脑卒中患者运用肌少症训练综合干预，可降低肌少症发生率，改善其骨骼肌厚度和握力，缓解其负面情绪，提升其生活质量。 Abstract:Objective To study the application value of rehabilitation training in stroke and its preventive effect on myopenia. Methods A total of 100 inpatients who suffered from stroke and admitted from July 2020 to December 2020 were divided into the control and observation groups of 50 cases each. The control group underwent routine rehabilitation training, whereas the observation group underwent routine rehabilitation training combined with comprehensive myopenia training intervention. The thickness of the anterior tibial flexor and biceps brachii, grip strength of healthy and affected sides, Hamilton Anxiety Scale (HAMA), depression scale (HAMD), quality of life scale (SF-36) and incidence of myopenia were compared between the two groups. Results The incidence rate of myopenia in the observation group (4%) was lower than that in the control group (18%; P < 0.05). After the intervention, the M-US values of the anterior tibial flexor muscle in the control group and the observation group were (1.78±0.36) cm and (2.06±0.48) cm, and the difference were significant (all P < 0.05). The M-US values of the biceps brachii were (2.36±0.58) cm and (2.64±0.63) cm, respectively, and the difference was significant (P < 0.05). After the intervention, the grip strength of the healthy side and that of the affected side in the observation group was higher than those in the control group (P < 0.05). After the intervention, the observation group had a lower HAMA score [(4.62±0.73) points] than the control group [(5.03±0.84) points], lower HAMD score [(4.73±0.82) points] than the control group [(5.19±0.87) points] and higher SF-36 score (all P < 0.05). Conclusion The comprehensive intervention of myopenia training in patients with stroke can reduce the incidence of myopenia, improve their skeletal muscle thickness and grip strength, alleviate their negative emotions and improve their quality of life. -
Key words:
- Quality of life /
- Sarcopenia /
- Stroke /
- Rehabilitation training
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表 1 2组脑卒中患者肌厚度及握力比较(x±s)
组别 例数 胫前屈肌肌厚度（cm） 肱二头肌肌厚度（cm） 健侧握力（N） 患侧握力（N） 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 对照组 50 2.22±0.53 1.78±0.36 2.74±0.63 2.36±0.58 239.45±84.56 264.53±85.31 156.13±43.29 178.96±54.85 观察组 50 2.20±0.51 2.06±0.48 2.72±0.61 2.64±0.63 238.97±83.97 314.83±93.16 154.94±42.37 209.37±50.26 t值 0.192 3.300 0.161 2.312 0.028 2.816 0.139 2.890 P值 0.848 0.001 0.872 0.023 0.977 0.006 0.890 0.005 
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表 2 2组脑卒中患者HAMA、HAMD评分比较(x±s，分)
组别 例数 HAMA HAMD 干预前 干预后 干预前 干预后 对照组 50 6.12±1.18 5.03±0.84 6.25±1.12 5.19±0.87 观察组 50 6.14±1.15 4.62±0.73 6.27±1.03 4.73±0.82 t值 0.086 2.605 0.093 2.721 P值 0.932 0.011 0.926 0.008
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表 3 2组脑卒中患者生活质量评分比较(x±s，分)
组别 例数 精神状况 生理职能 一般健康 社会职能 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 对照组 50 52.17±13.54 63.18±9.36 54.63±12.15 65.49±10.15 55.36±11.84 65.83±8.31 50.32±8.69 63.18±7.34 观察组 50 52.11±13.26 67.59±8.42 54.57±11.89 71.43±10.27 55.29±11.79 70.79±8.24 50.29±8.71 67.49±7.15 t值 0.022 2.477 0.025 2.909 0.030 2.997 0.017 2.974 P值 0.982 0.015 0.980 0.004 0.976 0.004 0.986 0.004
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