低负荷小强度抗阻运动对卧床老年患者肌力和心肺功能的影响

doi:10.3761/j.issn.0254-1769.2021.11.001

摘要/Abstract

摘要：

目的制订适合高龄老年卧床患者的低负荷小强度抗阻运动方案,评价其对患者肌力和心肺功能的影响。方法便利选取北京市某三级甲等医院老年病房2020年3月—4月收治的80岁及以上疾病稳定期患者64例,随机分为试验组和对照组。试验组在常规治疗和护理的基础上,给予6个月的低负荷小强度抗阻训练,对照组给予常规治疗和护理,比较两组的肌力和心肺功能。结果共有59例患者完成研究,试验组29例,对照组30例。试验组握力在3个月和6个月时高于对照组（P<0.05）,仰卧举腿和30 s反复坐起次数在6个月时多于对照组（P<0.05）。肺活量在6个月时高于对照组（P<0.05）,两组血压、心率、左心室射血分数等比较,差异均无统计学意义（P>0.05）。结论低负荷小强度抗阻运动不仅能提高高龄卧床老年患者的肌力,还能有效改善患者的肺功能,但对改善心功能的效果不明显。

关键词: 高龄, 卧床, 抗阻运动, 肌力, 心肺功能, 老年护理学

Abstract:

Objective The aim of this study is to establish resistance exercise in the bedridden elderly in China and to study its effect on muscle strength and cardiopulmonary function. Methods This RCT consecutively enrolled 64 patients aged 80 years and above with stable diseases at a tertiary hospital during March to April 2020. The patients were randomly divided into a control group（received routine treatment and nursing care） and a training group（undergoing 6 months of low-load resistance training with routine treatment and nursing care）. The differences in muscle strength and cardiopulmonary function between the patients of 2 groups were analyzed. Results 64 patients were included in the study,while 59 patients（with 29 in the training group and 30 in the control group） completed the study. In terms of muscle strength,the patients of the training group had better grip strength compared with that of the control group at 3 and 6 months（P<0.05）,and better supine leg lifts and 30 s sit-to-stand actions than those of the control group at 6 months（P<0.05）. In terms of cardiopulmonary function,the patients in the training group had better lung capacity compared with that in the control group at 6 months（P<0.05）. There were no significant differences in blood pressure,heart rate and left ventricular ejection fraction between the 2 groups（P>0.05）. Conclusion The low-load and low-intensity resistance training using elastic band and ball can effectively improve the muscle strength of the bedridden elderly,as well as the lung function to a certain extent. However,the effect on improving the cardiac function is not obvious.

Key words: The Elderly, Bed-Ridden, Resistance Training, Muscle Strength, Cardiopulmonary Function, Geriatric Nursing

王英杰, 乔然, 于彤, 王帅, 王晓晶. 低负荷小强度抗阻运动对卧床老年患者肌力和心肺功能的影响[J]. 中华护理杂志, 2021, 56(11): 1605-1611.

WANG Yingjie, QIAO Ran, YU Tong, WANG Shuai, WANG Xiaojing. Effect of resistance exercise program on muscle strength and cardiopulmonary function in elderly bedridden patients[J]. Chinese Journal of Nursing, 2021, 56(11): 1605-1611.

图/表 4

图1 卧位低负荷小强度抗阻运动方案

Figure 1 Supine resistance exercise program

表1 两组一般资料比较（n=59）

Table 1 Comparison of general data between the two groups（n=59）

表2 干预前后两组肌力比较

Table 2 Comparison of muscle strength between the two groups before and after intervention

表3 干预前后两组心肺功能比较

Table 3 Comparison of cardiopulmonary function between the two groups before and after intervention

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