血流限制联合低强度抗阻训练对高位脊髓损伤患者上肢功能和日常活动能力的影响

关键词：高位脊髓损伤  血流限制  上肢功能  日常活动能力

Keywords:high-level spinal cord injury  blood flow restriction  upper limb function  activities of daily living

摘要：

      摘要 目的：探讨血流限制联合低强度阻力训练对高位脊髓损伤患者上肢功能和日常活动能力的影响。 方法：选取2023年3—10月于北京博爱医院收治的颈段脊髓损伤患者34例，随机分为试验组和对照组，每组17例。对照组进行单纯双上肢低强度阻力训练，试验组在对照组的基础上添加血流限制条件。干预前后对比两组肌肉厚度、肌力、上肢功能问卷评分、日常活动能力和生存质量5个方面。 结果：①上肢功能：6周治疗后，试验组各肌肉的肌肉厚度较治疗前都有显著增加（P<0.05），对照组仅部分有改善（P<0.05），试验组各肌肉厚度的差值较对照组有显著差异（P<0.05）；治疗后，试验组和对照组大部分肌群的肌力较治疗前均有增加，另外试验组的双侧屈肘和伸肘肌群肌力优于对照组（P<0.05）；6周治疗后，两组患者CUE-Q评分均明显增加（P<0.05），且试验组评分高于对照组（P<0.05）；②日常活动能力变化：6周治疗后，两组患者SCIM-Ⅲ、SCIDOLRS在治疗后均有提高（P<0.05），且试验组评分优于对照组（P<0.05）。 结论：相较于常规低强度阻力训练，血流限制联合低强度阻力训练可以更有效地改善高位脊髓损伤患者的上肢功能及日常活动能力。

Abstract:

      Abstract Objective：To investigate the effects of blood flow restriction combined with low intensity resistance training on upper limb function and activities of daily living (ADL) in patients with high-level spinal cord injury. Method：Thirty-four patients with cervical spinal cord injury admitted to Beijing Boai hospital from March 2023 to October 2023 were randomly divided into an experimental group and a control group， with 17 patients in each group. The control group received low intensity resistance training for both upper limbs， while the experimental group added blood flow restriction conditions on top of the control group. Comparing five aspects of muscle thickness， muscle strength， capabolities of upper extremity questionnaire（CUE-Q）， spinal cord independence measure-Ⅲ（SCIM-Ⅲ）and spinal cord injury of dysfunction quality of life rating scale（SCIDOLRS）between the two groups before and after intervention. Result：①Upper limb function： After 6 weeks of treatment， the muscle thickness of each muscle in the experimental group significantly increased compared to before treatment （P<0.05）， while the control group only partially improved （P<0.05）. The difference in muscle thickness between the experimental group and the control group was significantly different （P<0.05）； After treatment， the muscle strength of most muscle groups in the experimental and control groups increased compared to before treatment. In addition， the muscle strength of bilateral elbow flexion and extension muscle groups in the experimental group were better than that in the control group （P<0.05）； After 6 weeks of treatment， the CUE-Q scores of both groups significantly increased （P<0.05）， and the scores of the experimental group were higher than control group （P<0.05） .②Changes in daily activity ability： After 6 weeks of treatment， both groups of patients showed improvements in SCIM-Ⅲ and SCIDOLRS scores（P<0.05）， and the experimental group scored better than the control group （P<0.05）. Conclusion：Compared to low intensity resistance training， blood flow restriction combined with low intensity resistance training can more effectively improve upper limb function and daily activity ability in patients with high level spinal cord injury.