血流限制训练对老年人肌肉力量、质量和躯体能力改变影响的Meta分析  

Effects of blood flow restriction training on muscle strength,muscle mass and physical performance in older adults:a Meta-analysis

作　　者：潘玮敏[1] 王兵[2] 韩亚兵 李婷 宋嘉琦 覃华生 刘洋[3] Pan Weimin;Wang Bing;Han Yabing;Li Ting;Song Jiaqi;Qin Huasheng;Liu Yang(Sports and Health Science School,Xi’an Physical Education University,Xi’an 710068,Shaanxi Province,China;Basic Science School,Xi’an Technological University,Xi’an 710021,Shaanxi Province,China;Graduate School,Xi’an Physical Education University,Xi’an 710068,Shaanxi Province,China;Physical Education Department,Shaanxi Xueqian Normal University,Xi’an 710100,Shaanxi Province,China)

机构地区：[1]西安体育学院运动与健康科学学院,陕西省西安市710068 [2]西安工业大学基础学院,陕西省西安市710021 [3]西安体育学院研究生部,陕西省西安市710068 [4]陕西学前师范学院体育学院,陕西省西安市710100

出　　处：《中国组织工程研究》2023年第5期805-812,共8页Chinese Journal of Tissue Engineering Research

基　　金：陕西省社会科学基金项目(2019R020),项目负责人:潘玮敏。

摘　　要：目的:通过系统评价目前应用于老年人群不同方式血流限制训练对肌肉力量、肌肉质量及躯体能力的综合影响,旨在为科学应用血流限制训练防治老年性肌减症提供理论依据。方法:计算机检索PubMed,Embase,Cochrane Library及中国知网、万方、维普和CBM数据库,搜索并收集关于血流限制训练对老年人肌肉力量、肌肉质量和躯体能力影响的随机对照试验,文献发表时间为各数据库建库至2021年8月,至少2名评价员利用Cochrane协作网推荐的偏倚评估工具对纳入的文献进行文献质量评估,采用RevMan 5.4软件对相关数据进行Meta分析。评价指标包括肌肉力量、肌肉质量和躯体能力3个连续性变量,对纳入文献中结局指标的不同测试方法进行亚组分析。结果:①共纳入16项随机对照试验,共348例受试者,文献质量分级依据Cochrane协作网偏倚风险评价工具,结果显示有11篇研究为B级,其他5篇为C级。②Meta分析结果显示:与高负荷抗阻训练相比较,低负荷血流限制训练对提高老年人的肌肉力量(SMD=-0.14,95%CI:-0.34-0.06,P=0.17)和肌肉质量(SMD=0.08,95%CI:-0.23-0.40,P=0.60)具有相同的效果;与低负荷抗阻训练相比,低负荷血流限制训练显著提高肌肉力量(SMD=0.57,95%CI:0.28-0.87,P=0.0002);与步行训练相比,血流限制-步行显著提高肌肉力量(SMD=0.62,95%CI:0.32-0.91,P<0.0001),但肌肉质量(SMD=0.28,95%CI:-0.01-0.57,P=0.06)和躯体能力(SMD=0.61,95%CI:-0.04-1.26,P=0.07)没有显著变化。③亚组分析结果显示:异质性降低,采用最大自主收缩(SMD=0.95,95%CI:0.25-1.65,P=0.008)和等速力矩(SMD=0.80,95%CI:0.16-1.45,P=0.01)测试肌肉力量时,低负荷血流限制训练明显优于低负荷抗阻训练;应用躯体功能(SMD=0.94,95%CI:0.35-1.52,P=0.002)评估躯体能力,血流限制性步行较步行训练显著提升。结论:现有的16项随机对照试验证据表明,与传统抗阻训练和步行相比,低负荷血流限制训练和血�OBJECTIVE:To systematically evaluate the effects of low-load blood flow restriction training and walking training with blood flow restriction on muscle strength,muscle mass and physical performance in older adults,thereby providing a theoretical basis for the scientific application of blood flow restriction to the prevention and treatment of senile sarcopenia.METHODS:A computer-based search was conducted in PubMed,Embase,Cochrane Library,CNKI,WanFang,VIP,and CBM.Randomized controlled trials regarding the effects of blood flow restriction training on muscle mass,muscle strength and physical performance in older adults were included from inception to August,2021.The literature quality was assessed using the bias assessment tool recommended by the Cochrane Collaboration by at least two evaluators and RevMan5.4 software was used to conduct meta-analysis of relevant data.Evaluation indicators contained three continuous variables including muscle strength,muscle mass and physical performance.Subgroup analysis was carried out for different test methods of outcome indicators included in the literature RESULTS:A total of 16 randomized controlled trials,including 348 patients in total,were included according to the inclusion criteria.The quality of the literature was graded according to the Cochrane Collaboration’s risk of bias assessment tool,including 11 studies of grade B and 5 of grade C.The results of Meta-analysis showed that compared with high-load resistance training,low-load blood flow restriction training could improve muscle strength[standardized mean difference(SMD)=-0.14,95%confidence interval(CI):-0.34-0.06,P=0.17]and muscle mass(SMD=0.08,95%CI:-0.23-0.40,P=0.60)in older adults;compared with low-load resistance training,low-load blood flow restriction training and walking training with blood flow restriction could significantly improve muscle strength(SMD=0.57,95%CI:0.28-0.87,P=0.0002);compared with walking training,walking blood flow restriction training significantly could improve muscle strength(SMD=0.62

关 键 词：老年人 血流限制训练 抗阻训练 步行 肌肉力量 肌肉质量 躯体能力 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R319