李静,董钊钊,张颖,等.血流限制训练对类风湿关节炎患者下肢关节功能恢复的影响[J].中华物理医学与康复杂志,2021,43(6):508-513
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| 血流限制训练对类风湿关节炎患者下肢关节功能恢复的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.06.006 |
| 中文关键词: 血流限制训练 类风湿关节炎 物理治疗 康复 |
| 英文关键词: Blood flow restriction training Rheumatoid arthritis Physical therapy Rehabilitation |
| 基金项目:河北省医学科学研究重点课题计划（20180432） |
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| 中文摘要: |
| 目的 观察血流限制训练(BFRT)对类风湿关节炎(RA)患者下肢关节功能恢复的影响。 方法 采用随机数字表法将60例RA患者分为观察组及对照组，每组30例。2组患者均给予常规药物治疗（慢作用抗风湿药物+小剂量糖皮质激素）及基础运动训练（包括关节训练和肌力训练），观察组患者在此基础上辅以BFRT训练，训练过程中保持腹股沟部位袖带压力恒定以限制肢体血流，训练项目主要包括双腿推举及双膝伸展等下肢运动。于干预前、干预12周后采用28个关节肿胀计数(SJC28)、28个关节压痛计数(TJC28)和疼痛视觉模拟评分法(VAS)评定患者关节症状情况；采用站立计时测验(TST)和起立-行走计时测验(TUG)评定患者下肢运动功能；采用健康评估问卷(HAQ)和关节炎自我效能感量表-8(ASES-8)评定患者生活质量；采用临床疾病活动指数(CDAI)、简化疾病活动指数(SDAI)和28个关节疾病活动指数(DAS28)评定患者疾病活动情况。 结果 干预前2组患者SJC28、TJC28、疼痛VAS评分、TST、TUG、HAQ、ASES-8、CDAI、SDAI及DAS28评分组间差异均无统计学意义(P>0.05)。干预后观察组患者上述指标（除DAS28外）均较治疗前明显改善（P<0.05），对照组上述指标均较治疗前无明显改善（P>0.05）；并且干预后观察组SJC28、TJC28、疼痛VAS评分、TST、TUG、HAQ、ASES-8及CDAI评分均显著优于对照组水平(P<0.05)。干预期间2组患者均未发生与治疗相关的严重不良事件。 结论 BFRT训练可减轻RA患者关节症状，改善下肢运动功能，提升生活质量，有效促进RA患者下肢关节功能恢复，同时安全性较好，该疗法值得临床进一步研究、推广。 |
| 英文摘要: |
| Objective To investigate the effect of blood flow restriction training (BFRT) on the rehabilitation of lower limb joint function in persons with rheumatoid arthritis (RA). Methods Sixty RA patients were randomly divided into an observation group and a control group, each of 30. Both groups were given conventional slow-acting anti-rheumatic medication with low-dose glucocorticoids. Everyone received basic exercise training including joint training and plyometric training, but the observation group additionally received BFRT training during which constant pressure in an inguinal cuff restricted blood flow to the lower limbs. The observation group′s training program also included double leg push-ups and double knee extensions. Before, and 12 weeks after the intervention, the joint symptoms were assessed using swollen joint counts out of 28 joints (SJC28), tender joint counts out of 28 joints (TJC28) and pain reported using a visual analogue scale (VAS). Lower limb motor functioning was assessed using a timed-stands test (TST) and the timed-up-and-go (TUG) test. Life quality was evaluated using a health assessment questionnaire (HAQ) and arthritis self-efficacy scale-8 (ASES-8). Disease activity was quantified using a clinical disease activity index (CDAI), a simplified disease activity index (SDAI) and disease activity scoring with a 28-joint count (DAS28). Results There were no significant differences between the two groups before the intervention. After the intervention all of the indicators except the DAS28 had improved significantly in the observation group. At that point they were also all better than the control group′s averages, where no significant improvement was observed. No serious adverse events occurred in either group during the experiment. Conclusions BFRT can safely relieve joint symptoms and improve the lower limb motor functioning and life quality of RA sufferers. It is worthy of further clinical research and promotion. |
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