The relationship of joint symptoms with exercise performance in older adults.
The relationship of joint symptoms with exercise performance in older adults.
复制标题
老年人关节症状与运动表现的关系。
DOI：
10.1111/j.1532-5415.1996.tb05632.x
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发表时间：
1996
影响因子：
6.3
通讯作者：
deLateur,BJ
中科院分区：
文献类型：
--
作者：
Coleman,EA;Buchner,DM;Cress,ME;Chan,BK;deLateur,BJ
目的：本研究的目的是确定运动是否会增加有关节炎病史的老年人的关节症状，或在没有关节炎病史的老年人中产生症状。此外，我们还研究了关节症状是否可以解释老年人在接受剧烈力量训练时所观察到的力量增益的巨大变化，并报告开始运动计划时肌肉骨骼损伤的发生率。设计：一项基于人群的单盲、随机对照试验，包括三个运动组和一个对照组。地点：大型城市健康维护组织。参与者：年龄 68 至 85 岁、腿部力量低于 50 的老年男性和女性 (N = 105)年龄、性别、身高和体重的百分位数，且无神经肌肉疾病或活动性心血管疾病。 干预措施：在监督下进行锻炼，每次 1 小时，每周 3 次，持续 24 至 26 周。一组运动组使用举重机进行力量训练 (ST) (n = 25)；另一组使用固定自行车进行耐力训练 (ET) (n = 25)；第三组进行力量训练和耐力训练相结合（ST+ET）（n = 25）。对照组（n = 30）不接受任何干预。测量：使用等速测力计测量踝关节、膝关节、髋关节和肘关节的力量。关节症状按 6 级评分（0 = 无，5 = 严重）。关节炎的严重程度基于自我报告的关节炎药物使用情况。健康状况通过 SF-36 和疾病影响概况 (SIP) 的子量表进行测量。 结果：所有运动组的关节症状随着时间的推移而波动，但在任何组中都没有显着改善或恶化。在任何组中，SIP 和 SF-36 子量表评分（包括身体疼痛评分）的身体维度都没有随时间变化。患有关节炎和关节症状的受试者通过力量训练获得的力量与没有关节症状的受试者一样多。年龄、性别、基线力量、坚持程度和运动组的调整不会影响这一发现。轻微肌肉骨骼损伤的发生率为每 1000 运动小时 2.2 次损伤。结论：中等强度固定循环运动和高强度力量训练似乎不会产生或加剧老年人的关节症状。关节症状并不能解释参加标准化力量训练计划的老年人力量增长的巨大差异。肌肉骨骼损伤发生的频率相对较低，并且没有发生重大损伤。在评估老年人在良好的运动计划中发生的关节疼痛时，临床医生在将疼痛归因于运动本身之前应考虑其他病因。J Am Geriatr Soc 44:14–21, 1996。
OBJECTIVES: The objective of this study is to determine if exercise increases joint symptoms in older adults with a history of arthritis or produces symptoms in older adults without such history. In addition, we examine whether joint symptoms explain the large observed variation in strength gain in older adults undergoing vigorous strength training exercise, and report the incidence of musculoskeletal injuries upon initiation of an exercise program.DESIGN: A population‐based, single blinded, randomized controlled trial with three exercise groups and one control group.SETTING: A large urban health maintenance organization.PARTICIPANTS: Older men and women (N = 105) aged 68 to 85, with leg strength below the 50th percentile for their age, sex, height, and weight and without neuromuscular disease or active cardiovascular disease.INTERVENTIONS: Supervised exercise in 1‐hour sessions, three times each week, for 24 to 26 weeks. One exercise group did strength training (ST) using weight machines (n = 25); another group did endurance training (ET) using stationary cycles (n = 25); and the third group did combined strength training and endurance training (ST+ET) (n = 25). The control group (n = 30) received no intervention.MEASUREMENTS: Strength was measured at the ankle, knee, hip, and elbow using an isokinetic dynamometer. Joint symptoms were rated on a 6‐point scale (0 = none, 5 = severe). Arthritis severity was based on self‐reported use of arthritis medication. Health status was measured with sub‐scales of the SF‐36 and Sickness Impact Profile (SIP).RESULTS: Joint symptoms fluctuated over time in all exercise groups, but they did not improve or worsen significantly in any group. The physical dimension of the SIP and SF‐36 subscale scores, including Bodily Pain Scores, did not change over time in any group. Subjects with arthritis and joint symptoms gained as much strength with strength training as did subjects without joint symptoms. Adjustment for age, gender, baseline strength, adherence, and exercise group did not affect this finding. The rate of minor musculoskeletal injuries was 2.2 injuries per 1000 exercise hours.CONCLUSIONS: Moderate intensity stationary cycle exercise and vigorous intensity strength training do not appear to produce or exacerbate joint symptoms in older adults. Joint symptoms did not explain the large variation in gains in strength in older adults participating in a standardized strength training exercise program. Musculoskeletal injuries occurred relatively infrequently, and no major injuries occurred. In evaluating joint pain that occurs in older adults in well regulated exercise programs, clinicians should consider other etiologies before attributing pain to exercise per se.J Am Geriatr Soc 44:14–21, 1996.