| 摘要: | 老化會造成身體組成的改變，尤其會引起肌肉功能及運動表現下降，進而促使肌肉減少症的發生。肌肉減少症（sarcopenia）主要是肌肉量的流失及肌力的下降所致，除此之外，也會影響免疫功能的正常運作及全身慢性低度的發炎現象，因而提高罹患疾病的發生率。本研究目的探討壺鈴訓練對老年人肌少症患者之身體組成、肌力表現、肺功能、輔助型T細胞及慢性低度的發炎指標影響情形。研究方法：經篩選肌少症指標納入標準後，以33位65-75歲具肌少症之老年人為研究對象，隨機分成壺鈴訓練組（kettlebell training, KT）與控制組（control, CON）兩組，KT組為期8週，每週2 次、每次 60 分鐘之訓練，而CON組僅維持日常生活習慣，避免參與相關運動訓練計畫。於訓練前（week 0）、8週訓練後（week 8）與停止訓練4週（week 12）檢測分析身體組成、肌力表現、肺功能、輔助型T細胞及慢性低度的發炎指標。所得資料以混和設計二因子變異數分析為統計方法，以α＝.05為顯著水準。結果：本研究發現在8週壺鈴訓練後（week 8, W8），以及停止訓練4週（week 12, W12），KT組在四肢肌肉量（ASM）及肌少症指數於W8及W12顯著高於前測；且肌少症指數在W8及W12 時KT組皆顯著高於CON組。另外，CON組W8及W12骨骼肌肉量（SMM）顯著低於前測（baseline），在W8時四肢肌肉量（ASM）及肌少症指數亦顯著低於前測；反之，CON組內臟脂肪面積（VFA）及體脂肪量（BFM）於Week 8皆顯著高於Week 0。針對肌肉能力部分，本研究發現，KT組在訓練後W8及W12的左手握力、背肌力及呼氣流速峰值（PEF）皆顯著高於CON組，W8之右手握力顯著高於CON組，且KT組背肌力及PEF於W8及W12顯著高於前測，雙手握力均於W8顯著高於前測；相反的，CON組雙手握力及PEF均於W8及W12顯著低於前測。關於細胞激素部分，KT組在訓練後W8及W12的IFN-γ、IL-17、IFN-γ/ IL-4比值濃度顯著低於CON組，IL-4則在W8顯著高於CON組，KT組IFN-γ、IFN-γ/ IL-4 比值及hs-CRP在W8及W12亦顯著低於前測；而CON組IFN-γ、IFN-γ/ IL-4 比值及hs-CRP在W8及W12顯著高於前測。結論：老年人患有肌肉減少症從事壺鈴訓練，可以顯著增加四肢肌肉量，進而改善肌少症指數，以及提升握力、背肌力與呼氣流速峰值，且保留效果至第12週。此外，可有效降低血液中促發炎激素，同時提高抗發炎濃度，相對的也降低Th1/Th2的比值。再者，顯著降低慢性低度發炎指標hs-CRP的濃度。
Aging results in biological changes in body composition. Especially, it is associated with decreases in the performance and function of muscle. Sarcopenia refers to the loss of skeletal muscle mass and decline in associated muscle strength. In addition, it will also affect the normal functioning of the immune function and chronic low-grade inflammation with advancing age, thus increasing the risk of disease incidence. Purpose: This study was to investigate the effects of kettlebell training ( KT ) on changes in body composition, muscle strength, pulmonary function, T helper cell and chronic low-grade inflammation in sarcopenia elderly. Methods: Thirty-three elderly patients ( aged 65-75 years) that fulfilled the sarcopenia index inclusion criteria. Participants were randomly assigned to an kettlebell training ( KT ) or control ( CON ) group. The KT group was performed for 60 min, two times per week for 8 weeks. The CON group were asked maintain daily activity and avoid participating in any exercise program. All participants were evaluated on body composition, muscle strength, pulmonary function, T helper cell and chronic low-grade inflammation at before ( Week 0) and after 8-week ( Week 8 ) and 4-week detraining ( Week 12 ). Data were analyzed using a two-way mixed design ANOVA analysis of variance. Results: After 8 weeks of kettlebell training program and 4 weeks detraining, appendicular skeletal muscle mass (ASM) and sarcopenia index were significantly improved in the KT group. And sarcopenia index were significantly increased in the KT group compared to the CON group. In contrast, visceral fat area (VFA) and body fat mass (BFM) in the CON at Week 8 significantly higher than Week 0; For muscle performance, the results demonstrated that left hand grip (LG), back muscle strength (BS) and peak expiratory flow (PEF) at Week 8 and Week 12 significantly improved in the KT group compared to the CON group, and right hand grip (RG) at Week 8 significantly increased in KT compared to CON. In addition, the BS andd PEF at Week 8 and Week 12 significantly higher than Week 0, and the both hand grip at Week8 higher than Week 0. In contrast, the both hand grip and PEF in CON at Week 8 and Week 12 significantly lower than Week 0; For cytokines, the IFN-γ、IL-17、IFN-γ/ IL-4 ratio concentrations at Week 8 and Week 12 significantly reduced in the KT group compared to the CON group, and IL-4 concentrations at Week 8 significantly increased in KT compared to CON. In addition, the IFN-γ, IFN-γ/ IL-4 ratio and hs-CRP concentrations at Week 8 and Week 12 significantly reduced than Week 0. Conclusions: The kettlebell training program were significantly increased in appendicular skeletal muscle mass, thus to improved sarcopenia index, as well as enhance grip, back muscle strength and peak expiratory flow, and the effect is reserved to the Week 12. In addition, it can effectively reduce blood pro-inflammatory cytokines, while increasing the concentration of anti-inflammatory, but also reduce the relative ratio of Th1 / Th2 of. Moreover, significantly reduced the concentration of low-grade chronic inflammation indicators of hs-CRP. |
