飲食控制及阻力運動訓練對成年肥胖的膝退化性關節炎者在疼痛緩解、身體組成、下肢功能及生活品質之影響

Effects of Diet Control and Resistance Exercise Training on Obesity Adults with Knee Osteoarthritis in Pain Relief, Body Composition, Lower Limb Function and Quality of Life.

徐硯怡(Yen-I Hsu)

指導教授 ： 張乃仁

高雄醫學大學/醫學院/運動醫學系碩士在職專班/碩士(2019年)

摘要

背景：肥胖是退化性膝關節炎的危險因子，也是導致病情加速惡化因子。因體重過重引起膝關節疼痛而導致行動上很多不便，造成失能機率增大。因此建議肥胖者應減重並進行運動鍛鍊，但肥胖者因體重對膝關節的負荷，須考量關節負重較低且容易執行。
目的：探討藉由居家式均衡低油的正確飲食觀念及彈力帶彈力帶阻力運動同時介入下是否能減少體重、體脂，強化下肢肌力，改善生活機能。
方法：在醫學中心招收受試者共66位肥胖(35 kg/m2 ≧身體質量指數≧27 kg/m2)合併輕中度退化性膝關節炎患者，隨機分為三組。飲食控制組（D ; 均衡低脂飲食）、彈力帶運動組（E ; 髖關節外展/內收，屈曲/伸直，內轉/外轉，膝關節屈曲/伸直，踝關節背屈/蹠屈，50分鐘/次，3次/週）、飲食控制加彈力帶運動組（D + E ; 包含Ｄ組和Ｅ組的介入）計入12 週居家介入。在介入前和介入12週後，評估體重、體脂、握力、30秒椅子坐站測試（Chair Stand Test，CST）、計時起立走(Timed Up and Go，TUG)、WOMAC、KOOS量表之變化。
結果：12週的介入發現，在體重方面，Ｄ組(減少4.4%)與D+E組（減少4.5%）顯著降低，但E組則無 ; 在體脂方面，D+E組顯著減少優於Ｄ組和Ｅ組。D+E組在握力與椅子坐站測試、計時起立走測試、WOMAC總分與KOOS都顯著較Ｄ組改善。此外， D+E組在計時起立走測試、WOMAC總分與KOOS量表都顯著較E組改善。
結論：肥胖合併輕中度退化性膝關節患者，建議可用飲食控制減重搭配彈力帶阻力訓練，同時達到減少體重及體脂，增強下肢肌力與改善生活品質。

關鍵字

退化性關節炎 ； 肥胖 ； 減重 ； 阻力訓練 ； 居家運動 ； 下肢功能 ； 生活品質

並列摘要

Background: Obesity is a risk factor for knee osteoarthritis, and it is also a factor that accelerates the deterioration of the condition. Patients often suffer from a lot of inconvenience caused by pain, resulting in an increased disability. Therefore, it is recommended that obese people should lose weight and exercise. However, obese people should consider the loading of the joint and thus they are suggested to weight loss and choice easy to performtraining exercise.
Purpose: To invesitage that whether the appropiate diet concept of home-based balanced low oil and elastic band elastic resistance exercise can reduce body weight, body fat and strengthen lower limb muscle, and improve quality of life.
Methods: A total of 66 subjects combordied obesity and mild-to-moderate knee osteoarthritis were enrolled in a medical center and randomly divided into the three groups. Diet control group (D; balanced low-fat diet). Elastic band exercise group (E; hip abduction/adduction, flexion/straight, internal rotation / external rotation, knee flexion / extension, ankle dorsiflexion / plantar flexion, 50 minutes / time, 3 times / week). Diet control plus elastic band exercise group (D + E) for 12 weeks of home-based intervention. Before and after 12 weeks intervention, the body weight, body fat, grip strength, 30-second Chair Stand Test (CST), Time Up and Go (TUG) test, the WOMAC and KOOS scales were assessed.
Outcomes: After 12 weeks of intervention, regarding body weight, the D group (4.4% reduction) and the D+E group (4.5% reduction) had significantly decline, but the E group did not. The D+E group had significantly body fat loss than the D and E groups. The D+E group was significant improvement than the D group in grip strength and CST, TUG test, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scaleWOMAC total scale and KOOS scale. In addition, The D+E group was significant improement than the E group in TUG test, WOMAC total scale and KOOS scales.
Conclusion: Patients with combordied obesity and mild-to-moderate knee osteoarthritis are recommended to use diet-controlled weight loss with elastic band resistance training to contol body weight loss and body fat loss, enhance lower limb muscle strength and improve quality of life.
Key Words: Osteoarthritis, obesity, weight loss, resistance trainng, home-based exercise, lower limb function, quality of life.

並列關鍵字

Osteoarthritis ； obesity ； weight loss ； resistance trainng ； home-based exercise ； lower limb function ； quality of life

參考文獻

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