摘要
目的探讨躯体综合能力评估工具简易机体功能评估(SPPB)及计时起走测试(TUG)评估老年人肌肉功能、肌力及肌量的价值。方法选取2015年7—10月上海市虹口区欧阳路街道社区卫生服务中心老年女性患者106例,对其进行SPPB、TUG评估,SPPB包括串联站立测试、2.44 m行走测试、5次坐立测试;并通过日常步速评估肌肉功能、握力评估肌力、双能X线骨密度仪(DXA)测定并计算相对四肢骨骼肌指数(RASM)以评估肌量。分析SPPB、TUG与日常步速、握力、RASM的相关性。结果 106例老年女性日常步速平均值为(1.32±0.28)m/s,握力为(19.46±3.91)kg,RASM为(5.94±0.82)kg/m^2。SPPB、TUG的测试结果:串联站立测试时间(7.81±3.13)s,2.44 m行走测试时间(1.83±0.44)s,5次坐立测试时间(9.91±3.06)s,TUG时间(8.96±2.34)s。年龄、体质指数(BMI)、2.44 m行走测试时间、5次坐立测试时间、TUG时间与日常步速均呈负相关(P<0.05),串联站立测试时间与日常步速无直线相关性(P>0.05);年龄、2.44 m行走测试时间与握力呈负相关(P<0.05),BMI、串联站立测试时间、5次坐立测试时间以及TUG时间与握力无直线相关性(P>0.05);BMI、5次坐立测试时间、TUG时间与RASM呈正相关(P<0.05),年龄、串联站立测试时间、2.44 m行走测试时间与RASM无直线相关性(P>0.05)。校正年龄及BMI后进行相关性分析,2.44 m行走测试时间、5次坐立测试时间、TUG时间与日常步速均呈负相关(P<0.05),串联站立测试时间与日常步速无直线相关性(P>0.05);2.44 m行走测试时间与握力呈负相关(P<0.05),串联站立测试时间、5次坐立测试时间以及TUG时间与握力无直线相关性(P>0.05);串联站立测试时间、2.44 m行走测试时间、5次坐立测试时间、TUG时间与RASM无直线相关性(P>0.05)。多元线性回归分析结果显示,2.44 m行走测试时间(β=-0.658,SE=0.024,t=-27.529,P<0.001)、TUG时间(β=-0.015,SE=0.005,t=3.254,P=0.002)是影响日常步速的因素;2.44 m行走测试时间(β=-2.422,SE=0.835,t=-2.628,P=0.005)是影响握力的因素。结论 2.44 m行走测试、TUG可反映肌肉功能,2.44 m行走测试可反映肌力。SPPB、TUG对评估肌量无价值,但可作为评估肌肉功能、肌力的工具。
Objective To evaluate the value of Short Physical Performance Battery（ SPPB） and timed up and go（ TUG） test in the measurement of muscle function,strength and mass in the elderly.Methods One hundred and six elderly women whose medical records were complied and maintained in Shanghai Hongkou District Ouyang Street Community Health Service Center from July to October in 2015 and met the inclusion criteria were enrolled in this study.SPPB（ tandem standing test,2.44-meter walking speed test and 5 times of sitting and standing test） and TUG test were performed in them.The muscle function was assessed by usual gait speed,muscle strength was measured by handgrip strength,and muscle mass was evaluated by calculating relative appendicular skeletal muscle mass（ RASM） by dual-energy X-ray absorptiometry（ DXA）.The correlation between SPPB,TUG and usual gait speed,handgrip strength,RASM were analyzed.Results The mean value of usual gait speed,handgrip strength,and RASM of the 106 elderly women was respectively（ 1.32 ± 0.28） m / s,（ 19.46± 3.91） kg,（ 5.94 ± 0.82） kg / m^2.Results of SPPB and TUG test showed that the mean time that the women needed to complete the tandem standing test,2.44-meter walking speed test,5 times of sitting and standing test,and TUG test was（ 7.81 ± 3.13） s,（ 1.83 ± 0.44） s,（ 9.91 ± 3.06） s,and（ 8.96 ± 2.34） s,respectively.Usual gait speed was negatively correlated with age,BMI,time needed to complete the 2.44-meter walking speed test,5 times of sitting and standing test,and TUG test（ P〈0.05）.The time needed to complete the tandem standing test had no relation with usual gait speed（ P〈0.05）.Level of handgrip strength was negatively correlated with age,and the time required to complete the 2.44-meter walking speed test（ P〈0.05）,but it had no relation with BMI,time required to complete the tandem standing test,5 times of sitting and standing test and TUG test（ P〈0.05）.Result of RASM was positively correlated with BMI,time required to complete 5 times of sitting and standing test,and TUG test（ P〈0.05）,but it had no correlation with age,time required to complete the tandem standing test,and 2.44-meter walking speed test（ P〈0.05）.After adjusting age and BMI,the results of correlation analysis demonstrated that usual gait speed was negatively correlated with the time required to complete the 2.44-meter walking speed test,5 times of sitting and standing test,and TUG test（ P〈0.05）,while it had no relation with the time needed to complete the tandem standing test（ P〈0.05）.Level of handgrip strength was negatively correlated with the time required to complete the 2.44-meter walking speed test（ P〈0.05）,but it had no relation with the time required to complete the tandem standing test,5 times of sitting and standing test,and TUG test（ P〈0.05）.The time required to complete the tandem standing test,2.44-meter walking speed test,5 times of sitting and standing test,and TUG test had no correlation with the result of RASM（ P〈0.05）.Multiple linear regression analysis showed that factors influencing the usual gait speed were the time needed to complete the 2.44-meter walking speed test（ β =-0.658,SE = 0.024,t =-27.529,P〈0.001）,and that needed to complete the TUG test（ β =-0.015,SE = 0.005,t = 3.254,P = 0.002）.And the time required to complete the2.44-meter walking speed test was the influencing factor for level of handgrip strength（ β =-2.422,SE = 0.835,t=-2.628,P = 0.005）.Conclusion Muscle function can be measured by both 2.44-meter walking speed test and TUG test.Muscle strength can be evaluated by 2.44-meter walking speed test.SPPB and TUG test are of no value in measuring muscle mass,but they can be used as the tools for the measurement of muscle function and strength.
作者
潘凌
方圆
陈琳
彭永德
谷文莎
陈瑾瑜
游利
PAN Ling FANG Yuan CHEN Lin PENG Yong - de GU Wen - sha CHEN Jin - yu YOU Li(Department of Endocrinology and Metabolism, First People＇s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China Shanghai Hongkou District Ouyang Street Community Health Service Center, Shanghai 200083, China)
出处
《中国全科医学》
CAS
北大核心
2017年第2期150-153,共4页
Chinese General Practice
基金
上海市自然科学基金资助项目(13ZR1433700)
关键词
肌力
肌肉功能
肌量
简易机体功能评估
计时起走测试
Muscle strength
Muscle function
Muscle mass
Short physical performance battery
Timed up and go test
