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维生素 D 补充剂联合 12 周多模式训练对骨密度低的老年女性的影响:一项随机、双盲、安慰剂对照试验。

Vitamin D supplementation associated with 12-weeks multimodal training in older women with low bone mineral density: A randomized double-blind placebo-controlled trial.

机构信息

Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Graduate Program in Aging Sciences from the University Sao Judas Tadeu (USJT), São Paulo, SP, Brazil.

Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Graduate Program in Aging Sciences from the University Sao Judas Tadeu (USJT), São Paulo, SP, Brazil.

出版信息

Exp Gerontol. 2021 Apr;146:111211. doi: 10.1016/j.exger.2020.111211. Epub 2021 Jan 6.

Abstract

OBJECTIVE

To evaluate the influence of vitamin D supplementation with a multimodal exercise program on postural balance and muscle strength in older women with low bone mineral density (BMD) and vitamin D insufficiency.

METHODS

12-week, randomized, double-blind, placebo-controlled clinical trial. Total of 422 subjects were screened for participation, and 46 met the inclusion criteria. Those were randomized into an experimental group (EG; n = 23) and control group (CG; n = 23). At the time of enrollment, all subjects had low BMD, vitamin D insufficiency, and were not practicing resistance exercise. Muscle strength assessments were performed by the 30-s sit to stand test; 15-steps climbing test; handgrip dynamometer and knee muscle strength using an isokinetic dynamometer at 60°/sec. Postural balance was clinically evaluated by the MiniBESTest and by a force platform. Dynamic balance was assessed by standing up from a chair and walk over a step, using also a force platform.

RESULTS

In the EG, vitamin D levels increased in the post-treatment period (P < 0.001) whereas in CG levels remained unchanged (P = 0.86). Both groups improved muscular strength in the dynamometry isokinetic test: flexors PT/BW - right (P < 0.02) and left side (P < 0.04). In the dynamic postural balance during the task to step up over: the Lift Up Left was better in the CG (P = 0.01); the Moment Time left was better in the CG (P = 0.01); the Impact index left was better in the EG (P = 0.01). The Mini-BESTest - both groups improved the postural balance test (P < 0.001).

CONCLUSION

Vitamin D supplementation associated with multimodal exercise program did not augment muscle strength adaptation or postural balance in older women with low bone mineral density and vitamin D insufficiency.

摘要

目的

评估维生素 D 补充剂联合多模式运动方案对低骨密度(BMD)和维生素 D 不足的老年女性姿势平衡和肌肉力量的影响。

方法

这是一项为期 12 周的随机、双盲、安慰剂对照临床试验。共筛选了 422 名受试者参加,其中 46 名符合纳入标准。他们被随机分为实验组(EG;n=23)和对照组(CG;n=23)。在入组时,所有受试者的 BMD 均较低,维生素 D 不足,且未进行抗阻运动。肌肉力量评估通过 30 秒坐立站起测试、15 步爬梯测试、握力计和等速测力计(角速度 60°/秒)测量膝关节肌肉力量进行。姿势平衡通过 MiniBESTest 和力台进行临床评估。动态平衡通过从椅子上站起来并走过一个台阶进行评估,同样使用力台。

结果

在 EG 中,维生素 D 水平在治疗后期间增加(P<0.001),而 CG 中水平保持不变(P=0.86)。两组在等速测力计测试中肌肉力量均得到改善:右侧(P<0.02)和左侧(P<0.04)的屈肌 PT/BW。在动态姿势平衡任务中,在跨过台阶时:CG 组的左侧抬起更好(P=0.01);CG 组的左侧时间更久(P=0.01);EG 组的左侧冲击指数更好(P=0.01)。Mini-BESTest-两组的姿势平衡测试均得到改善(P<0.001)。

结论

维生素 D 补充剂联合多模式运动方案并未增强低骨密度和维生素 D 不足的老年女性的肌肉力量适应性或姿势平衡。

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