伸展運動可預防體重超低嬰兒骨骼強度流失


  July 7, 2003--根據一項發表在七月份的Pediatrics隨機實驗的結果指出,每天五分鐘簡單的被動鍛鍊、每週進行五次一直持續四個星期,可以減緩出生體重超輕(VLBW)嬰兒骨骼強度的流失。
  
  以色列Meir綜合醫院Sapir醫學中心的Ita Litmanovitz, MD博士寫到,VLBW 嬰兒會增加骨質缺少症的危險,這是因為出生之前骨骼增加有限,所以對骨骼營養物質的需求更大,另外有幾項研究也顯示,透過體力活動可以增加孩童青少年和成人的骨骼密度,反之如果不活動將會導致骨骼再吸收,骨骼礦物質密度降低。
  
  研究按照懷孕週數和出生體重配對的24個嬰兒,將12個隨機分到對照組,12個分到鍛鍊組,這些受試的小嬰兒平均出生體重是1,135 ± 247 g,平均懷孕時間是28.5 ± 2.3 週,從出生後開始,包括每天四肢的伸展和彎曲鍛鍊。
  
  研究使用超音波測量骨骼聲波速度(SOS)來數量化評估骨骼強度,測量的位置是嬰兒的中間左側脛骨幹,研究顯示,對照組的嬰兒顯著減少了骨骼強度,從基線2,892 ± 30 m/sec降到四週時的2,799 ± 26 m/sec,但是鍛鍊組的骨骼SOS維持穩定 (基線:2,825 ± 32 m/sec,四週:2,827 ± 26 m/sec),雖然鍛鍊可以改善骨骼SOS,但是骨骼形成和再吸收指標並沒有跟著改變。
  
  作者推薦進行其他的研究確定促進未成熟嬰兒骨骼發育的鍛鍊的最佳程度,他們寫到,在嬰兒出生之後顯著減少骨骼SOS時,進行簡單的手腳伸展運動,可以鍛鍊減緩骨骼強度的減少,降低發生骨骼缺少症的危險。
  

Passive Exercise Prevents Decr

By Laurie Barclay, MD
Medscape Medical News

July 7, 2003 — Brief passive exercise for five minutes per day, five days per week for four weeks attenuated the loss of bone strength in very low birth weight (VLBW) infants, according to the results of a randomized trial published in the July issue of Pediatrics.

"VLBW infants have an increased risk of osteopenia because of limited accretion of bone mass in utero and a greater need for bone nutrients," write Ita Litmanovitz, MD, from Meir General Hospital at Sapir Medical Center in Kfar Saba, Israel, and colleagues. "Several studies have demonstrated that physical activity increases bone density in children, adolescents, and adults, whereas inactivity results in bone resorption and decreased bone mineral density."

Of 24 infants matched for gestational age and birth weight, 12 were randomized to the control group and 12 to an exercise protocol beginning at the first week of life and involving daily extension and flexion range of motion against passive resistance of the upper and lower extremities. Mean birth weight was 1,135 ± 247 g, and mean gestational age was 28.5 ± 2.3 weeks.

Bone strength, determined using quantitative ultrasound measurement of bone speed of sound (SOS) at the middle left tibial shaft, decreased significantly in the control group from 2,892 ± 30 m/sec at baseline to 2,799 ± 26 m/sec at four weeks. However, bone SOS of the exercise group remained stable (2,825 ± 32 m/sec at baseline and 2,827 ± 26 m/sec at four weeks). Despite improvement in bone SOS with exercise, there were no accompanying changes in markers of bone formation and resorption.

The authors recommend additional research to determine the optimal degree of exercise for bone development in premature infants.

"There is a significant postnatal decrease in the bone SOS of [VLBW] infants," they write. "A brief range-of-motion exercise attenuates the decrease in bone strength and may decrease the risk of osteopenia."

Pediatrics. 2003;112:15-19

Reviewed by Gary D. Vogin, MD

    
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