[[alternative]]Effects of protein supplementation on rehabilitation treatment outcomes in individuals with chronic stroke.

Abstract

[[abstract]]腦中風是造成慢性失能 (chronic disability) 並影響日常生活功能的主要原因之一。然而，如何讓慢性中風病人得到最佳的復健治療，對提高中風患者身體健康狀態與更有效地利用健康照護資源，在物理治療領域仍有極大的努力空間。目前，運動後補充醣類合併蛋白質或胺基酸補充品用以提高肌肉量與肌力的概念已被運動員廣泛應用；然而，國內外尚無研究針對慢性中風者運動治療與蛋白質補充關係進行探討。本研究目的探討為期 8 週的中風物理治療運動訓練合併豆漿增補對慢性中風病人復健成效 (患側下肢肌肉力量、體能表現) 之影響。本研究共招募 20 位慢性中風受試者，並依體脂率與中風年份將受試者分為豆漿增補組 (soy milk 組，SMS 組，N=10) 及安慰劑對照組 (placebo，PLA 組，N=10)。本研究結果顯示 SMS 組在 8 英呎行走測試中，後測之行走速度改變量顯著高於 PLA 組 (SMS: +39.9% V.S PLA:+19.6%, p<0.05)；在 15 英呎行走測試中，SMS 組同樣顯示了較 PLA 組顯著的行走速度改變量 (SMS: +48.0% V.S PLA:+39.6%, p<0.05)；而 6MWT 的行走距離改變量同樣是 SMS 組顯著高於 PLA 組 (SMS: +40.0% V.S PLA:+19%, p<0.05)。然而，本研究中蛋白質增補對受試者身體組成、平衡能力、坐到站速度、患側下肢肌力各方面並無差異。本研究證實大豆蛋白質增補合併物理治療運動治療對慢性中風病人在行走能力部分的治療效果有顯著效益，可能對於其日常生活功能有幫助，這些發現將可做為臨床人員將營養介入融入中風物理治療計畫之科學依據。[[abstract]]Stroke is one of the primary causes resulting in chronic disability that impairs activity of daily living (ADL) and life quality.Recently, provision of carbohydrate plus protein after exercise training has been wildly accepted by athletes to improve their muscle mass and strength. However, there are still very few studies focusing the effects of nutritional supplementation on promoting therapeutic exercise training effects in chronic stroke survivors. Therefore, the purpose of this proposal is to investigate whether a 8-week stroke therapeutic exercise training combined with soy milk supplementation on rehabilitation outcomes (i.e. muscle strength of affected lower extremity, physical performance) in individuals with chronic stroke. In this proposed proposal, we recruited 20 subjects with chronic stroke, and they were assigned to either soy milk group (SMS group, N=10) or placebo control group (PLA group, N=10) by their body fat percentage and years after stroke. Results of this study indicate that the Δ% of 8-feet walking speed of the SMS group was significantly higher than that of the PLA group. In the 15-foot walking test, the SMS group also showed a significant improvement in walking speed compared to the PLA group. In the 6MWT, the SMS group also showed a significant improvement % of 6WMT distance compared to the PLA group. In the present study, protein supplementation had no significant effects on body composition, balance, sit-to-stand speed, and muscle strength of affected lower limb. Results of this study provide preliminary evidence that protein supplementation combined with therapeutic exercise therapy is useful in walking ability in patients with chronic stroke