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국문

골다공증/골감소증, 근감소증에 대한 비약물적 치료 가이드라인이 각각 존재하나, 골근감소증에 대한 비약물적 치료 가이드라인에 대하여는 아직 연구되어야 할 부분이 많다. 따라서 본 연구자들은 골근감소증에서의 비약물적 중재, 그 중에서도 영양과 근력 운동 두 가지에 초점을 맞추어 중재의 효과를 확인하고자 한다. 본 연구의 가설 및 목적은 “한국 65세 이상 폐경기 여성에서 골근감소증이 있을 때, 영양 + 근력 운동 중재를 시행하였을 때, 근력 강화, 골근량 증가, 그리고 골밀도 수치의 증가가 있을 것이다.”이며, 이러한 가설을 확인하기 위한 임의 배정 연구를 시행하고자 한다. 총 34명의 골근감소증 대상자를 모집하여 시험군은 24주간 주 2회 순환 근력 운동프로그램과 단백질 복합물 파우더 섭취를 중재하고, 대조군은 24주간 단백질 복합물 파우더 섭취와 운동 브로셔를 제공하여 환자를 교육하며 주 2회 이상 운동을 실시하도록 중재할 것이다.

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 Although there are guidelines for non-pharmacological treatment for osteoporosis/osteopenia and sarcopenia, there are still many areas to be studied for non-pharmacological treatment guidelines for osteosarcopenia. Therefore, this study tried to confirm the effect of non-pharmacological interventions in osteosarcopenia, focusing on two, especially nutrition and resistance exercise. 
 In this study, randomized controlled trial will be conducted to confirm the hypothesis. The hypothesis and purpose of this study is that nutrition + resistance exercise  intervention will increase muscle strength, bone muscle mass, and bone mineral density in post-menopausal female aged between 65 years and 90 years with osteosarcopenia. 

A total of 34 osteosarcopenia subjects will be recruited. the experimental group intervened with a circuit strength exercise program and nutritional supplement intake twice a week for 24 weeks, and the control group provided nutritional supplement intake and exercise brochures for 24 weeks to educate patients.

국문

1. 시험군의 운동 중재는 총 24주의 운동 중재 및 추적 관찰을 시행하며, 피험자는 최소 주2회 충남대 병원 재활의학과에 내원하여 상지와 하지의 근력운동을 시행하도록 한다. 운동 처방에 대하여는 운동 기능실의 Circuit Resistance Training machine을 사용한다. Circuit Resistance machine은 8가지의 운동으로 구성되어 있으며, 하지 근력 운동 4가지, 상지 근력 운동 3가지, 중심 근력 운동 1가지로 구성되어 있다. 피험자는 다음과 같은 3가지 단계를 거치며, 근력 운동을 수행한다.

2. 대조군의 운동 중재는 중재를 실시하지는 않지만 운동 브로셔를 제공하여 환자를 교육하며, 주기적인 외래 및 관찰을 통하여 지속적인 교육이 가능할 수 있도록 한다. 주 2회 이상 운동을 하도록 교육하며, 운동 일지 자가 작성을 통하여 확인한다.

3. 시험군, 대조군 모두에서 영양 중재는 , 단백질 복합물 파우더 (셀렉스 코어프로틴 , Maeil Dairies Co., Ltd., protein 20 g [50% casein + 40% whey + 10% soy, total leucine: 3000 mg], vitamin D: 800 IU [20 µg], calcium: 300 mg, fat: 1.1 g, carbohydrate: 2.5 g) 2pack을 공급할 것이다.

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1. Exercise intervention in the experimental group will be exercised for a total of 24 weeks, and the subject will visit the department of rehabilitation medicine at Chungnam National University Hospital at least twice a week to perform upper and lower extremity strength exercises. Exercise prescription will use the circuit resistance training machine in the exercise room. The circuit resistance machine will consist of 8 exercises, 4 lower limb strength exercises, 3 upper limb strength exercises, and 1 core strength exercise.

2. The exercise intervention of the control group did not implement the intervention, but provided exercise brochures to educate the patient, and to enable continuous education through periodic outpatient visits and observation. It is taught to exercise more than twice a week, and it will be checked through self-written exercise diary.

3. Nutritional intervention of test group and control group will provide a daily supply 2pack of protein complex powder (Celex core-protein; protein: 20 g [50% casein + 40% whey + 10% soy, total leucine: 3000 mg], vitamin D: 800 IU [20 µg], calcium: 300 mg, fat: 1.1 g, carbohydrate: 2.5 g; Maeil Dairies Co., Ltd., Seoul, South Korea)

상세내용 영문

Exercise intervention in the experimental group will be exercised for a total of 24 weeks, and the subject will visit the department of rehabilitation medicine at Chungnam National University Hospital at least twice a week to perform upper and lower extremity strength exercises. Exercise prescription will use the circuit resistance training machine in the exercise room. The circuit resistance machine will consist of 8 exercises, 4 lower limb strength exercises, 3 upper limb strength exercises, and 1 core strength exercise.

(1) Phase 1 (Weeks 1-8); Applying the concept of non-repetition maximum (nRM) for each exercise, select a weight that can be performed for 8-15 repetitions, and perform 1-3 repetitions less than the number of repetitions determined by the patient as possible. In this case, between sets After giving 90 to 120 seconds of rest, teach them to do 2 sets if they can repeat them.

(2) Phase 2 (weeks 9-18); For each exercise, the concept of nRM is applied, the number of repetitions is 7-10, and if the number of repetitions is more than 10, the number of repetitions is reduced by 2, and if it is less than 10, the number of repetitions is reduced by 1. Other applied exercises and rest time between sets were performed in the same way as phase 1.

(3) Phase 3 (Weeks 19-24); For each exercise, apply the concept of RM, give 7-10 repetitions, and perform the number of repetitions determined to be possible as much as possible. Other applied exercises and rest time between sets were performed in the same way as phase 1.

8 weeks of treatment is applied to this weight increase process, and when the exercise is increased with high intensity (phase 3), periodization is applied, followed by 3 weeks of high-intensity exercise (RM) and 1 week of medium-intensity exercise (nRM). ; apply the exercise in the same way as phase 1). Also provide exercise handouts (brochures) to educate patients. Exercise time is conducted through the exercise process of a total of 60 minutes (10 minutes of warm-up, 40 minutes of main exercise, and 10 minutes of clean-up) for one exercise, and exercise experts (physical therapists) reside in the exercise space and various exercise equipment and safety supplies are provided.

Nutritional intervention will provide a daily supply 2pack of protein complex powder (Celex core-protein; protein: 20 g [50% casein + 40% whey + 10% soy, total leucine: 3000 mg], vitamin D: 800 IU [20 µg], calcium: 300 mg, fat: 1.1 g, carbohydrate: 2.5 g; Maeil Dairies Co., Ltd., Seoul, South Korea)

상세내용 영문

A total of 24 weeks of observation is carried out, and exercise intervention is not performed, but exercise brochures are provided to educate patients, and continuous education will be possible through periodic outpatient visits and observation. It is taught to exercise more than twice a week, and it will be checked through self-written exercise diary.

Nutritional intervention will provide a daily supply 2pack of protein complex powder (Celex core-protein; protein: 20 g [50% casein + 40% whey + 10% soy, total leucine: 3000 mg], vitamin D: 800 IU [20 µg], calcium: 300 mg, fat: 1.1 g, carbohydrate: 2.5 g; Maeil Dairies Co., Ltd., Seoul, South Korea)

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Osteosarcopenia 

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 The patient's appendicular muscle mass, skeletal muscle index, and bone mineral density (measurement site - spine, femur neck) measured through DEXA scan

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Assessments will be conducted 3 times at 0-week, 12-weeks and 24-weeks.

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Appendicular muscle mass, whole-body phase angle, lean body mass, total fat mass (%) and skeletal muscle index measured by bioelectrical impedance analysis, patient's quality of life and psychological state, patient's functional evaluation, muscle quality,  and CTX

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The evaluation will be conducted 5 times at 0-weeks, 6-weeks, 12-weeks, 18-weeks and 24 -weeks and the bone resorption marker will be evaluated 3 times at 0 weeks, 12 weeks, and 24 weeks.