腿部伸展運動改善肝硬化病人肌肉抽痙之成效探討

Calf-Stretching for Muscle Cramps in Patients with Liver Cirrhosis

肌肉抽筋是肝硬化病人常見的症狀，大多數病人因為半夜小腿肌肉劇烈疼痛醒來，雖然沒有生命危險，卻嚴重影響病人生活品質。本研究為前瞻性研究，以立意取樣，實驗組執行腿部伸展運動，每次伸展維持10秒，再放鬆10秒，雙腳一起執行，重複做10次，每日分別時間執行三次。兩組個案皆於研究介入前、第四週與第八週完成填寫抽筋頻率、10公分數字疼痛量表及慢性肝病生活品質量表。共收案71位病人，對照組40人與實驗組31人。實驗組從前測到後測第八週肌肉抽筋頻率比對照組低，有統計顯著差異（p=.005）。疼痛得分有下降但無顯著差異；兩組病人CLDQ量表平均得分，實驗組皆明顯高於對照組，生活品質於第八達顯著差異（p=.025）。基本變項僅肝硬化分類對生活品質得分有顯著差異（p=.005）。腿部伸展運動非侵入性且容易執行，建議護理人員以實證方式協助執行，以達緩解肌肉抽筋發生。

Muscle cramping is a common symptom in the lower limbs of patients with liver cirrhosis. Many patients wake up during the night because of extremely painful muscle cramps. Although not life-threatening, muscle cramping seriously affects patients' quality of life. Patients with liver cirrhosis were prospectively selected. In total, 71 participants were eligible for the analysis, of which 40 were divided into the control group and 31 into the intervention (stretches) group. Participants in the stretches group performed bilateral leg stretches 3 times a day, 10 rounds each time, and held each stretch for 10 seconds before relaxing. We used the Chronic Liver Disease Questionnaire, a 10-cm visual analog scale to record the severity of muscle cramping pain and patients' self-reported cramping frequency. We found that participants in the stretches group had significantly decreased cramp frequency in week 8 (p=.005). Moreover, participants in the stretches group exhibited decreased pain scores, but no significant difference between groups was observed. Average Chronic Liver Disease Questionnaire scores were significantly higher in the stretches group than in the control group, and quality of life was significantly different in week 8 (p=.025). No significant demographic differences were observed between the two groups, except liver cirrhosis type (p=.005). Leg stretching exercises are noninvasive and easy to perform at home. Therefore, our study recommends applying leg stretching exercises to relieve muscle cramps in these patients.