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截瘫患者中健康和不健康个体从手臂运动峰值进行自主恢复的情况。

Autonomic recovery from peak arm exercise in fit and unfit individuals with paraplegia.

作者信息

Wecht Jill M, Marsico Robert, Weir Joseph P, Spungen Ann M, Bauman William A, De Meersman Ronald E

机构信息

VA RR&D Service Center of Excellence, Bronx 10468, and Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA.

出版信息

Med Sci Sports Exerc. 2006 Jul;38(7):1223-8. doi: 10.1249/01.mss.0000227306.34149.ba.

Abstract

INTRODUCTION

Altered autonomic cardiovascular control in persons with paraplegia may reflect peripheral sympathetic denervation caused by the injury or deconditioning due to skeletal muscle paralysis. Parameters of autonomic cardiovascular control may be improved in fit persons with paraplegia similar to effects reported in the noninjured population.

PURPOSE

To determine differences in resting and recovery HR and cardiac autonomic control in fit and unfit individuals with paraplegia.

METHODS

Eighteen healthy males with paraplegia below T6 were studied; nine participated in aerobic exercise conditioning (fit: >or=30 min.d, >or=3 d.wk, >or=6 months), and nine were sedentary (unfit). Analysis of heart rate variability (HRV) was used to determine spectral power (ln transformed) in the high- (lnHF) and low-frequency (lnLF) bandwidths, and the LF/HF ratio was calculated. Data were collected at baseline (BL) and at 2, 10, 30, 60, and 90 min of recovery from peak arm cycle ergometry.

RESULTS

The relative intensity achieved on the peak exercise test was comparable between the groups (i.e., 88% peak predicted HR). However, peak watts (P<0.001) and oxygen consumption (P<0.01) were higher in the fit compared with the unfit group (56 and 51%, respectively). Recovery lnHF was increased (P<0.05), and recovery lnLF (P<0.01) and LF/HF (P<0.05) were reduced in the fit compared with the unfit group. Mean recovery autonomic activity was not different from BL in the fit group. In the unfit group, mean recovery lnHF was reduced, and mean recovery lnLF and LF/HF remained elevated above BL.

CONCLUSION

These data suggest that fit individuals with paraplegia have improved cardiac autonomic control during the postexercise recovery period compared with their unfit counterparts.

摘要

引言

截瘫患者自主心血管控制的改变可能反映了由损伤引起的外周交感神经去神经支配或由于骨骼肌麻痹导致的身体机能下降。与未受伤人群中报道的效应类似,截瘫患者通过适当锻炼,自主心血管控制参数可能会得到改善。

目的

确定健康和不健康的截瘫个体在静息和恢复心率以及心脏自主控制方面的差异。

方法

对18名T6以下的健康截瘫男性进行了研究;其中9人参加了有氧运动训练(健康组:每天锻炼≥30分钟,每周锻炼≥3天,锻炼时间≥6个月),另外9人久坐不动(不健康组)。采用心率变异性(HRV)分析来确定高频(lnHF)和低频(lnLF)带宽中的频谱功率(经自然对数转换),并计算低频与高频功率比值(LF/HF)。在基线(BL)以及从峰值手臂周期测力计运动恢复后的2、10、30、60和90分钟收集数据。

结果

两组在峰值运动测试中达到的相对强度相当(即预测心率峰值的88%)。然而,与不健康组相比,健康组的峰值功率(P<0.001)和耗氧量(P<0.01)更高(分别为56%和51%)。与不健康组相比,健康组恢复时的lnHF升高(P<0.05),恢复时的lnLF(P<0.01)和LF/HF(P<0.05)降低。健康组恢复时的平均自主神经活动与基线无差异。在不健康组中,恢复时的平均lnHF降低,恢复时的平均lnLF和LF/HF仍高于基线水平。

结论

这些数据表明,与不健康的截瘫个体相比,健康的截瘫个体在运动后恢复期心脏自主控制得到了改善。

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