Departamento de Fisioterapia, Faculdade de Ciências e Tecnologia da Universidade Estadual Paulista (UNESP) Presidente Prudente, São Paulo, Brazil -
Eur J Phys Rehabil Med. 2013 Dec;49(6):793-801. Epub 2013 May 23.
The chronic obstructive pulmonary disease (COPD) is associated with the strength and resistance decreasing in addition to the dysfunction on autonomic nervous system (ANS). The aerobic training isolated or in association with the resistance training showed evidence of beneficial effects on an autonomic modulation of COPD; however, there are no studies addressing the effect of isolated resistance training.
This study aims at investigating the influence of resistance training on an autonomic modulation through heart rate variability (HRV), functional capacity and muscle strength in individuals with COPD.
Clinical series study.
Outpatients.
The study involved 13 individuals with COPD.
The experimental protocol was composed by an initial and final evaluation that consisted in autonomic evaluations (HRV), cardiopulmonary functional capacity evaluation (6-minute walk test) and strength evaluation (dynamometry) in addition by the resistance training performed by 24 sessions lasted 60 minutes each one and on a frequency of three times a week. The intensity was determined initially with 60% of one maximum repetition and was progressively increased in each five sessions until 80%.
The HRV temporal and spectral indexes analysis demonstrates improvement of autonomic modulation, with significant statistical increases to sympathetic and parasympathetic components of ANS representing by SDNN, LF and HF. In addition, it was observed significant statistical increases to shoulder abduction and knee flexion strength and functional capacity.
The exclusive resistance training performed was able to positively influence the autonomic modulation; in addition it promoted benefits on cardiorespiratory functional capacity and strength benefits in individuals with COPD.
This study could contribute to clinical and professionals researchers that act with COPD, even though the resistance component of pulmonary rehabilitation presents consensual benefits on several healthy indicators parameters. There is no evidence about the effects on HRV before. Moreover, this study showed, on clinical practice, the HRV uses as an ANS activity on sinus node evaluation and highlights further importance on scientific context.
慢性阻塞性肺疾病（COPD）除了自主神经系统（ANS）功能障碍外，还与力量和抵抗力下降有关。单独的有氧运动或与抗阻运动相结合的训练对 COPD 的自主神经调节显示出有益的影响；然而，目前还没有研究涉及单独的抗阻运动训练。
本研究旨在通过心率变异性（HRV）、功能能力和肌肉力量来研究抗阻训练对 COPD 患者自主神经调节的影响。
临床系列研究。
门诊。
该研究纳入了 13 名 COPD 患者。
实验方案由初始和最终评估组成，包括自主神经评估（HRV）、心肺功能评估（6 分钟步行试验）和力量评估（测力），此外还进行了 24 次阻力训练，每次 60 分钟，每周 3 次。强度最初用 1 个最大重复的 60%来确定，并在每 5 次训练中逐渐增加到 80%。
HRV 时频指标分析表明自主神经调节得到改善，交感和副交感神经 ANS 成分的 SDNN、LF 和 HF 均有显著统计学增加。此外，还观察到肩外展和膝关节屈伸力量以及功能能力的显著统计学增加。
单独进行的抗阻训练能够对自主神经调节产生积极影响；此外，它还能改善 COPD 患者的心肺功能能力和力量。
本研究可能为 COPD 患者的临床和专业研究人员提供帮助，尽管肺康复的阻力成分对许多健康指标参数都有共识性的益处。目前还没有关于 HRV 影响的证据。此外，本研究在临床实践中展示了 HRV 作为窦房结活动评估的自主神经系统活动的应用，并在科学背景下进一步强调了其重要性。
