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稳定期慢性阻塞性肺疾病患者递增负荷运动期间特定呼吸肌和骨骼肌的募集与脱氧情况

Recruitment and Deoxygenation of Selected Respiratory and Skeletal Muscles During Incremental Loading in Stable COPD Patients.

作者信息

Reid W Darlene, Sheel A William, Shadgan Babak, Garland S Jayne, Road Jeremy D

机构信息

Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada (Dr Reid); and School of Kinesiology (Dr Sheel), Center for International Collaboration on Repair Discoveries (Dr Shadgan), and Respiratory Division (Dr Road), University of British Columbia, Vancouver, British Columbia, Canada; Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada (Dr Garland).

出版信息

J Cardiopulm Rehabil Prev. 2016 Jul-Aug;36(4):279-87. doi: 10.1097/HCR.0000000000000185.

Abstract

PURPOSE

To evaluate changes in oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) of the sternocleidomastoid (SCM), parasternal (PS), biceps (BC), and tibialis anterior (TA) using near-infrared spectroscopy during incremental loading of the inspiratory muscles and the elbow flexors in people with stable chronic obstructive pulmonary disease.

METHODS

Fifteen participants with obstructive pulmonary disease were recruited in a repeated-measures crossover design. Near-infrared spectroscopy optodes were applied over the SCM, PS, BC, and TA to measure O2Hb, HHb, and tHb. Participants were randomly assigned to perform incremental inspiratory threshold loading or elbow flexor loading that imposed higher loads every 2 minutes until task failure. At least 1 week later, participants performed the other test. Arterial oxygen saturation (SpO2) was monitored continuously.

RESULTS

O2Hb of the main agonist muscles, SCM and BC, decreased compared with the other muscles during inspiratory threshold loading and elbow flexor loading, respectively. SCM O2Hb and BC O2Hb decreased at higher loads compared with baseline. SCM tHb and HHb increased, whereas TA tHb decreased during inspiratory threshold loading. tHb did not change among any muscles during elbow flexor loading. SpO2 did not change from baseline to task failure.

CONCLUSIONS

Our data suggest that the SCM was recruited progressively during incremental inspiratory threshold loading; however, O2Hb was not maintained in this muscle. Similarly, O2Hb was not maintained in the biceps during elbow flexor loading. This regional deoxygenation in SCM and BC during incremental loading protocols was not reflected by a decrease in SpO2.

摘要

目的

在稳定期慢性阻塞性肺疾病患者进行吸气肌和肘屈肌递增负荷运动时,使用近红外光谱技术评估胸锁乳突肌(SCM)、胸骨旁肌(PS)、肱二头肌(BC)和胫前肌(TA)的氧合血红蛋白(O2Hb)、脱氧血红蛋白(HHb)和总血红蛋白(tHb)的变化。

方法

采用重复测量交叉设计招募了15名患有阻塞性肺疾病的参与者。将近红外光谱探头置于SCM、PS、BC和TA上,以测量O2Hb、HHb和tHb。参与者被随机分配进行递增吸气阈值负荷或肘屈肌负荷运动,每2分钟施加更高的负荷,直至任务失败。至少1周后,参与者进行另一项测试。持续监测动脉血氧饱和度(SpO2)。

结果

在吸气阈值负荷和肘屈肌负荷运动期间,主要激动肌SCM和BC的O2Hb分别比其他肌肉降低。与基线相比,SCM的O2Hb和BC的O2Hb在更高负荷下降低。在吸气阈值负荷运动期间,SCM的tHb和HHb增加,而TA的tHb降低。在肘屈肌负荷运动期间,任何肌肉的tHb均未改变。从基线到任务失败,SpO2没有变化。

结论

我们的数据表明,在递增吸气阈值负荷运动期间,SCM逐渐被募集;然而,该肌肉中的O2Hb未得到维持。同样,在肘屈肌负荷运动期间,肱二头肌中的O2Hb也未得到维持。递增负荷运动方案期间SCM和BC的这种局部脱氧并未通过SpO2的降低反映出来。

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