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与中风患者运动中氧耗量增加相关的心肺因素。

Cardiorespiratory factors related to the increase in oxygen consumption during exercise in individuals with stroke.

机构信息

Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Nagano, Japan.

Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Chiba, Japan.

出版信息

PLoS One. 2019 Oct 9;14(10):e0217453. doi: 10.1371/journal.pone.0217453. eCollection 2019.

Abstract

BACKGROUND

Understanding the cardiorespiratory factors related to the increase in oxygen consumption ([Formula: see text]) during exercise is essential for improving cardiorespiratory fitness in individuals with stroke. However, cardiorespiratory factors related to the increase in [Formula: see text] during exercise in these individuals have not been examined using multivariate analysis. This study aimed to identify cardiorespiratory factors related to the increase in [Formula: see text] during a graded exercise in terms of respiratory function, cardiac function, and the ability of skeletal muscles to extract oxygen.

METHODS

Eighteen individuals with stroke (aged 60.1 ± 9.4 years, 67.1 ± 30.8 days poststroke) underwent a graded exercise test for the assessment of cardiorespiratory response to exercise. The increases in [Formula: see text] from rest to first threshold and that from rest to peak exercise were measured as a dependent variable. The increases in respiratory rate, tidal volume, minute ventilation, heart rate, stroke volume, cardiac output, and arterial-venous oxygen difference from rest to first threshold and those from rest to peak exercise were measured as the independent variables.

RESULTS

From rest to first threshold, the increases in arterial-venous oxygen difference (β = 0.711) and cardiac output (β = 0.572) were significant independent variables for the increase in [Formula: see text] (adjusted R2 = 0.877 p < 0.001). Similarly, from rest to peak exercise, the increases in arterial-venous oxygen difference (β = 0.665) and cardiac output (β = 0.636) were significant factors related to the increase in [Formula: see text] (adjusted R2 = 0.923, p < 0.001).

CONCLUSION

Our results suggest that the ability of skeletal muscle to extract oxygen is a major cardiorespiratory factor related to the increase in [Formula: see text] during exercise testing in individuals with stroke. For improved cardiorespiratory fitness in individuals with stroke, the amount of functional muscle mass during exercise may need to be increased.

摘要

背景

了解与运动时耗氧量增加相关的心肺因素([Formula: see text])对于提高脑卒中患者的心肺功能至关重要。然而,使用多变量分析尚未检查与这些个体运动时[Formula: see text]增加相关的心肺因素。本研究旨在确定与呼吸功能、心脏功能以及骨骼肌提取氧气的能力相关的心肺因素与运动时[Formula: see text]增加有关。

方法

18 名脑卒中患者(年龄 60.1±9.4 岁,脑卒中后 67.1±30.8 天)进行了分级运动测试,以评估运动时的心肺反应。将[Formula: see text]从休息到第一阈值的增加和从休息到峰值运动的增加作为因变量进行测量。将呼吸频率、潮气量、分钟通气量、心率、每搏量、心输出量和动静脉氧差从休息到第一阈值以及从休息到峰值运动的增加作为自变量进行测量。

结果

从休息到第一阈值,动静脉氧差(β=0.711)和心输出量(β=0.572)的增加是[Formula: see text]增加的显著独立变量(调整后的 R2=0.877,p<0.001)。同样,从休息到峰值运动,动静脉氧差(β=0.665)和心输出量(β=0.636)的增加是与[Formula: see text]增加相关的重要因素(调整后的 R2=0.923,p<0.001)。

结论

我们的结果表明,骨骼肌提取氧气的能力是与脑卒中患者运动试验时[Formula: see text]增加相关的主要心肺因素。为了提高脑卒中患者的心肺健康水平,可能需要增加运动时的功能性肌肉量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25d8/6785174/f5890aefacfd/pone.0217453.g001.jpg

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