老年脑卒中患者有氧运动中心血管自主反应的利用：作为公共卫生政策的功能康复。
The Use of Cardiac Autonomic Responses to Aerobic Exercise in Elderly Stroke Patients: Functional Rehabilitation as a Public Health Policy.
机构信息
Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715-Cerqueira César, Sao Paulo 01246-000, Brazil.
Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Av. Lauro Gomes, 2000-Vila Sacadura Cabral, Santo Andre 09060-870, Brazil.
出版信息
Int J Environ Res Public Health. 2021 Oct 31;18(21):11460. doi: 10.3390/ijerph182111460.
BACKGROUND AND PURPOSE
The development of public policies must be guided by full knowledge of the health-disease process of the population. Aerobic exercises are recommended for rehabilitation in stroke patients, and have been shown to improve heart rate variability (HRV). Our aim was to compare the cardiac autonomic modulation of elderly stroke patients with that of healthy elderly people during and after an acute bout of aerobic exercise.
METHODS
A total of 60 elderly people participated in the study (30 in the control group, mean age of 67 ± 4 years; 30 in the stroke group, mean age of 69 ± 3 years). HRV was analyzed in rest-10 min of rest in supine position; exercise-the 30 min of peak exercise; and recovery-30 min in supine position post-exercise.
RESULTS
Taking rest and exercises together, for SDNN, RMSSD, pNN50, RRTri, and TINN, there was no difference between the stroke and control groups ( = 0.062; = 0.601; = 0.166; = 0.224, and = 0.059, respectively). The HF (ms) was higher and the LF/HF ratio was lower for the stroke group than the control group ( < 0.001 and = 0.007, respectively). The SD2 was lower for the stroke group than for the control group ( = 0.041).
CONCLUSION
Stroke patients present reduced variability at rest, sympathetic predominance during exercise, and do not return to baseline after the 30 min of recovery, with similar responses found in the healthy elderly group.
背景与目的
公共政策的制定必须充分了解人群的健康-疾病过程。有氧运动被推荐用于中风患者的康复，并且已经证明可以改善心率变异性（HRV）。我们的目的是比较老年中风患者和健康老年人在急性有氧运动期间和之后的心脏自主神经调节。
方法
共有 60 名老年人参加了这项研究（对照组 30 人，平均年龄 67 ± 4 岁；中风组 30 人，平均年龄 69 ± 3 岁）。HRV 在休息时（仰卧位休息 10 分钟）；运动时（峰值运动 30 分钟）；和恢复时（运动后仰卧位 30 分钟）进行分析。
结果
将休息和运动结合起来，对于 SDNN、RMSSD、pNN50、RRTri 和 TINN，中风组和对照组之间没有差异（= 0.062；= 0.601；= 0.166；= 0.224 和= 0.059，分别）。与对照组相比，中风组的 HF（ms）更高，LF/HF 比值更低（<0.001 和= 0.007，分别）。与对照组相比，中风组的 SD2 更低（= 0.041）。
结论
中风患者在休息时变异性降低，运动时交感神经占优势，并且在 30 分钟恢复后不能恢复到基线，健康老年人组也有类似的反应。
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