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膝关节骨关节炎老年人对向心运动和离心运动的急慢性心血管反应。

Acute and chronic cardiovascular responses to concentric and eccentric exercise in older adults with knee osteoarthritis.

作者信息

Vincent Heather K, Sharififar Sharareh, McLaren Christian, May James, Vincent Kevin R

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA.

出版信息

BMC Sports Sci Med Rehabil. 2023 Aug 1;15(1):95. doi: 10.1186/s13102-023-00708-1.

Abstract

PURPOSE

Muscle contraction type in resistance exercise training may confer benefits besides strength in individuals with osteoarthritis and cardiovascular disease (CVD) risks. The purpose of the study was to explore whether Eccentric-resistance training (RT) improved hemodynamic responses to acute walking exercise stress compared to Concentric-RT among individuals with knee OA over four months.

METHODS

This was a secondary analysis from a randomized, controlled, single-blinded study. Participants (N = 88; 68.3 ± 6.4 yrs; 67.4% female) were randomized to one of two work-matched resistance training (RT) programs against a non-RT control group. Pre-training and month four, participants completed a self-paced Six-Minute Walk Test (6MWT) and progressive treadmill exercise test. Heart rates, blood pressures and mean arterial pressures (MAP) were captured during each test. Antihypertensive medications use was documented at each time point.

RESULTS

Leg strength improved in both training groups by month four (p < .05). Changes in 6MWT distance and progressive treadmill test time were not different across groups over four months. Neither Concentric or Eccentric RT produced different hemodyamic responses during the 6MWT compared to the control group post-training. However, Concentric RT was associated with 6.0%-7.4% reductions in systolic blood pressure during the graded treadmill walking test at 50%, 75% and 100% of the test time compared to Eccentric RT and the controls (p = .045). MAP values were lower at 75% and 100% of the treadmill test after Concentric RT (5.7%-6.0% reductions) compared to Eccentric RT (1.0%-2.4% reductions) and controls (1.5% and 4.0% elevations) post-training (p = .024). Antihypertensive medication use did not change in any group.

CONCLUSIONS

The repeated, progressive exposures of Concentric RT-induced blunted the hypertensive responses to acute exercise compared to Eccentric-RT. Among people with knee OA, Concentric-RT may confer strength benefits to manage OA and possibly reduce cardiovascular stress during exercise.

摘要

目的

在患有骨关节炎和有心血管疾病(CVD)风险的个体中,抗阻运动训练中的肌肉收缩类型可能除了增强力量之外还具有其他益处。本研究的目的是探讨在四个月的时间里,与向心抗阻训练相比,离心抗阻训练(RT)是否能改善膝关节骨关节炎患者对急性步行运动应激的血流动力学反应。

方法

这是一项来自随机、对照、单盲研究的二次分析。参与者(N = 88;68.3±6.4岁;67.4%为女性)被随机分配到两个与工作匹配的抗阻训练(RT)项目之一,与一个非抗阻训练对照组进行对比。在训练前和第四个月,参与者完成了一次自定步速的六分钟步行测试(6MWT)和渐进式跑步机运动测试。在每次测试过程中记录心率、血压和平均动脉压(MAP)。记录每个时间点的降压药物使用情况。

结果

到第四个月时,两个训练组的腿部力量均有所提高(p <.05)。在四个月的时间里,各组之间6MWT距离和渐进式跑步机测试时间的变化没有差异。与训练后的对照组相比,在6MWT期间,向心或离心RT均未产生不同的血流动力学反应。然而,与离心RT和对照组相比,在分级跑步机步行测试的50%、75%和100%测试时间时,向心RT与收缩压降低6.0%-7.4%相关(p =.045)。与训练后的离心RT(降低1.0%-2.4%)和对照组(升高1.5%和4.0%)相比,向心RT后在跑步机测试的75%和100%时MAP值较低(降低5.7%-6.0%)(p =.024)。任何一组的降压药物使用情况均未改变。

结论

与离心RT相比,向心RT的重复、渐进暴露减弱了对急性运动的高血压反应。在膝关节骨关节炎患者中,向心RT可能有助于增强力量以管理骨关节炎,并可能减轻运动期间的心血管应激。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a9b/10394881/db72751df37d/13102_2023_708_Fig1_HTML.jpg

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