Cruz Aline Ângela Silva, Wanner Samuel Penna, Stieler Eduardo, Romão Júlia, Esteves Andrea Maculano, Andrade Henrique de Araújo, Lôbo Ingrid Ludimila Bastos, Amaral Adriana Souza, Rabelo Patrícia Conceição Rocha, de Mello Marco Túlio, Silva Andressa
Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil.
Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, R. Pedro Zaccaria, 1300, Jardim Santa Luiza, Limeira, SP, Brazil.
Sleep Med. 2024 May;117:25-32. doi: 10.1016/j.sleep.2024.03.006. Epub 2024 Mar 7.
The present study assessed the influence of physical training on cardiac autonomic activity in individuals with spinal cord injury (SCI) during different sleep stages.
Twenty-six volunteers were allocated into three groups: 9 sedentary individuals without SCI (control, CON); 8 sedentary tetraplegic individuals with chronic SCI (SED-SCI); 9 physically trained tetraplegic individuals with chronic SCI (TR-SCI). All participants underwent nocturnal polysomnography to monitor sleep stages: wakefulness, non-rapid eye movement (NREM) sleep (N1, N2, and N3 stages), and REM sleep. The electrocardiography data obtained during this exam were extracted to analyze the heart rate variability (HRV).
Sleep stages influenced HRV in the time [RR interval and root mean square of successive RR interval differences (RMSSD)] and frequency [low-frequency (LF) and high-frequency (HF) powers and LF-to-HF ratio] domains (P < 0.05). SED-SCI individuals showed unchanged HRV compared to CON (P > 0.05). When comparing the TR-SCI and SED-SCI groups, no significant differences in HRV were reported in the time domain (P > 0.05). However, in the frequency domain, more accentuated HF power was observed in TR-SCI than in SED-SCI individuals during the N2 and N3 stages and REM sleep (P < 0.05). Moreover, TR-SCI had higher HF power than CON during the N3 stage (P < 0.05).
TR-SCI individuals have greater HF power, indicative of parasympathetic modulation, than sedentary (injured or not injured) individuals during different sleep stages. Therefore, enhanced parasympathetic activity induced by physical training may improve cardiac autonomic modulation during sleep in individuals with chronic SCI.
本研究评估体育锻炼对脊髓损伤（SCI）个体在不同睡眠阶段心脏自主神经活动的影响。
26名志愿者被分为三组：9名无SCI的久坐个体（对照组，CON）；8名患有慢性SCI的久坐四肢瘫痪个体（久坐SCI组，SED - SCI）；9名患有慢性SCI的经过体育锻炼的四肢瘫痪个体（锻炼SCI组，TR - SCI）。所有参与者均接受夜间多导睡眠图检查以监测睡眠阶段：清醒、非快速眼动（NREM）睡眠（N1、N2和N3阶段）以及快速眼动（REM）睡眠。提取该检查期间获得的心电图数据以分析心率变异性（HRV）。
睡眠阶段在时间域[RR间期和连续RR间期差值的均方根（RMSSD）]和频率域[低频（LF）和高频（HF）功率以及LF与HF比值]影响HRV（P < 0.05）。与CON组相比，SED - SCI个体的HRV无变化（P > 0.05）。比较TR - SCI组和SED - SCI组时，在时间域HRV未报告显著差异（P > 0.05）。然而，在频率域，在N2和N3阶段以及REM睡眠期间，TR - SCI个体比SED - SCI个体观察到更明显的HF功率（P < 0.05）。此外，在N3阶段，TR - SCI个体的HF功率高于CON组（P < 0.05）。
在不同睡眠阶段，锻炼SCI个体比久坐（受伤或未受伤）个体具有更大的HF功率，表明副交感神经调制。因此，体育锻炼诱导的副交感神经活动增强可能改善慢性SCI个体睡眠期间的心脏自主神经调制。
