King A C, Haskell W L, Young D R, Oka R K, Stefanick M L
Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, Calif, USA.
Circulation. 1995 May 15;91(10):2596-604. doi: 10.1161/01.cir.91.10.2596.
Although exercise parameters such as intensity and format have been shown to influence exercise participation rates and physiological outcomes in the short term, few data are available evaluating their longer-term effects. The study objective was to determine the 2-year effects of differing intensities and formats of endurance exercise on exercise participation rates, fitness, and plasma HDL cholesterol levels among healthy older adults.
Higher-intensity, group-based exercise training; higher-intensity, home-based exercise; and lower-intensity, home-based exercise were compared in a 2-year randomized trial. Participants were 149 men and 120 postmenopausal women 50 to 65 years of age who were sedentary and free of cardiovascular disease. Recruitment was achieved through a random digit-dial community telephone survey and media promotion. All exercise occurred in community settings. For higher-intensity exercise training, three 40-minute endurance training sessions per week were prescribed at 73% to 88% of peak treadmill heart rate. For lower-intensity exercise, five 30-minute endurance training sessions per week were prescribed at 60% to 73% of peak treadmill heart rate. Treadmill exercise performance, lipoprotein levels and other heart disease risk factors, and exercise adherence were evaluated at baseline and across the 2-year period. Treadmill exercise test performance improved for all three training conditions during year 1 and was successfully maintained during year 2, particularly for subjects in the higher-intensity, home-based condition. Subjects in that condition also showed the greatest year 2 exercise adherence rates (P < .003). Although no significant increases in HDL cholesterol were observed during year 1, by the end of year 2 subjects in the two home-based training conditions showed small but significant HDL cholesterol increases over baseline (P < .01). The increases were particularly pronounced for subjects in the lower-intensity condition, whose exercise prescription required more frequent exercise sessions per week. For all exercise conditions, increases in HDL cholesterol were associated with decreases in waist-to-hip ratio in both men and women (P < .04).
While older adults can benefit from initiating a regular regimen of moderate-intensity exercise in terms of improved fitness levels and small improvements in HDL cholesterol levels, the time frame needed to achieve HDL cholesterol change (2 years) may be longer than that reported previously for younger populations. Frequency of participation may be particularly important for achieving such changes. Supervised home-based exercise regimens represent a safe, attractive alternative for achieving sustained participation.
尽管运动参数如强度和形式已被证明在短期内会影响运动参与率和生理结果，但评估其长期影响的数据却很少。本研究的目的是确定不同强度和形式的耐力运动对健康老年人运动参与率、体能和血浆高密度脂蛋白胆固醇水平的两年影响。
在一项为期两年的随机试验中，对高强度、基于小组的运动训练；高强度、居家运动；以及低强度、居家运动进行了比较。参与者为149名男性和120名50至65岁的绝经后女性，她们久坐不动且无心血管疾病。通过随机数字拨号社区电话调查和媒体宣传进行招募。所有运动均在社区环境中进行。对于高强度运动训练，每周规定进行三次40分钟的耐力训练，强度为跑步机峰值心率的73%至88%。对于低强度运动，每周规定进行五次30分钟的耐力训练，强度为跑步机峰值心率的60%至73%。在基线和两年期间对跑步机运动表现、脂蛋白水平和其他心脏病风险因素以及运动依从性进行了评估。在第1年，所有三种训练条件下的跑步机运动测试表现均有所改善，并在第2年成功维持，特别是对于高强度居家运动条件下的受试者。该条件下的受试者在第2年的运动依从率也最高（P < .003）。尽管在第1年未观察到高密度脂蛋白胆固醇有显著增加，但到第2年末，两种居家训练条件下的受试者的高密度脂蛋白胆固醇水平均比基线有小幅但显著的增加（P < .01）。对于低强度运动条件下的受试者，这种增加尤为明显，其运动处方要求每周进行更频繁的运动。在所有运动条件下，高密度脂蛋白胆固醇的增加与男性和女性腰臀比的降低相关（P < .04）。
虽然老年人可以从开始定期进行中等强度运动中受益于体能水平的提高和高密度脂蛋白胆固醇水平的小幅改善，但实现高密度脂蛋白胆固醇变化所需的时间框架（2年）可能比之前报道的年轻人群更长。参与频率对于实现这种变化可能尤为重要。有监督的居家运动方案是实现持续参与的一种安全、有吸引力的选择。
