Phillips W, Burkett L N, Munro R, Davis M, Pomeroy K
Stanford University Medical School, USA.
Paraplegia. 1995 Feb;33(2):90-3. doi: 10.1038/sc.1995.21.
Eight spinal cord injured (SCI) patients performed three sets of exercise with two conditions, 60% and 80% of VO2peak, with an arm crank ergometer. Functional neuromuscular stimulation was used to induce static leg contractions in two of the above sets of exercise. The three exercise sets were performed with no functional neuromuscular stimulation (NOS); with functional neuromuscular stimulation at 40 milliamperes; and with functional neuromuscular stimulation at 80 milliamperes (HIS). The lower limb blood flow was estimated by a photoelectric plethysmograph. Results showed that the lower limb blood flow was consistently reduced across both functional neuromuscular stimulation levels (17.4% from NOS to LOS; 13.8% from LOS to HIS; and 28.8% from NOS to HIS), and work loads (15.3% from rest to 60% VO2peak; 38.0% from 60% VO2peak to 80% VO2peak; and 47.5% from rest to 80% VO2peak). Rate-pressure product was decreased by 8.3% between NOS and HIS at 60% VO2peak (15.7 +/- 3.4 to 14.4 +/- 3.8), by 6.8% between NOS and HIS at 80% VO2peak (18.9 +/- 53 to 17.6 +/- 4.8), and by 12.4% between LOS and HIS at 80% VO2peak (20.1 +/- 6.7 to 17.6 +/- 4.8). These data indicate that in SCI (a) functional neuromuscular stimulation-induced contractions of the lower limb muscles can increase blood flow and thus reduce venous blood pooling in the paralyzed muscles, and (b) such improvements are associated with a reduced rate pressure product.(ABSTRACT TRUNCATED AT 250 WORDS)
八名脊髓损伤(SCI)患者使用手臂曲柄测力计,在两种运动强度条件下(分别为最大摄氧量的60%和80%)进行了三组运动。在上述两组运动中,使用功能性神经肌肉电刺激来诱发腿部静态收缩。三组运动分别在无功能性神经肌肉电刺激(NOS)、40毫安功能性神经肌肉电刺激以及80毫安功能性神经肌肉电刺激(HIS)的情况下进行。通过光电体积描记法估算下肢血流量。结果显示,在两种功能性神经肌肉电刺激水平下(从NOS到LOS降低17.4%;从LOS到HIS降低13.8%;从NOS到HIS降低28.8%)以及不同工作负荷下(从休息到60%最大摄氧量降低15.3%;从60%最大摄氧量到80%最大摄氧量降低38.0%;从休息到80%最大摄氧量降低47.5%),下肢血流量均持续减少。在60%最大摄氧量时,NOS和HIS之间的心率血压乘积降低了8.3%(从15.7±3.4降至14.4±3.8);在80%最大摄氧量时,NOS和HIS之间降低了6.8%(从18.9±5.3降至17.6±4.8),LOS和HIS之间在80%最大摄氧量时降低了12.4%(从20.1±6.7降至17.6±4.8)。这些数据表明,在脊髓损伤患者中:(a)功能性神经肌肉电刺激诱发的下肢肌肉收缩可增加血流量,从而减少瘫痪肌肉中的静脉血淤积;(b)这种改善与心率血压乘积降低有关。(摘要截断于250字)