Lin K H, Lai J S, Kao M J, Lien I N
Department of Physical Therapy, School of Rehabilitation Medicine, National Taiwan University, R.O.C.
Arch Phys Med Rehabil. 1993 May;74(5):515-20. doi: 10.1016/0003-9993(93)90116-r.
The major purpose of this investigation was to compare the anaerobic threshold (AT) and maximal cardiopulmonary responses to arm exercise between persons with paraplegia and the able-bodied. The locomotive stress on the heart in paraplegic subjects was also examined. Thirty-nine paraplegic subjects (T1-L4 lesions) and 32 able-bodied subjects completed a continuous, progressive, resisted arm cranking exercise test. The AT was determined from the ventilatory parameters. At the AT, the mean values of Vo2/body weight (BW) for class II (T1-T5, N = 9), III (T6-T10, N = 11), and IV (T11-L4, n = 19) paraplegic subjects were 10.9, 13.2, and 13.5mL/kg/min, respectively, and only class II had significantly lower value than the able-bodied (14.4mL/kg/min). During maximal exercise, the mean values of maximal oxygen consumption per body weight (Vo2max/BW) for class II and III paraplegics were 17.4 and 17.7mL/kg/min, respectively, which were significantly lower (p < 0.05) than that of class IV (21.3mL/kg/min) and the able-bodied (28.2mL/kg/min). The heart rate (HR) during wheelchair-propelling (119bpm, n = 37) was significantly less than that at the AT (134bpm), but the HR during crutch-walking (151bpm, n = 17) was significantly higher. The results indicate that both submaximal and maximal cardiopulmonary functions in high-lesion paraplegics were less than that of the able bodied. Furthermore, the intensity of wheelchair-propelling at comfortable speed is not enough for improving the cardiopulmonary functions.
本研究的主要目的是比较截瘫患者和健全人在手臂运动时的无氧阈值(AT)和最大心肺反应。同时也研究了截瘫患者心脏所承受的运动压力。39名截瘫患者(胸1至腰4损伤)和32名健全人完成了一项持续、渐进、抗阻的手臂摇柄运动测试。通过通气参数确定无氧阈值。在无氧阈值时,II级(胸1至胸5,N = 9)、III级(胸6至胸10,N = 11)和IV级(胸11至腰4,n = 19)截瘫患者的每公斤体重摄氧量(Vo2/体重)平均值分别为10.9、13.2和13.5mL/kg/min,只有II级患者的值显著低于健全人(14.4mL/kg/min)。在最大运动时,II级和III级截瘫患者每公斤体重的最大耗氧量(Vo2max/体重)平均值分别为17.4和17.7mL/kg/min,显著低于IV级患者(21.3mL/kg/min)和健全人(28.2mL/kg/min)(p < 0.05)。轮椅推进时的心率(119次/分钟,n = 37)显著低于无氧阈值时的心率(134次/分钟),但拄拐行走时的心率(151次/分钟)显著更高。结果表明,高位截瘫患者的次最大和最大心肺功能均低于健全人。此外,以舒适速度推进轮椅的强度不足以改善心肺功能。