Walat S
Katedry i Zakładu Fizjologii Pomorskiej Akademii Medycznej w Szczecinie.
Ann Acad Med Stetin. 1995;41:109-29.
Regarding the peculiar character of exercise adaptation in developmental age, two questions have been stated; in what degree heart rate (HR) changes after physical effort reflect and diagnose the physical fitness in children and if these values can be the base of indirect method of maximal oxygen intake (VO2max). The practical problem was to choose the method, which could make the data for the comparative analysis of the heart's chronotropic reaction in children practising swimming professionally and in non-practising ones possible to obtain. The research method should not be connected with excessive workload for children. The heart's chronotropic reaction has been thoroughly analysed in different phases of submaximal progressive effort, according to the methods specific for the PWC170 index estimation; its diagnostic value would determine its differentiation in the age groups of swimmers and non-practising children and correlation between its indexes and real oxygen efficiency estimated using maximal oxygen intake values obtained in direct method (VO2maxEZ). 186 girls and 225 boys aged 10 to 15, practicing systematically since the 10th year of life, were investigated. During six years of the study 1308 exercise trials have been performed, including 654 tests with submaximal workload specific for the PWC170 index estimation (Physical Work Capacity), and 654 spiroergometric tests (TSE) with maximal workload and direct measurement of oxygen intake. Data obtained from the test with submaximal workload were compared with those noted in the same age groups of non-practicing children (246 girls and 256 boys), who formed the control groups for male and female swimmers. Those children from primary school had never practised any organized form of sport apart from obligatory physical exercises at school. Comparative analysis of physical efficiency indexes followed the estimation of basic morphologic features in studied children (body weight, fat-free body weight, body height). The heart's chronotropic reaction has been characterized in a traditional way as PWC170 and PWC150 indexes; it has been also thoroughly analyzed during following stages of the test estimated by workload changes, as well as the resultant for the whole workload dynamics of the HR changes, which has characterized the physiologic chronotropic expense of one watt of the workload applied. In the same time relationship between values obtained directly before the beginning of the exercises (HRW) have been analyzed. Although it has been found that discussed PWC indexes can differentiate in mean falues the groups of practising and non-practising children in the same age, but in significant percentage their values were nearing in both groups; it has been distinctly shown in the value distribution in percentile scores (Fig 1). This situation undoubtedly reduces the diagnostic advantages of the discussed indexes. HRW values have influenced the course of the test and its final result, and especially PWC indexes (significant in some groups of children), which has been emphasized. In the research a problem is discussed: in what degree the changes of the heart rate can describe the general physical fitness of people studies. Comparative analysis of the PWC and TSE tests performed in swimmers show no relationship between physical oxygen efficiency and values of PWC170 and PWC150 indexes. In the longitudinal research the PWC170 test results have significantly fluctuated during progressively increasing values of maximal oxygen intake measured directly, which has been pointed out. Maximal oxygen intake should be evaluated critically on the base of the heart's chronotropic reaction after exercise in children. It seems that more reliable in estimating the exercise adaptation is to describe the heart's chronotropic reaction using its direct indexes. It is possible to use PWC170 results, but it is necessary to regard the initial HR values when starting the exercise.
关于发育年龄阶段运动适应的特殊性质,提出了两个问题:体力活动后心率(HR)的变化在何种程度上反映和诊断儿童的身体素质,以及这些数值是否可以作为间接测定最大摄氧量(VO2max)方法的基础。实际问题是要选择一种方法,以便能够获取专业练习游泳儿童和非专业练习游泳儿童心脏变时反应的比较分析数据。该研究方法不应给儿童带来过大的工作量。根据用于估算PWC170指数的特定方法,在次最大渐进性运动的不同阶段对心脏变时反应进行了深入分析;其诊断价值将决定其在游泳运动员和非练习游泳儿童年龄组中的差异,以及其指标与使用直接法(VO2maxEZ)获得的最大摄氧量估算的实际氧效率之间的相关性。对186名女孩和225名10至15岁的男孩进行了调查,这些孩子从10岁起就开始系统地训练。在六年的研究期间,共进行了1308次运动试验,其中包括654次针对PWC170指数估算(体力工作能力)的次最大工作量测试,以及654次最大工作量的运动心肺功能测试(TSE)并直接测量摄氧量。将次最大工作量测试获得的数据与同年龄组非练习游泳儿童(246名女孩和256名男孩)的数据进行比较,这些儿童构成了男女游泳运动员的对照组。那些小学生除了学校规定的体育锻炼外,从未参加过任何有组织的体育活动。在对研究儿童的基本形态特征(体重、去脂体重、身高)进行估算之后,对身体效率指标进行了比较分析。心脏变时反应传统上以PWC170和PWC150指数来表征;在根据工作量变化估算的测试后续阶段,以及整个工作量过程中心率变化的结果,即每施加一瓦工作量的生理变时消耗,也进行了深入分析。同时,还分析了运动开始前直接测得的值(HRW)之间的关系。尽管已发现所讨论的PWC指数在平均数值上可以区分同年龄的练习游泳儿童组和非练习游泳儿童组,但在相当大的比例上,两组的数值接近;这在百分位数的数值分布中得到了明显体现(图1)。这种情况无疑降低了所讨论指数的诊断优势。HRW值影响了测试过程及其最终结果,特别是PWC指数(在某些儿童组中具有显著性),这一点已得到强调。在研究中讨论了一个问题:心率变化在何种程度上能够描述所研究人群的总体身体素质。对游泳运动员进行的PWC和TSE测试的比较分析表明,身体氧效率与PWC170和PWC150指数的值之间没有关系。在纵向研究中,有人指出,在直接测量的最大摄氧量逐渐增加时,PWC170测试结果有显著波动。在儿童运动后,应根据心脏变时反应对最大摄氧量进行批判性评估。似乎在描述心脏变时反应时使用其直接指标来估算运动适应更为可靠。可以使用PWC170的结果,但在开始运动时必须考虑初始心率值。