Iellamo F, Legramante J M, Raimondi G, Castrucci F, Damiani C, Foti C, Peruzzi G, Caruso I
Fisiopatologia Medica, Dipartimento di Medicina Interna, Universita' di Roma Tor Vergata, Rome, Italy.
Eur J Appl Physiol Occup Physiol. 1997;75(2):89-96. doi: 10.1007/s004210050131.
The purpose of the present study was to compare arterial pressure (AP) and heart rate (HR) responses to submaximal isokinetic, isotonic and isometric exercises currently employed in physical rehabilitation therapy in terms of both magnitude and time-course. To this aim AP and HR were continuously and noninvasively measured in ten healthy subjects performing isokinetic, isotonic and isometric exercises at the same relative intensity. Isokinetic and isotonic exercises consisted of 30 knee extension/flexion repetitions at 40% of maximal effort. Isokinetic speed was set at 180 degrees s(-1). Isometric exercise consisted of a 60-s knee extension at 40% maximal voluntary contraction. The AP showed a rapid and marked increase from the onset of all types of exercise progressing throughout the exercises. Peak systolic (SAP) and diastolic (DAP) arterial pressure were 190.7 (SEM 8.9) and 121.6 (SEM 7.8) mmHg during isokinetic and 197.6 (SEM 11.2) and 128.3 (SEM 7.7) mmHg during isotonic exercise, respectively. During isometric exercise peak SAP and DAP were 168.1 (SEM 6.3) and 102.1 (SEM 3.7) mmHg, respectively [both lower compared to isokinetic and isotonic exercise (P < 0.05)]. The HR rose abruptly and after five isokinetic and isotonic repetitions it had already increased by about 30 beats min(-1), continuing to rise throughout the exercises. The HR response to isometric exercise was significantly less (P < 0.05) at all times. An immediate fall in AP, undershooting resting levels, was observed at the cessation of all types of exercise, being more marked after isokinetic and isotonic exercise. These results indicate that submaximal exercise of a dynamic type induces greater AP responses than intensity-matched isometric exercise and that even submaximal endurance-type rehabilitation exercise yields an elevated functional stress on the cardiovascular system which could precipitate hazardous events particularly in subjects with unrecognized cardiac diseases.
本研究的目的是比较目前在物理康复治疗中使用的次最大等速、等张和等长运动在幅度和时间进程方面对动脉压(AP)和心率(HR)的影响。为此,在十名健康受试者以相同相对强度进行等速、等张和等长运动时,连续无创地测量了AP和HR。等速和等张运动包括以最大努力的40%进行30次膝关节伸展/屈曲重复动作。等速运动速度设定为180度·秒⁻¹。等长运动包括以最大自主收缩的40%进行60秒的膝关节伸展。在所有类型运动开始时,AP迅速显著升高,并在整个运动过程中持续上升。等速运动期间,收缩压峰值(SAP)和舒张压峰值(DAP)分别为190.7(标准误8.9)mmHg和121.6(标准误7.8)mmHg,等张运动期间分别为197.6(标准误11.2)mmHg和128.3(标准误7.7)mmHg。等长运动期间,SAP峰值和DAP峰值分别为168.1(标准误6.3)mmHg和102.1(标准误3.7)mmHg[均低于等速和等张运动(P<0.05)]。HR在等速和等张运动重复五次后突然上升,已经增加了约30次·分钟⁻¹,并在整个运动过程中持续上升。等长运动期间HR反应在所有时间均显著较小(P<0.05)。在所有类型运动停止时,观察到AP立即下降,低于静息水平,等速和等张运动后更为明显。这些结果表明,动态类型的次最大运动比强度匹配的等长运动引起更大的AP反应,并且即使是次最大耐力型康复运动也会对心血管系统产生升高的功能应激,这可能会引发危险事件,特别是在患有未被识别的心脏病的受试者中。