مقایسه‌ی تأثیر هشت هفته تمرین تناوبی با شدت زیاد و تمرین تداومی با شدت متوسط بر متغیرهای فیزیولوژیک آزمون ورزشی در بیماران قلبی پس از عمل جراحی بای‌پس شریان کرونر

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، گروه فیزیولوژی ورزشی، دانشکده‌ی تربیت بدنی، دانشگاه تهران، تهران، ایران

2 دانشجوی دکتری، گروه فیزیولوژی ورزشی، دانشکده‌ی تربیت بدنی، دانشگاه تهران، تهران، ایران

3 کارشناس ارشد، گروه فیزیولوژی ورزشی، دانشکده‌ی تربیت بدنی، دانشگاه تهران، تهران، ایران

چکیده

مقدمه: بازتوانی قلبی موجب بهبود ظرفیت عملکردی بیماران قلبی پس از عمل بای‌پس شریان کرونر (Coronary artery bypass graft یا CABG) می‌شود. بنابراین، هدف این مطالعه مقایسه‌ی هشت هفته تمرین تناوبی با تمرین تداومی بر متغیرهای فیزیولوژیک آزمون ورزشی در بیماران قلبی پس از عمل پیوند بای‌پس شریان کرونر بود.روش‌ها: در این مطالعه‌ی کارآزمایی بالینی، 30 بیمار قلبی مرکز قلب تهران که عمل جراحی CABG بر روی آن‌ها انجام شد، به طور تصادفی به دو گروه برنامه‌ی تمرینی تناوبی با شدت زیاد و تمرین تداومی با شدت متوسط (برنامه‌ی رایج) تقسیم شدند. برنامه‌ی گروه تناوبی شامل 6 تکرار 4 دقیقه‌ای با شدت 95-90 درصد ضربان قلب حداکثر و گروه تداومی 80-60 دقیقه با شدت 85-70 درصد ضربان قلب حداکثر سه جلسه در هفته به مدت هشت هفته بود. قبل و بعد از برنامه‌ی تمرینی، ظرفیت عملکردی (VO2 peak یا Peak oxygen uptake)، مسافت طی شده، زمان رسیدن تا واماندگی و ضربان قلب بیشینه هنگام اجرای آزمون ورزشی بروس برآورد شد. داده‌های جمع‌آوری شده، با استفاده از آزمون One-way analysis of variance (One-way ANOVA) و آزمون تعقیبی LSD (Fisher's least significant difference) تجزیه و تحلیل شدند.یافته‌ها: ظرفیت عملکردی به دنبال هر دو برنامه‌ی تمرینی، بدون تفاوت معنی‌دار بین دو گروه، افزایش معنی‌داری پیدا کرد (05/0 > P). افزایش مسافت طی شده، زمان رسیدن تا واماندگی و ضربان قلب بیشینه، پس از برنامه‌ی تناوبی بیشتر از برنامه‌ی تداومی بود (05/0 > P).نتیجه‌گیری: به نظر می‌رسد هر دو برنامه‌ی تمرینی تناوبی با شدت زیاد و تداومی با شدت متوسط موجب بهبود ظرفیت عملکردی بیماران قلبی پس از عمل بای‌پس شریان کرونر می‌شوند. با این حال، تمرین تناوبی نسبت به تداومی در برخی پارامترها مثل مسافت طی شده، زمان رسیدن تا واماندگی و ضربان قلب بیشینه هنگام آزمون ورزشی مؤثرتر بود.

کلیدواژه‌ها

عنوان مقاله [English]

Comparing the Effect of Eight Weeks of High-Intensity Interval Training and Moderate-Intensity Continuous Training on Physiological Variables of Exercise Stress Test in Cardiac Patient after Coronary Artery Bypass Graft

نویسندگان [English]

  • Abbas Ali Gaeini 1
  • Sadegh Satarifard 2
  • Ali Heidary 3
1 Professor, Department of Exercise Physiology, School of Physical Education, University of Tehran, Tehran, Iran
2 PhD Student, Department of Exercise Physiology, School of Physical Education, University of Tehran, Tehran, Iran
3 Department of Exercise Physiology, School of Physical Education, University of Tehran, Tehran, Iran
چکیده [English]

Background: Cardiac rehabilitation improves functional capacity in cardiac patients after coronary artery bypass. The aim of this study was to compare the eight weeks of interval training with continuous training on stress test physiological variables in patient with cardiac diseases after coronary artery bypass graft (CABG) surgery .Methods: In this clinical trial study, 30 patient with cardiac diseases in Tehran Heart Center (Iran) having had CABG surgery were randomly divided into two groups, high-intensity interval and continuous moderate-intensity training (program common). The program of interval group was included 4 repeats × 4 minutes at 90-95% peak of heart rate (HR) and continuous group, 60-80 minute at 70-85% peak HR, three sessions per week for 8 weeks. Functional capacity (VO2 peak), distance traveled, time to exhaustion and maximum heart rate  (HRmax) were assessed during the Bruce exercise stress test before and after the training program. The collected data were analyzed using the one-way analysis of variances (ANOVA) and post hoc Fisher's least significant difference (LSD) tests.Findings: Functional capacity was increased significantly following the both of training programs with no significant difference between the two groups (P < 0.05). The increases in traveled distance, time to exhaustion, and HRmax after interval program were more in interval program group (P < 0.05).Conclusion: It seems that both high-intensity interval and moderate-intensity continuous training improve functional capacity in cardiac patient with cardiac diseases after coronary artery bypass sugery. However, interval training was more beneficial than continuous training in some parameters such as traveled distance, time to exhaustion, and HRmax during exercise stress test.

کلیدواژه‌ها [English]

  • Exercise stress test
  • Interval training
  • Coronary artery bypass graft (CABG) surgery

مراجع

  1. World Health Organization. Cardiovascular disease. Geneva, Switzerland: WHO; 2008.
  2. Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111(3): 369-76.
  3. Reibis RK, Treszl A, Wegscheider K, Ehrlich B, Dissmann R, Voller H. Exercise capacity is the most powerful predictor of 2-year mortality in patients with left ventricular systolic dysfunction. Herz 2010; 35(2): 104-10.
  4. Piepoli MF, Davos C, Francis DP, Coats AJ. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004; 328(7433): 189.
  5. Dendale P, Berger J, Hansen D, Vaes J, Benit E, Weymans M. Cardiac rehabilitation reduces the rate of major adverse cardiac events after percutaneous coronary intervention. Eur J Cardiovasc Nurs 2005; 4(2): 113-6.
  6. Conraads VM, Beckers PJ. Exercise training in heart failure: practical guidance. Heart 2010; 96(24): 2025-31.
  7. Ghroubi S, Elleuch W, Abid L, Abdenadher M, Kammoun S, Elleuch MH. Effects of a low-intensity dynamic-resistance training protocol using an isokinetic dynamometer on muscular strength and aerobic capacity after coronary artery bypass grafting. Ann Phys Rehabil Med 2013; 56(2): 85-101.
  8. Warburton DE, McKenzie DC, Haykowsky MJ, Taylor A, Shoemaker P, Ignaszewski AP, et al. Effectiveness of high-intensity interval training for the rehabilitation of patients with coronary artery disease. Am J Cardiol 2005; 95(9): 1080-4.
  9. Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 2007; 115(24): 3086-94.
  10. Moholdt TT, Amundsen BH, Rustad LA, Wahba A, Lovo KT, Gullikstad LR, et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J 2009; 158(6): 1031-7.
  11. Munk PS, Staal EM, Butt N, Isaksen K, Larsen AI. High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation A randomized controlled trial evaluating the relationship to endothelial function and inflammation. Am Heart J 2009; 158(5): 734-41.
  12. Stewart KJ, Badenhop D, Brubaker PH, Keteyian SJ, King M. Cardiac rehabilitation following percutaneous revascularization, heart transplant, heart valve surgery, and for chronic heart failure. Chest 2003; 123(6): 2104-11.
  13. Maiorana A. Interval training confers greater gains than continuous training in people with heart failure. J Physiother 2012; 58(3): 199.
  14. Iellamo F, Manzi V, Caminiti G, Vitale C, Castagna C, Massaro M, et al. Matched dose interval and continuous exercise training induce similar cardiorespiratory and metabolic adaptations in patients with heart failure. Int J Cardiol 2013; 167(6): 2561-5.
  15. Eagle KA, Guyton RA, Davidoff R, Edwards FH, Ewy GA, Gardner TJ, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 2004; 110(14): e340-e437.
  16. Rognmo O, Moholdt T, Bakken H, Hole T, Molstad P, Myhr NE, et al. Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation 2012; 126(12): 1436-40.
  17. Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 2008; 118(4): 346-54.
  18. Haykowsky MJ, Timmons MP, Kruger C, McNeely M, Taylor DA, Clark AM. Meta-analysis of aerobic interval training on exercise capacity and systolic function in patients with heart failure and reduced ejection fractions. Am J Cardiol 2013; 111(10): 1466-9.
  19. Tomczak CR, Thompson RB, Paterson I, Schulte F, Cheng-Baron J, Haennel RG, et al. Effect of acute high-intensity interval exercise on postexercise biventricular function in mild heart failure. J Appl Physiol (1985 ) 2011; 110(2): 398-406.
  20. Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol 2012; 590(Pt 5): 1077-84.
  21. Fu TC, Wang CH, Lin PS, Hsu CC, Cherng WJ, Huang SC, et al. Aerobic interval training improves oxygen uptake efficiency by enhancing cerebral and muscular hemodynamics in patients with heart failure. Int
  22. J Cardiol 2013; 167(1): 41-50.
  23. Carvalho VO, Mezzani A. Aerobic exercise training intensity in patients with chronic heart failure: principles of assessment and prescription. Eur J Cardiovasc Prev Rehabil 2011; 18(1): 5-14.
  24. Lenk K, Schur R, Linke A, Erbs S, Matsumoto Y, Adams V, et al. Impact of exercise training on myostatin expression in the myocardium and skeletal muscle in a chronic heart failure model. Eur J Heart Fail 2009; 11(4): 342-8.
  25. Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 2000; 343(19): 1355-61.
  26. Beauchamp MK, Nonoyama M, Goldstein RS, Hill K, Dolmage TE, Mathur S, et al. Interval versus continuous training in individuals with chronic obstructive pulmonary disease--a systematic review. Thorax 2010; 65(2): 157-64.
مجله دانشکده پزشکی اصفهان
دوره 31، شماره 267 - شماره پیاپی 267
بهمن و اسفند 1392
صفحه 2171-2181

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  • تاریخ دریافت: 05 مرداد 1392
  • تاریخ بازنگری: 23 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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