登階運動後不同身體姿勢短期心率變異度信度分析

Reliability of Short-Term Heart Rate Variability in Different Body Positions after Step Exercise

賴威霖(Wai-Lin Lai) ； 呂萬安(Wan-An Lu) ； 呂昱賢(Yu-Xian Lu) ； 陳永盛(Yung-Sheng Chen)

《北市醫學雜誌》 16卷2期 (2019/06) Pp. 117-130

https://doi.org/10.6200/TCMJ.201906_16(2).0003

摘要

目的：研究認為5分鐘短期測量能有效檢驗心率變異度（Heart rate variability，HRV），但尚未有研究證實測量姿勢對運動後短期測量方法的影響，本研究目的為探討不同身體姿勢對於運動後5分鐘短期HRV對數轉換值測量的信度。方法：本研究召募21名大專學生，以隨機方式分別進行仰臥姿、坐姿、站姿試驗，測量運動後15分鐘安靜心跳，運動介入為3分鐘登階運動。心率資料每5分鐘為區間與15分鐘總記錄以單因子變異數、Cohen's效果量、ICC_(2,1)組內相關係數、標準誤差（Standard error of the mean，SEM）與布蘭德－奧特曼差異圖（Bland-Altman difference plot）進行統計分析。結果：ICC值在仰臥姿最高；而站姿的SEM幾乎都大於仰臥姿及坐姿。InSDNN與InrMSSD的SEM較小，而頻域分析的指標SEM都較大。InrMSSD的ICC值最高，其次InHF的ICC值，InLF、InLF／HF的ICC值較低。結論：短期InrMSSD指標不受到登階運動影響，最適合運動後6~10分鐘測量，而且仰臥姿心率變異度具較好的測量信度。

關鍵字

布蘭德－奧特曼差異圖 ； 自律神經 ； 登階測試 ； 臥姿測量 ； 運動後心率恢復

並列摘要

Objective: Recent studies have revealed a good reliability of 5-min short-term measurement of heart rate variability (HRV). The purpose of this study was to investigate the reliability and agreement of a post-exercise 5-min HRV measurement. Methods: Twenty-one undergraduate students voluntarily participated in this study. Fifteen-min resting HRV was recorded in supine, sitting or standing positions after a 3-min step exercise in 3 occasions. A portable heart rate monitor was used to collect the heart rate beats during the experiment. The 0-5 min, 6-10min, and 11-15 min temporal segments and the sum of 15 min were compared. One-way analysis of variance (ANOVA), Cohen's d, intraclass correlation coefficient2,1 (ICC), standard error of measurement (SEM) and Bland-Altman difference plot were used for statistical analyses. Results: The highest ICC value was found in supine position while SEMs of standing position were almost always higher than in supine and sitting positions. The SEMs in the lnSDNN and lnrMSSD were relatively low. Higher SEMs were found in all frequency domains. The InrMSSD showed the highest ICC value. The InHF demonstrated a higher ICC value and lower ICC values in InLF and InLF/HF indices. Conclusion: The agreement and reliability of InrMSSD was not influenced by the 3-min step exercise. The 5-min post-exercise HRV measurement was best conducted during the 6-10 min recovery period, with better reliability in lying supine position.

並列關鍵字

Bland-Altman difference plot ； autonomic nervous system ； step test ； lying position measurement ； exercise recovery heart rate