居家運動計畫對改善停經後合併有冠狀動脈疾病婦女心率變異度及心肺耐力之成效探討

The Effects of Home-Based Exercise Program on Heart Rate Variability and Functional Capacity Among Postmenopausal Women With Coronary Artery Disease

杜詩婷(Shih-Ting Tu)

指導教授 ： 鄭綺

臺北醫學大學/護理學院/護理學研究所/碩士(2008年)

https://doi.org/10.6831/TMU.2008.00072

摘要

研究背景和目標：心率變異度近年來常被用來監控自主神經系統對人體的調控，也是心血管系統自動調節的重要指標。文獻指出無合併症的 CAD患者心率變異度較低，隨著年紀的增長，心肺耐力也會隨之下降，而規律運動訓練能改善心肺耐力及心率變異度，但先前研究大都採用機構式的運動訓練計畫，且大多數是以男性為主。故本篇研究目的在於探討居家運動計畫對停經後合併有CAD婦女心肺耐力及心率變異度改善之成效。
　　研究方法與受試者：以某醫學中心心臟科診斷為CAD之停經後婦女為研究對象，共32位參與本研究，其中16位為實驗組，16位為控制組，平均年齡分別為64.19（±5.86）歲與66.69（±5.26）歲（p> .05）。實驗組接受為期八週、每週三次的居家運動計畫。在訓練期間二組皆維持日常之活動、飲食及服用藥物情形。在八週運動訓練前後，每位受試者均分別接受心肺耐力（六分鐘走距測試）及心率變異度的測量。本研究採用描述性統計、χ2及t-test檢定來分析二組之同質性，以Pearson correlation來分析心肺耐力及心率變異度前測值和成效之相關性，最後以Pair t-test、Independent t-test及Two-way ANOVA來比較二組心肺耐力及心率變異度改善之成效。
　　研究結果：實驗組與控制組的基本屬性、心肺耐力及心率變異度的前測值間並無顯著差異（p> .05）。所有受試者心率變異度的前測值與各變項間，唯有六分鐘走距測試與年齡呈負相關（γ=-.518, p =.002），其餘皆未達統計上之顯著相關。實驗組八週居家運動訓練後與控制組相比，心肺耐力進步成效之差異（41.86 vs. 9.18 m）達顯著差異（p =.001）。在心率變異度指標中，實驗組經過八週居家運動訓練後TP（ms2）、HF（ms2）、LF（ms2）及HF（nu）達顯著差異（p< .05），LF（nu）及LF/HF ratio在成效上則未達顯著意義，而控制組所有指標皆未有顯著差異。
　　研究結論：給予八週居家運動計畫訓練，可以增加停經後合併有CAD婦女的心肺耐力，且個案在心率變異度及副交感神經活性上也皆有明確的改善。

關鍵字

居家運動計畫 ； 停經後合併冠狀動脈疾病婦女 ； 心肺耐力 ； 心率變異度

並列摘要

Background: Heart rate variability(HRV)was commonly used to monitor the autonomic regulation and was an important indicator of cardiovascular autoregulation. Decreased HRV was noted in coronary artery disease(CAD). The purpose of this study is to investigate the effects of home-based exercise program on functional capacity and HRV in postmenopausal women with CAD.
Methods and Subjects: Thirty-two postmenopausal women with CAD were recruited from one medical center, and assigned to an exercise group(n=16, averaged age 64.19 ± 5.86 years) or a control group(n=16, averaged age 66.69 ± 5.26 years). The home-based exercise program was 3 times per week for 8 weeks. All the subjects were asked to keep their daily activity, dietary intake, and medication during the study period. Functional capacity(6-minute walking test) and HRV were measured before and after a 8-week study period for each subjects. Differences in demographic data between groups were evaluated by using χ2 and t-test. Relations between functional capacity and HRV were assessed by Pearson correlation. Paired t-test, Independent t-test, and two-ways ANOVA were used for comparison between and within the two groups.
Results: No significant difference in baseline demographic, functional capacity, and HRV was observed between two groups. No correlations were found between functional capacity and HRV either at baseline or after training in the exercise group. Age and 6-minute walking test had negative relation(γ=-.518, p =.002). The increase of functional capacity of the exercise group was significantly and markedly greater than the control group(41.86 vs. 9.18 m)(p =.001). After 8 weeks home-based exercise training, the exercise group had significant increase in HRV indexes: TP(ms2), HF(ms2), LF(ms2), and HF(nu)(p< .05), but the LF(nu) and LF/HF ratio remained unchanged. In addition, all HRV variables remained unchanged in the control group.
Conclusion: Eight weeks home-based exercise program can significantly improve functional capacity, HRV, and vagal activity in postmenopausal women with CAD.

並列關鍵字

Home-based exercise program ； Postmenopausal women with CAD ； Functional capacity ； Heart rate variability

參考文獻

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