肥胖與健康成人在不同姿勢下緩慢呼吸對自主神經活性的影響

Slow Breathing on Autonomic Nervous Activity under Different Body Positions in Obese Adults and Healthy Adults

林雨勤(Yu-Chin Lin)

指導教授 ： 許妙如

高雄醫學大學/健康科學院/物理治療學系碩士班/碩士(2019年)

摘要

研究背景與研究目的：肥胖族群有自主神經失調的問題，緩慢呼吸可以提高副交感神經活性，但在哪一種身體姿勢下可以達到最大的效益則仍有待探討，因此本研究欲探討不同身體姿勢下肥胖者與健康成人緩慢呼吸的自主神經活性，以確立緩慢呼吸達到最大效益之姿勢，提供臨床施用緩慢呼吸技術之參考。研究方法：招募39位健康成年人與20位肥胖成年人，在兩種呼吸模式(平靜呼吸與緩慢呼吸)、五種姿勢(前傾30度坐姿、直立坐姿、有靠背的坐姿、後傾60度坐姿、平躺)之下進行心電圖、潮氣容積、呼吸速率之測量，分析不同呼吸模式及各姿勢下的自主神經活性(高頻功率、低頻功率、標準化高頻功率、標準化低頻功率、低高頻功率比)。研究結果：平靜呼吸時，肥胖者心率變異度各參數在姿勢上多數無顯著差異(p>0.05)；而健康組在直立坐姿、有靠背的坐姿、後傾60度坐姿，相較於平躺之下則顯著有較高標準化高頻功率、較低標準化低頻功率及低高頻比(p<0.05)。緩慢呼吸時，健康組與肥胖組在各姿勢下之心率變異度各參數均無顯著差異(p>0.05)。結論：健康族群的自主神經活性比起肥胖族群更容易因姿勢變化而改變，而直立坐姿、有靠背的坐姿或後傾60度坐姿也許是執行緩慢呼吸較佳的選擇。

關鍵字

自主神經 ； 姿勢 ； 緩慢呼吸 ； 肥胖

並列摘要

Background：Autonomic nervous system (ANS) dysfunction is found in individuals with obesity. Slow breathing (SB) can modulate ANS activities. However, it still remains unknown that SB in what body posture can maximize the effect in individuals with obesity. Therefore, this study was to investigate the effect of SB under different postures on ANS activities in obese and healthy individuals. Method: Thirty-nine healthy adults and twenty obese adults were recruited. Electrocardiogram (ECG), tidal volume, and respiratory rate were measured during two types of breathing (normal breathing and SB) under five postures (30∘forward sitting, upright sitting, sitting with back support, 60∘backward sitting, and supine). The parameters of heart rate variability (HRV) included high frequency (HF), low frequency (LF), normalized high frequency (nHF), normalized low frequency (nLF), and low/high frequency (L/H) ratio. Result: During normal breathing, obese subjects revealed no significant differences across five postures for most of the HRV parameters (p>0.05), while healthy subjects had significantly lower nHF and higher nLF and L/H ratio in upright sitting, sitting with back support, and 60∘backward sitting, compared to supine position (p<0.05). During SB, there was no significant difference on HRV parameters across five postures for obese subjects and healthy subjects (p>0.05). Conclusion：It appears that ANS activities are more influenced by body postures in healthy adults than in obese adults. It may be better to perform SB under upright sitting, upright sitting with back support, or 60∘backward sitting posture.

並列關鍵字

Autonomic nervous system ； posture ； slow breathing ； obesity

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