心肺同步呼吸訓練對休息與定速呼吸狀態腦波之影響

目的：心肺同步呼吸訓練(cardiorespiratory synchrony training，簡稱CRST)常以緩慢腹式呼吸和定速呼吸(paced breathing)作為介入方案，過去研究顯示6次/分定速呼吸能提升腦波(electroencephalogram, EEG)中的absolute theta與absolute alpha，使用緩慢呼吸之心跳變異生理回饋訓練使參與者在介入當下有較高的relative theta與較低的relative beta，並在介入後提升absolute theta與relative alpha。但較少研究探討使用緩慢定速呼吸之心跳變異生理回饋對腦波的療效。本研究目的為探討CRST在休息與6次/分定速呼吸狀態的腦波療效。方法：本研究採二因子混合隨機控制實驗，參與者分派至CRST組(n = 27; 25.30 ± 6.86歲)接受四周心肺同步呼吸訓練，控制組(n = 26; 31.23 ± 14.77歲) 未接受介入，兩組在前測與後測時接受5分鐘基準期(休息狀態)與6個2分鐘定速呼吸期，包括4.5、5、5.5、6、6.5次/分與自然呼吸期(使用參與者基準期的平均呼吸速率)，測量19頻道腦波，並輸出Fz、F3、F4、Cz、C3、C4與Pz之absolute low/high theta(4-6/6-8 Hz)、low/high alpha(8-10/10-12 Hz)、low/high beta(12-20/20-32 Hz)，再轉換為relative EEG。結果：二因子變異數分析發現，組別*前後測之基準期腦波有顯著交互作用，包括F3與Pz的relative high alpha(分別為F(1, 51) = 4.75., p < .05, ηp2 = .09；F(1, 51) = 4.07, p < .05, ηp2 = .07)，以及Fz、F4、Cz、C3與C4的relative high beta(分別為F(1, 51) = 8.81, p < .01, ηp2 = .15；F(1, 51) = 5.89, p < .05, ηp2 = .10；F(1, 51) = 8.01, p < .01, ηp2 = .14；F(1, 51) = 10.39, p < .01, ηp2 = .17；與F(1, 51) = 5.70, p < .05, ηp2 = .10)，Bonferroni’s事後檢定顯示CRST組在基準期下，後測的relative high alpha顯著高於前測，relative high beta顯著低於前測。組別*前後測之6次/分定速呼吸期在F4、C3與C4的relative high beta有顯著交互作用(分別為F(1, 51) = 4.53, p < .05, ηp2 = .08；F(1, 51) = 5.91, p < .05, ηp2 = .10；與F(1, 51) = 5.23, p < .05, ηp2 = .09)，Bonferroni’s事後檢定顯示CRST組在6次/分定速呼吸期下，後測的relative high beta顯著低於前測。結論：本研究證實參與者接受CRST後，可提升休息狀態下的relative high alpha並降低relative high beta，以及降低在6次/分定速呼吸狀態下的relatvie high beta。

關鍵字

心肺同步呼吸訓練；腦波；定速呼吸；心跳變異生理回饋

並列摘要

Objective: Cardiorespiratory synchrony training (CRST) unsurely used slow abdomnial breathing and paced breathing as the mainly part of training program. Previous studies found that absolute theta and absolute alpha in electroencephalography (EEG) increase at 6 breaths per minute (BPM). Some evidence shows that participants can increase relative theta and decrease relative beta during the heart rate variability biofeedback training with slow breathing, in addition to increase absolute theta and relative alpha after training. A lack of study to investigate the effect of paced breathing with heart rate variability biofeedback on EEG. Therefore, this study aims to investigate the effect of CRST on EEG under resting and 6 BPM paced breathing states. Methods: This study was a randomized controlled trial. Participants randomly assigned to the CRST group (n = 27, mean age 25.30 ± 6.86 years) which received four weeks of cardiorespiratory synchrony training and the control group (n = 26, mean age 31.23 ± 14.77 years) which did not received any intervention. 19 channels EEG was recorded for both groups at the pretest and posttest including 5 minute baseline (resting state) and 6 stage of 2 minute paced breathing (4.5, 5, 5.5, 6, and 6.5 BPM and the natural breathing stage used the average respiration rate of participants at baseline). Absolute power was computed for low/high theta (4-6/6-8 Hz), low/high alpha (8-10/10-12 Hz) and low/high beta (12-20/20-32 Hz) at Fz, F3, F4, Cz, C3, C4 and Pz. Then, absolute power was transformed to relative EEG. Results: The results of two-way ANOVA showed the group * time interaction in relative high alpha at F3 and P3 under baseline (F(1, 51) = 4.75., p < .05, ηp2 = .09; F(1, 51) = 4.07, p < .05, ηp2 = .07), as well as in relative high beta at Fz, F4, Cz, C3, and C4 (F(1, 51) = 8.81, p < .01, ηp2 = .15; F(1, 51) = 5.89, p < .05, ηp2 = .10; F(1, 51) = 8.01, p < .01, ηp2 = .14; F(1, 51) = 10.39, p < .01, ηp2 = .17; and F(1, 51) = 5.70, p < .05, ηp2 = .10). The Bonferroni’s post hoc comparison showed that the CRST group increased relative high alpha and decreased high beta at posttest under baseline, compared with pretest. There were group * time interaction in relative high beta at F4, C3, and C4 under 6 BPM paced breathing state (F(1, 51) = 4.53, p < .05, ηp2 = .08; F(1, 51) = 5.91, p < .05, ηp2 = .10; and F(1, 51) = 5.23, p < .05, ηp2 = .09). The Bonferroni’s post hoc comparison showed that the CRST group decreased high beta at posttest under 6 BPM paced breathing state, compared with pretest. Conclusion: This study confirmed that CRST can increase slow waves and decrease fast waves under resting state, in addition to decreasing fast waves under 6 BPM paced breathing state.

並列關鍵字

cardiorespiratory synchrony training ； electroencephalography (EEG) ； paced breathing ； heart rate variability biofeedback

參考文獻

Vaschillo, E. G., Vaschillo, B., & Lehrer, P. M. (2006). Characteristics of resonance in heart rate variability stimulated by biofeedback. Applied Psychophysiology and Biofeedback, 31(2), 129-142. doi:10.1007/s10484-006-9009-3

呂學禎(2015)。心跳變異生理回饋在冠心病患者的生理病理機制之驗證(碩士論文)。取自http://hdl.handle.net/11296/3gqmxh