老年男性不同踝臂指數與下肢肌肉氧合能力及心肺適能之研究
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2013
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踝臂指數 (Ankle Brachial Index, ABI) 是一項用來評估周邊動脈栓塞的嚴重程度及判斷全身動脈粥狀硬化的重要指標，近年研究指出較低的ABI之老年人其心肌梗塞及中風的死亡率也較高，但ABI過高亦會導致血管鈣化，有關不同ABI老年人之身體功能和下肢氧化功能過去較少文獻探討。本研究目的比較三組不同ABI老年男性下肢肌肉氧化功能、心肺適能和身體活動量之差異，及六分鐘步行運動期間與恢復期之肌肉氧化功能之差異，同時探討心肺功能、身體活動量和肌肉氧化功能之相關。本研究招募及篩選20名年齡64~85歲男性為自願參與者，其中5位ABI<1.1為實驗A組、10位ABI介於1.1~1.3之間為正常對照組、5位ABI>1.3為實驗B組，所有受試者接受ABI指數測量、身體活動量問卷調查、六分鐘走路測驗，並利用近紅外光光譜儀 (Near Infrared Spectroscopy, NIRS) 作為肌肉氧化能力檢測工具，觀察受試者在運動前、六分鐘步行運動中及運動後恢復期的下肢肌肉氧化功能變化。所得資料以獨立樣本單因子變異數分析 (one-way ANOVA) 比較三組運動前與運動期間各項參數之差異，其顯著水準定為α=.05，再以薛費法進行事後比較，並以皮爾遜積差相關探討依變項之間的相關。結果顯示(一)正常對照組老年人每週身體活動量大於實驗兩組，而坐姿時間部分實驗A組顯著大於實驗B組 (p<.05) 。(二) 正常對照組老年人之心肺適能顯著大於實驗A組 (p<.05)。(三)三組老年人間安靜期總血紅素 (THB) 和組織氧飽和指數 (TSI%) 無顯著差異，運動期時，正常對照組老年人THB和TSI%顯著高於實驗兩組 (p<.05) 。(四)老年人心肺適能與TSI%呈顯著正相關 (p<.05) 。ABI正常組之老年男性有較大之心肺適能，運動期間下肢肌肉有較佳的氧化功能。
Ankle Brachial Index (ABI) is an important indicator used to assess the severity of peripheral arterial embolism and systemic atherosclerosis. Recent studies have indicated the elderly with lower ABI will have higher heart attack and stroke mortality; however, too high ABI will lead to vascular calcification. The relationship between varied ABI, the physical fitness and muscle oxygenation of the elderly is unknown. The purposes of this study were to compare the difference in cardiovascular fitness (CF), physical activity (PA), muscle oxygenation among 3 ABI groups of older men, and to investigate the change of muscle oxygenation of lower extremity before, during and after 6 minutes walking. Additionally, the relationship between the CF, PA and muscle oxygenation will be investigated. Methods: Twenty male elderly aged 64-85 were recruited as the subjects following the criteria, including the experiment A group ( ABI<1.1, n=5); the normal control group (ABI 1.1~1.3, n=10) and the experiment B group ( ABI>1.3, n=5). All subjects were asked to take ABI, PA questionnaire and 6-minute walk test (for CF) , and the near-infrared spectrometer (NIRS) was used to measure the lower extremity muscle oxidative capacity before, during and recovery period of 6-minute walk. The collecting data were analyzed by independent sample one-way ANOVA to compare the differences of each variable among three groups; and to observe the change of muscle oxygenation at different period of 6 minute walk. The significance level was set at α = .05, and the Scheffe's Test post hoc comparison method was used if any significance exist. The Pearson product moment correlation was used for the correlation between the dependent variables. Results: (1) The PA per week of Normal control group is significantly greater than both experimental groups (p<.05) , while the sedentary time of the experiment A was significantly greater than group A (p<.05) . (2) The CF of Normal control group was significantly greater than that of experimental A group (p<.05) . (3) The total hemoglobin (THB) and tissue oxygen saturation index (TSI%) of 3 groups were not significant different at resting period; however, the THB and TSI% of normal control group during the 6-minute walking period were significantly higher than the both experimental groups (p<.05) . (4)The CF and the TSI% were positive significantly correlated (p<.05) . The elderly with normal ABI have better cardiorespiratory fitness and have better muscles oxygenation capacity during walking exercise.
Ankle Brachial Index (ABI) is an important indicator used to assess the severity of peripheral arterial embolism and systemic atherosclerosis. Recent studies have indicated the elderly with lower ABI will have higher heart attack and stroke mortality; however, too high ABI will lead to vascular calcification. The relationship between varied ABI, the physical fitness and muscle oxygenation of the elderly is unknown. The purposes of this study were to compare the difference in cardiovascular fitness (CF), physical activity (PA), muscle oxygenation among 3 ABI groups of older men, and to investigate the change of muscle oxygenation of lower extremity before, during and after 6 minutes walking. Additionally, the relationship between the CF, PA and muscle oxygenation will be investigated. Methods: Twenty male elderly aged 64-85 were recruited as the subjects following the criteria, including the experiment A group ( ABI<1.1, n=5); the normal control group (ABI 1.1~1.3, n=10) and the experiment B group ( ABI>1.3, n=5). All subjects were asked to take ABI, PA questionnaire and 6-minute walk test (for CF) , and the near-infrared spectrometer (NIRS) was used to measure the lower extremity muscle oxidative capacity before, during and recovery period of 6-minute walk. The collecting data were analyzed by independent sample one-way ANOVA to compare the differences of each variable among three groups; and to observe the change of muscle oxygenation at different period of 6 minute walk. The significance level was set at α = .05, and the Scheffe's Test post hoc comparison method was used if any significance exist. The Pearson product moment correlation was used for the correlation between the dependent variables. Results: (1) The PA per week of Normal control group is significantly greater than both experimental groups (p<.05) , while the sedentary time of the experiment A was significantly greater than group A (p<.05) . (2) The CF of Normal control group was significantly greater than that of experimental A group (p<.05) . (3) The total hemoglobin (THB) and tissue oxygen saturation index (TSI%) of 3 groups were not significant different at resting period; however, the THB and TSI% of normal control group during the 6-minute walking period were significantly higher than the both experimental groups (p<.05) . (4)The CF and the TSI% were positive significantly correlated (p<.05) . The elderly with normal ABI have better cardiorespiratory fitness and have better muscles oxygenation capacity during walking exercise.
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Keywords
身體活動, NIRS, 周邊動脈栓塞, Physical activity, NIRS, Peripheral arterial disease