Exercise and the autonomic nervous system.
Exercise and the autonomic nervous system.
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DOI：
10.1016/b978-0-444-53491-0.00013-4
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发表时间：
2013-01-01
影响因子：
--
通讯作者：
Levine, Benjamin D
中科院分区：
文献类型：
--
作者：
Fu, Qi;Levine, Benjamin D
自主神经系统在动物和人类对急性（动态）运动的心血管反应中起着至关重要的作用。在运动过程中，摄氧量是心率和每搏量（即心输出量）的三重积和动脉-混合静脉氧差（菲克原理）的函数。每个变量增加的程度决定了最大摄氧量（V˙O2max）。“中央指令”和“运动压反射”在确定心血管反应和运动期间动脉压反射的重置以精确匹配全身氧输送与代谢需求方面都很重要。一般来说，自主神经紊乱患者的V˙O2max水平较低，表明身体健康和运动能力下降。此外，绝大多数患者对运动的心血管反应迟钝或异常，特别是在最大运动时。现在有令人信服的证据表明，慢性运动训练的一些保护和治疗作用与对自主神经系统的影响有关。此外，训练诱导的血管功能、血容量扩张、心脏重塑、胰岛素抵抗和肾肾上腺功能的改善也可能有助于心血管、代谢和自主神经疾病的保护和治疗。运动训练还能改善心理健康，有助于预防抑郁，促进或保持积极的自尊。对于大多数人来说，建议每天至少30分钟，每周至少5天的中等强度运动。有监督的运动训练是最好的，以最大限度地发挥功能能力，并可能特别重要的病人有自主神经障碍。
The autonomic nervous system plays a crucial role in the cardiovascular response to acute (dynamic) exercise in animals and humans. During exercise, oxygen uptake is a function of the triple-product of heart rate and stroke volume (i.e., cardiac output) and arterial-mixed venous oxygen difference (the Fick principle). The degree to which each of the variables can increase determines maximal oxygen uptake (V˙O2max). Both "central command" and "the exercise pressor reflex" are important in determining the cardiovascular response and the resetting of the arterial baroreflex during exercise to precisely match systemic oxygen delivery with metabolic demand. In general, patients with autonomic disorders have low levels of V˙O2max, indicating reduced physical fitness and exercise capacity. Moreover, the vast majority of the patients have blunted or abnormal cardiovascular response to exercise, especially during maximal exercise. There is now convincing evidence that some of the protective and therapeutic effects of chronic exercise training are related to the impact on the autonomic nervous system. Additionally, training induced improvement in vascular function, blood volume expansion, cardiac remodeling, insulin resistance and renal-adrenal function may also contribute to the protection and treatment of cardiovascular, metabolic and autonomic disorders. Exercise training also improves mental health, helps to prevent depression, and promotes or maintains positive self-esteem. Moderate-intensity exercise at least 30 minutes per day and at least 5 days per week is recommended for the vast majority of people. Supervised exercise training is preferable to maximize function capacity, and may be particularly important for patients with autonomic disorders.