Optimal exercise intensity for rehabilitation program in patients with multifunctional disabilities.

多功能残疾患者康复计划的最佳运动强度。

• 批准号: 08671633
• 负责人: HIWATARI Masao
• 金额: $ 1.47万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671633/
• 关键词: rehabilitation; myocardial infarction; cerebral stroke; renal failure; heart rate variability; quality of life; anaerobic threshold; ultrasonic cardiography; リハビリテーション; 高血圧; 糖尿病; QOL(quality of life); 片麻痺; 運動負荷試験; 腎不全(透析); QOL(Quality of li

It has been reported that rehabilitation after acute myocardial infarction (AMI) improves circulatory functions and physical performance. In the current project, we have demonstrated short-term intensive educational program following AMI also improves the mental status, especially diminishing depression and anxiety, which contributes to better quality of life for patients with AML Moreover, the importance of intensive education has been revealed in conduction of long-term exercise training. As to evaluate the efficacy of exercise training, we have applied heart rate variability (HRV) analysis. The patients who have frequently performed physical exercise (as recommended from the doctors) demonstrates favorable changes in HRV (relatively increased parasympathetic activity at rest, and reduced sympathetic activation under stress conditions)while patients with rarely exercised shows no remarkable changes in HRV.Ultrasonic cardiographical examination in patients with cerebral stroke has sho … More wn higher rates of abnormal findings, i.e., thickening of left ventricular wall, calcifications and/or regurgitation of aortic valve, atrial fibrillation with enlarged left atrium, etc. These abnormalities have much more frequently detectedin cases of recurrence of stroke, which suggests management of risk factors of stroke (hypertension, hyperlipidemia, diabetes mellitus, ...) is very important for reducing the recurrence of stroke. We have performed HRV analysis during the course of rehabilitation in patients with stroke, in which we have observed similar changes in HRV with AMI patients who have conductedphysical exercise frequently.Concerning with the multifunctioal disabilities, we have reported rehabilitation methods for stroke under the condition of hemodialysis (HD) due to renal failure, Such patients as HD often claimed less numbers of rehabilitation therapy because of easily fatigue on the day of HD.Of course the fatigue depends on many factors, but extraction volume during HD is one of the major determinants of fatigue in these patients. It will be better for patients with multifunctional disability to determine the intensity of rehabilitation exercise by the levels that the general conditions of patients are not getting worse. In general, intensity levels of exercise with anaerobic threshold or less will be most convenient for rehabilitation from the survey of circulatory and some other function in patients without contraindications, although the intensity levels must be adjusted by conditions of functional disorder in any other organs. Less

据报道，急性心肌梗死（AMI）后的康复可以改善循环功能和身体表现。在本项目中，我们已经证明AMI后的短期强化教育计划也改善了AML患者的精神状态，特别是减少抑郁和焦虑，这有助于提高AML患者的生活质量。此外，强化教育在长期运动训练中的重要性也得到了揭示。在评价运动训练的效果方面，我们应用心率变异性（HRV）分析。经常进行体育锻炼（医生建议）的患者HRV有较好的变化（静息时副交感神经活动相对增加，应激时交感神经活动减少），而很少运动的患者HRV无明显变化。脑卒中患者的超声心动图检查显示，运动对心率变异性有明显的影响。 ...更多信息 异常发现率较高，即，左心室壁增厚、主动脉瓣钙化和/或反流、房颤伴左心房扩大等。这些异常在卒中复发病例中更常见，这表明应管理卒中的危险因素（高血压、高脂血症、糖尿病等）。对减少中风的复发非常重要。本文对脑卒中患者康复过程中的心率变异性（HRV）进行了分析，观察到与经常进行体育锻炼的急性心肌梗死（AMI）患者相似的HRV变化，并针对脑卒中患者的多功能障碍，报道了肾功能衰竭血液透析（HD）条件下脑卒中患者的康复方法。像HD这样的患者，由于HD当天容易疲劳，所以往往要求较少的康复治疗次数，当然，疲劳取决于许多因素，但是HD期间的拔牙量是这些患者疲劳的主要决定因素之一。对于多功能残疾患者，以患者一般情况不恶化为标准来确定康复运动强度更好。一般来说，无氧阈值或更低的运动强度水平对于无禁忌症患者的循环和其他一些功能的康复是最方便的，尽管强度水平必须根据任何其他器官的功能障碍情况进行调整。少

项目成果

Hiwatari M,Ouchi N et al.: "Diabetes mellitus" J Clin Reha. (spple). 57-61 (1997)

Hiwatari M、Ouchi N 等人：“糖尿病”J Clin Reha。

Hiwatari M.et al.: "Treatment for hypertensive patients accompanied by any other desease.(ed.by Abe K.et al.)" Iyaku Journal, Inc. 271 (1998)

Hiwatari M.et al.：“伴有任何其他疾病的高血压患者的治疗。（Abe K.et al.编辑）”Iyaku Journal, Inc. 271 (1998)

吉田俊子, 樋渡正夫ほか: "急性心筋梗塞患者のQuality of Life (QOL)に及ぼす要因" 心臓リハビリテーション. 2. 125-130 (1997)

Toshiko Yoshida、Masao Hiwatari 等：“影响急性心肌梗塞患者生活质量 (QOL) 的因素”心脏康复。2. 125-130 (1997)

樋渡 正夫: "高血圧と脳卒中" 宮城県対脳卒中協会会報. 41. 2-3 (1997)

Masao Hiwatari：“高血压和中风”宫城县中风协会通报41. 2-3 (1997)。

佐藤徳太郎,樋渡正夫ほか: "リハに関連する内科的疾患の評価" 別冊Journal of Clinical Rehabilitation (別冊卯臨床リハ). 別冊. 111-125 (1996)

Tokutaro Sato、Masao Hiwatari 等：“与康复相关的医学疾病的评估”Bessatsu Journal of Clinical Rehabilitation 111-125 (1996)。