Cardiovascular safety and effects on peripheral circulation of a leg resistance exercise training in the elderly

对175名老年人进行了下肢抗阻运动（直腿抬高（SLR）和膝关节伸展（KE））的安全性检查，并对31名老年人进行了呼吸指导（运动过程中缓慢呼气，不要屏住呼吸）。本文对18例冠心病患者进行了心肌造影。运动期间无胸部症状。在运动过程中没有出现缺血性ST段改变。约半数受试者在60%1RM运动强度下血压过度升高（收缩压> 180 mmHg）。运动时的血压升高通过呼吸指导显著降低。75岁以下的老年人在60%1RM以下的运动强度和适当的呼吸指导下进行腿部抗阻运动是安全的。在20名75岁以上的老年受试者中，9名（45%）在腿部抗阻运动中血压过度升高，1名（5%）在腿部抗阻运动中出现严重肌肉疼痛。因此，需要谨慎的运动处方 ...更多信息 老年人>75岁。18例患者中，8例（44%）在运动过程中的心肌灌注造影显示可逆性灌注缺损。因此，即使临床稳定的冠心病患者没有心绞痛症状和缺血性ST段压低或抬高，腿部抗阻运动也可能诱发心肌缺血。106名受试者参加了3 ~ 24个月的有监督抗阻训练，未发生心脏事件。本文应用近红外光谱技术对54名中老年人进行了下肢抗阻训练时运动肌肉血容量和氧合的研究。在运动过程中连续测定总血红蛋白指数（THI）作为血容量指标，并以% TOI评价氧合。%THI在运动期间显著增加。血清总胆固醇浓度和%THI之间存在微弱但显著的负相关性。这些结果表明，高胆固醇血症是与受损的血容量反应，腿部阻力运动在中年或老年人。在40%-1 RM和60%-1 RM之间，% TOI显著降低，而在60%-1 RM和80%-1 RM之间，% TOI没有显著降低。大腿皮肤脂肪厚度和1 RM-重量与%TOI变化相关。结论：中老年人下肢抗阻运动时运动肌氧合变化受运动强度的影响。少

Safety of leg-resistance exercise (straight leg raising (SLR) and knee extension (KE)) was examined in 175 elderly subjects and usefulness of respiratory guidance (exhale slowly and not hold one's breath during exercise) was in 31 subjects. Myocardial scintigraphy was performed in 18 patients with coronary artery disease. There were no chest symptoms during the exercise. None had ischemic ST changes during the exercise. Excessive rise in blood pressure (systolic blood pressure>180mmHg) was revealed during 60%1RM exercise intensity in about half subjects. Blood pressure elevation during exercise was significantly lowered by respiratory guidance. Leg-resistance exercise is safe for the elderly less than 75 years with less than 60%1RM exeicise intensity and appropriate respiratory guidance. Of 20 elderly subjects more than 75 years, 9(45%) had excessive blood pressure rise and 1(5%) had severe muscle pain during leg-resistance exercise. Therefore, careful exercise prescription is required … More for the elderly>75 years of age. The myocardial scintigraphy during exercise revealed reversible perfusion defects in 8(44%) of the 18 patients. Thus, leg-resistance exercise can possibly induce myocardial ischemia even though there is absence of anginal symptoms and ischemic ST-segment depression or elevation in patients with clinically stable coronary artery disease. No cardiac events occurred in 106 subjects participated in supervised resistance training program (3〜24 months).The blood-volume and oxygenation in exercising muscles during leg-resistance exercise (KE) was studied with near-infrared spectroscopy in 54 middle aged or elderly subjects. The total hemoglobin index (THI) as the index of blood volume and the oxygenation evaluated by % TOI was measured continuously during exercise. The %THI increased significantly during exercise. There was a weak but significant negative correlation between the serum total cholesterol concentration and the %THI. These results suggested that hypercholesterolemia is associated with impaired blood-volume response to leg-resistance exercise in middle-aged or elderly subjects. The % TOI significantly decreased between 40%-1RM and 60%-1RM, while did not between 60%-1RM and 80%-1RM. The thigh skin fat thickness and 1RM-weight correlated to the %TOI changes. In conclusion, the oxygenation changes in exercising muscles during leg-resistance exercise are influenced by the exercise intensity in middle-aged or elderly subjects. Less