Aerobic exercise training improves autonomic nervous control in patients with COPD

被引:83
作者
Borghi-Silva, Audrey [1 ]
Arena, Ross [2 ,3 ,4 ]
Castello, Viviane [1 ]
Simoes, Rodrigo Polaquini [1 ]
Barreto Martins, Luis Eduardo [5 ]
Cataii, Aparecida Maria [1 ]
Costa, Dirceu [6 ]
机构
[1] Univ Fed Sao Carlos, Cardiopulm Physiotherapy Lab, Nucleus Res Phys Exercise, Dept Physiotherapy,UFSCar, BR-13565905 Sao Carlos, SP, Brazil
[2] Virginia Commonwealth Univ, Dept Phys Therapy, Richmond, VA USA
[3] Virginia Commonwealth Univ, Dept Internal Med, Richmond, VA USA
[4] Virginia Commonwealth Univ, Dept Physiol, Richmond, VA USA
[5] Univ Estadual Campinas, Fac Phys Educ, Exercise Physiol Lab, Campinas, SP, Brazil
[6] Univ 9 Julho, Phys Therapy Dept, Sao Paulo, Brazil
基金
巴西圣保罗研究基金会;
关键词
Pulmonary disease; Exercise; Autonomic nervous system; Six-minute walking test; OBSTRUCTIVE PULMONARY-DISEASE; HEART-RATE-VARIABILITY; LUNG-FUNCTION TESTS; REFERENCE VALUES; VENTILATION; DYSFUNCTION; MANAGEMENT;
D O I
10.1016/j.rmed.2009.04.015
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Objectives: Autonomic modulation is adversely impacted in patients with chronic obstructive pulmonary disease (COPD). The purpose of the present investigation is to assess the effects of a 6-week aerobic exercise training program on autonomic modulation of heart rate in patients with COPD. Methods: Forty patients of both sexes with moderate-to-severe COPD were randomly allocated to aerobic exercise training (PT, n = 20) or to usual care (Control, n = 20). The training program consisted of tower and upper limb stretching and 30 min of treadmill. exercise, 3 times per week for a 6-week period. Physiological data during symptom-limited exercise testing and the six-minute walk test (6MWT) were assessed. In addition, R-R intervals were obtained at rest and during the 6MWT. Heart rate variability was analyzed by time (rMSSD and SDNN index) and frequency domains (high frequency - HF, low frequency - LF and HF/LF ratio). Results: Peak oxygen consumption significantly improved in the training group only (p < 0.05). Moreover, the training group demonstrated significant improvements (p < 0.05) in blood lactate, minute ventilation, dyspnea at peak exercise, sympathetic activity, and parasympathetic activity at rest and during submaximal exercise. Lastly, a positive and significant correlation was found between change in 6MWT distance and rMSSD index (r = 0.65 and p = 0.001). Conclusions: Neural control of heart rate, in addition to other clinically valuable measures, is positively altered in moderate-severe COPD patients following 6 weeks of aerobic exercise training. The improvement in submaximal performance after exercise training was associated with parasympathetic activity. Published by Elsevier Ltd.
引用
收藏
页码:1503 / 1510
页数:8
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