본문 바로가기
KERD
논문KCI 등재

8주간의 유산소성 체조활동을 통한 뇌병변 장애인의 체력 및 염증반응지표 변화

The Effect of Aerobic Gymnastic Exercise on Physical Fitness and Inflammatory Markers in Hemiplegic Disabled after Cerebral Stroke

0

조회

0

다운로드

12

인용

0

참고문헌

키워드

초록

본 연구의 목적은 뇌병변 장애인을 대상으로 8주간의 유산소성 체조활동을 실시하여 신체조성, 체력 및 염증반응지표의 변화에 대하여 알아보는 것이다. 본 연구의 피험자는 남·녀 뇌병변장애 중 대표적인 뇌졸중 장애인 17명을 대상으로 시작되었지만 9명이 중도 포기하여 최종 8명이 참가하였다. 운동 프로그램 참여 전 사전 검사를 실시하였으며, 기본적 변인으로 신장, 체중, Body Mass Index(BMI), 안정시 심박수, 안정시 혈압을 측정하고, 체력 변인으로는 체간 굴곡과 신전, 견관절 굴곡과 신전의 유연성과 악력을 통한 근력, 폐활량을 통한 폐기능을 측정하였다. 또한 혈액성분으로는 혈중지질, 그리고 심혈관질환 위험인자인 염증반응지표로서 C-reactive protein(CRP), Interleukin-6(IL-6), Tumor Necrosis Factor-α(TNF-α)를 분석하였다. 8주 유산소성 체조활동 프로그램은 매회 50분씩 주 2회 실시하였으며, 운동강도는 운동자각도(RPE) 수준 13으로 유지하였다. 뇌병변 장애인의 유산소성 체조활동 프로그램 참여 후 운동의 효과를 검증한 결과 전체 집단에서 안정시 수축기혈압과 이완기혈압이 유의하게 감소하였다(p<.01). 또한 체력 요인에서는 체간 굴곡과 신전(p<.05), 건측의 견관절 굴곡과 신전(p<.01), 환측의 견관절 굴곡(p<.05)이 유의하게 증가하였다. 혈액 성분의 분석 결과 혈중지질에는 유의한 변화가 나타나지 않았으며, 염증반응지표의 경우 IL-6가 유의하게 감소하였고(p<.05), 유의하지는 않으나 CRP도 감소하는 경향을 나타냈다(p<.088). 결론적으로, 지속적이고 규칙적인 유산소성 체조활동은 뇌병변 장애인의 안정시 심박수와 혈압 및 체력을 개선시키는 효과가 있을 뿐만 아니라 심혈관질환의 위험요소로 알려져 있는 염증반응지표를 개선하는 데에도 긍정적인 영향을 주는 것으로 나타났다.

Abstract

The purpose of this study was to analysis the effect of aerobic gymnastic exercise for eight weeks on physical fitness and inflammatory markers which are known as risk factors for cardiovascular diseases in hemiplegic disabled after cerebral stroke. For this purpose, stroke patients(n=8) participated in aerobic exercise training 2 days/week, 50 mins/day, for 8 weeks and maintained at 13 level of RPE. Body composition , resting heart rate and blood pressure were measured before physical fitness test. Trunk flexion/extension, shoulder flexion/extension, grip strength, pulmonary function were measured as physical fitness test. Blood sample of 15ml was drawn from antecubital veins for measuring inflammatory markers(c-reactive protein, interleukin-6, tumor necrosis factor-α). The result of this study is as follows: Resting blood pressure decreased significantly after 8-week aerobic exercise training in total stroke patients (p<.01). After completion of the aerobic exercise program, trunk extension/flexion(p<.05), shoulder extension/fexion(p<.01), were significantly improved in total stroke patients. There was no significant improvement on blood lipid profiles in total stroke patients. However, IL-6 was significantly improved in stroke patients after 8-week aerobic exercise(p<.05). In conclusion, These findings suggests that regular aerobic gymnastic exercise decreases resting heart rate and blood pressure, and improves physical fitness, inflammatory markers which are known as a risk factor of cardiovascular diseases in person with disability occurred due to hemiparetic stroke

참고문헌 (42)

  1. 김태선, "초기 뇌졸중 환자에서 심혈관계에 대한 유산소 운동의 효과", 대한재활의학회지, 23(5), pp.1020~1027 (1999)
  2. 신군수, "유산소 운동이 뇌졸중 환자의 혈압, 심박수 및 혈중지질에 미치는 영향", 한국체육학회지, 42(6), pp.773~786 (2003), 한국체육학회
  3. 이달엽 역, "재활상담을 위한 장애편람" (1998), 대구대학교출판부
  4. 이수정, "본태성 고혈압 환자의 저염식 이행실태 및 관련요인", 석사, pp.1999
  5. 이정균, "고혈압:(역학 및 한국의 근황)", 대한의학협회지, 35(2), pp.164~168 (1992)
  6. 정우곤, "증가된 C-Reactive Protein은 관상동맥 중재술 후 재협착에 대한 유일한 예측인자", 대한내과학회지, 62(4), pp.5~414 (2002), 대한내과학회
  7. American College of Sports Medicine, "ACSM’s resourcemanual for guidelines for exercise testing and prescription", pp.443~444 (2006), Lippincott Williams & Wilkins
  8. Anderson N. E., "Delays in hospital admission and investigation in acute stroke", British Medical Journal, 311(6998), pp.162~ (1995)
  9. Ballantyne, C. M, "Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the atherosclerosis Risk in Communities(ARIC) study", Arch Intern Med., 165, pp.2479~2484 (2005)
  10. Blair, S. N, "Is physical activity or physical fitness more important in defining health benefits?", Med. Sci. Sports Exercise, 33, pp.379~399 (2001)
  11. Booth, F. W, "Waging war on modern chronic diseases: primary prevention through exercise biology", J. Appl. Physiol., 88, pp.774~787 (2000)
  12. Chamorro, A., "Role of inflammation in stroke and atherothrombosis", Cerebrovasc Dis., 17(3), pp.1~5 (2004)
  13. Christos, K., "The effects of physical activity on serum C-reactive protein and inflammatory markers", J. Am. Coll. Cardiol., 45(10), pp.1563~1569 (2005)
  14. Church, T. S, "Associations between cardiorespiratory fitness and C-reactive protein in men", Arterioscler Thromb. Vas. Biol., 22, pp.1869~1876 (2002)
  15. Cohn P.E, "Serum Lipid levels in angiographically defined coronary artery disease", Ann. Intern. Med., 84, pp.241~ (1977)
  16. Esposito, K, "Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women", JAMA, 289, pp.1799~1804 (2003)
  17. Gillen, G., "Stroke rehabilitation: A function-based approach, Second edition" (2004), Mosby
  18. Goldhammer, E, "Exercise training modulates cytokines activity in coronary heart disease patients", Int. J. Cardiol., 100, pp.93~99 (2005)
  19. Kohut M. L, "Aerobic exercise, but not flexibility", resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of beta-blockers, BMI, and psychosocial factors in older adults, 2006, pp.20(3), 201~209
  20. Kumar K. P, "Complete thrombolysis for acute embolic stroke during coronary angiography", Indian Heart Journal, 51(4), pp.429~431 (1999)
  21. Lakka, T. A, "Effect of exercise training on plasma levels of C-reactive protein in healthy adults: the HERITAGE Family Study", European Heart Journal, 26, pp.2018~2025 (2005)
  22. LaMonte, M. J, "Cardiorespiratory fitness and C-reactive protein among a tri-ethnic sample of women", Circulation, 106, pp.403~406 (2000)
  23. Levy, W. C., "Effect of exercise training on heart rate variability at rest in healthy young and older men", American Journal of Cardiology, 82(10), pp.1236~1241 (1998)
  24. Li, J. J., "Inflammatory marker but also a direct cause of cardiovascular diseases", Medical Hypotheses, 62, pp.499~506 (2004)
  25. Luft A., "Post-stroke exercise rehabilitation: what we know about retraining the motor system and how it may apply to retraining the heart", Cleve. Clin. J. Med., 2, pp.S83~S86 (2008)
  26. Macko R. F, "Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial", Stroke, 36(10), pp.2206~2211 (2005)
  27. Manns, P. J, "Physical activity, body fat, and serum c-reactive protein in postmenopausal women with and without hormone replacement", Am. J. Human Biol., 15, pp.91~100 (2003)
  28. Masotti, L, "Prognostic role of C-reactive protein in very old patients with acute ischaemic stroke", J. intern Med., 258, pp.145~152 (2005)
  29. Paffen, E., "C-reactive prtein in atherosclerosis: a causal factor?", Cardiovasc Res., 71, pp.30~39 (2006)
  30. Plaisance, E.,P., "Physical activity and high-sensitivity C-reactive protein", Sports Med., 36(5), pp.443~458 (2006)
  31. Ridker, P. M., "Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men", N. Engl. J. Med., 336, pp.973~979 (1997)
  32. Ridker, P. M, "C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction", Circulation, 97, pp.2007~2011 (1998)
  33. Ridker, P. M., "High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease", Criculation, 103, pp.1813~1818 (2001)
  34. Rimmer, J. H., "Exercise training in a predominantly African-American group of stroke survivors", Med Sci Sports Exerc, 32(12), pp.1990~1996 (2000)
  35. Rizzo M., "Prediction of cerebrovascular and cardiovascular events in patients with subclinical carotid atherosclerosis: the role of C-reactive protein", J. Investig. Med., 56(1), pp.32~40 (2008)
  36. Smith, J. K, "Long-term exercise and atherogenic activity of blood mononuclear cells in persons at risk of developing ischemic heart disease", JAMA., 281, pp.1722~1727 (1999)
  37. Stewart, L. K., "The influence of exercise training on inflammatory cytokines and C-reactive protein", Medicine and Science in Sports and Exercise, 39(10), pp.1714~1719 (2007)
  38. Taaffe, D. R, "Cross-sectional and prospective relationships of interleukin-6 and C-reactive protein with physical performance in elderly persons: Macarthur studies of successful aging", J. Gerontol. A. Biol. Sci. Med. Sci., 55, pp.709~715 (2000)
  39. Wing, R. R., "Effect of modest weight loss on change in cardiovascular risk factor: Are there differences between men and women or between weight loss and maintenance?", Int. J. Obes. Relat.Meta. Disord., 19(1), pp.67~73 (1995)
  40. Yang, Y. R., "Dual task-related gait changes in individuals with stroke", Gait. Posture., 25(2), pp.185~190 (2007)
  41. You, T., "Effects of hypocaloric diet and exercise training on inflammation and adipocyte lipolysis in obese postmenopausal women", J. Clin. Endocrinol. Metab., 89, pp.1739~1746 (2004)

관련 논문AI추천

이 간행물의 다른 논문 (13건)