장기간의 복합운동이 남녀 뇌졸중 환자의 심혈관 위험요인과 산화스트레스 관련 지표의 변화에 미치는 영향
The effects of long-term aerobic and resistance combined exercise training on cardiovascular risk factors and oxidative stress in stroke patients
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본 연구의 목적은 남녀 뇌졸중 환자들에게 장기간의 복합운동을 실시한 후 성별에 따른 심혈관 위험요인과 산화스트레스 지표 변화에 대한 운동 프로그램의 효과를 비교하고, 심혈관 위험요인과 산화스트레스 관련지표의 관련성을 알아보는데 있다. 본 연구는 남성 편마비 환자 27명과 여성 편마비 환자 23명으로 총 50명을 대상으로 실시하였다. 유산소 운동 강도는 70%HRmax, 13~14RPE의 강도에서 고정식 자전거 운동을 실시하였으며, 근력 운동은 8개의 대근육군을 중심으로 한 종목당 10~15RM으로 1RM의 65~75% 강도에서 운동을 실시하였다. 운동 프로그램은 24주간 주3회, 준비운동 5분, 본 운동 80분, 정리운동 5분으로 총 90분간 실시하였다. 24주간 복합 운동 후 뇌졸중 환자들의 체중(p<.05), WHR(p<.001) 및 총콜레스테롤(p<.01)이 유의하게 감소하였으며, HDL-C가 유의하게 증가하였고(p<.05), 심혈관질환 위험요인수가 유의하게 감소하였다(p<.01). 또한 ox-LDL, ox-LDL/LDL (p<.001)과 ferritin 수준(p=.053)이 감소를 나타내었다. 그러나 성별에 따른 변화량의 유의한 차이는 나타나지 않았다. 전체적으로 ox-LDL은 총콜레스테롤(r=.575, p<.001) 및 중성지방(r=.338, p<.05)과 유의한 양의 상관관계를 나타내었다. 전체적으로 ox-LDL/LDL은 중성지방(r=.476, p<.001)과 유의한 양의 상관관계를 나타내었다. Ferritin은 체중(r=.409, p<.01), 체질량지수(r=.316, p<.05), 및 공복시 혈당수준(r=.458, p<.005)과 유의한 양의 상관관계를 나타내었으며, CRP는 체중(r=.292, p<.05), 체질량지수(r=.359, p<.01)와 유의한 양의 상관관계를 나타내었다. 산화스트레스의 지표들은 ferritin과 CRP 수준(r=.298, p<.05)이 유의한 양의 상관관계를 나타내었다. 따라서 산화스트레스 관련 지표들은 심혈관질환의 위험과 유의한 관련성이 있는 것으로 나타났으며, 특히 남성 뇌졸중 환자들이 더 높은 관련성을 나타났다. 결과를 종합해보면, 본 연구에서 실시한 장기간의 복합운동은 뇌졸중 환자들의 심혈관 위험요인과 산화스트레스 관련 지표들을 감소시키고, 뇌졸중 재발을 방지하는데 효과적인 운동프로그램이었던 것으로 나타났다.
Abstract
The purpose of this study was designed to determine the effect of 24weeks aerobic and resistance combined exercise training on cardiovascular risk factors, oxidative stress in stroke patients and the association between cardiovascular risk factors and markers of oxidative stress. Fifty stroke patients(male: 27, female: 23) volunteered for this study. Stroke patients participated in a supervised training program for 24 weeks(3days a week, warm-up 5minutes, exercise 80minutes, and colo-down 5minutes) consisting of aerobic exercise(75% HRmax, 13~14RPE) and resistance exercise(65~75% RM, 10~15RM). After exercise training, body weight(p<.05), WHR(p<.001), and total cholesterol(p<.01) were significantly decreased in all exercise groups. High density lipoprotein levels(p<.05) were significantly increased and cardiovascular risk factor number(p<.01) were significantly decreased after exercise training. Ox-LDL, ox-LDL/LDL(p<.001) and ferritin concentrations(p=.053) were significantly after exercise training. However, there was no difference between male and female stroke patients. Totally, a significant positive correlation between ox-LDL, total cholesterol(r=.575, p<.001) and triglyceride(r=.338, p<.05) was observed. The ox-LDL/LDL were a significant positive correlation with triglyceride(r=.476, p<.001). Ferritin concentration was a significant positive correlation with body weight(r=.409, p<.01), body mass index(r=.316, p<.05), and fasting glucose levels(r=.458, p<.005) and CRP levels was a significant positive correlation with body weight(r=.292, p<.05) and body mass index(r=.359, p<.01). Moreover, ferritin concentration was a significant positive correlation with CRP levels(r=.298, p<.05). These findings indicate that markers of oxidative stress affect the cardiovascular risk factors, especially in male stroke patients. Taken together, the aerobic and resistance combined exercise programs were effect on the reduction of cardiovascular risk factors, oxidative stress and the prevent of recurrent stroke
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