리컴번트 각도가 운동과 회복기 중 뇌혈류와 심부담도에 미치는 영향
Effects of Recumbent Angle during Cycling on Cerebral Blood Flow Velocity and Rate Pressure Product during Exercise and Recovery
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초록
연구배경: 리컴번트 자세는 직립자세에 비해 운동 중 뇌혈류속도는 증가시키고 심근 산소소비량은 감소시킨다. 따라서 본 연구의 목적은 뇌혈류속도와 심근 산소소비량 향상에기여할 수 있는 최적의 리컴번트 각도를 조사하는 것이다. 방법: 본 연구에 참여한 15명의 건강한 성인 남성은 직립(upright, 90°), 67° 리컴번트(R), 47°R, 15°R와 같이 네 개의각도에 각각 교차되도록 무작위 배정되었다. 자전거 에르고미터 운동부하는 점진적으로 주었다. 뇌혈류속도는 뇌혈류초음파장비에 의해 측정되었으며, 심근 산소소비량은 분당심박수와 수축기 혈압을 이용하여 계산되었다. 측정된 모든데이터는 이원반복측정 분산분석을 이용하여 분석하였다. 결과: 뇌혈류속도는 회복기 10분에 15°R 집단이 upright, 67°R 집단에 비해 유의하게 높은 것으로 나타났다(69±16 vs. 56±7, 58±10 cm/s, P<0.05). 심근 산소소비량은 67°R, 47°R, 그리고 15°R 집단이 upright 집단에 비해 운동종료직후 유의하게 낮은 것으로 나타났다(176±23, 177±22, 173±26 vs. 241±42 mmHg×beats/min×10-2, P<0.001). 결론: 이 결과는 67° 이하의 리컴번트 자전거 운동은 뇌혈류속도를 증가시키고 심근 산소소비량을 감소시키지만 특별히15° 리컴번트 자전거 운동 종료 후 회복기의 뇌혈류를 더욱촉진시킬 수 있음을 시사한다.
Abstract
Background: The cerebral blood flow velocity (CBFV) and rate pressure product (RPP) have been reported to benefit hemodynamics more during exercise in the recumbent position than during that in the upright position. However, it is unclear which angle is of the greatest benefit to hemodynamics during exercise in the recumbent position. This study aimed to evaluate the effect of the recumbent angle on CBFV and RPP during exercise. Methods: In a balanced crossover study, 15 healthy volunteers (age, 18.7±1.1 years) were asked to perform the bicycle exercise four times in the upright and at recumbent angles of 67° (R), 47°R, and 15°R, with weekly intervals between each condition. The exercise intensity was set initially at 50 W and increased by 25 W every 2 minutes up to 150 W. CBFV in the middle cerebral artery (MCA) was measured using transcranial doppler sonography. All data were analyzed using two-way repeated-measures analysis of variance. Results: CBFV at 15°R was significantly higher than that in the upright position and at 67°R at 10 minutes recovery (69±16 vs. 56±7 and 58±10 cm/s, respectively; P<0.05). The RPP was significantly lower at 67°R, 47°R, and 15°R than in the upright position immediately after exercise (176±23, 177±22, and 173±26, respectively, vs. 241±42 mmHg×beats/min×10-2; P<0.001). Conclusions: At an angle of less than 67°R, exercise increases CBFV and reduces RPP, relative to those during exercise in the upright position. This hemodynamic effect was most prominent at 15°R, where cerebral circulation was further increased in the recovery phase.
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