有氧运动疗法对老年卧床患者心率变异性的影响

The effects of aerobic exercise therapy on the heart rate variability in the elderly bedridden patients

目的:观察卧床不起老年患者行有氧运动疗法治疗后心率变异性的变化,探讨这一干预措施对预后的可能影响。方法:选择符合条件的患者45例,根据功能独立测试(FIM),有部分依赖25例或完全依赖20例,随机分为两组,即治疗组23例,在常规治疗基础上行有氧运动疗法;对照组22例,只给予常规治疗。治疗组治疗前后和对照组20周前后分别检测24小时动态心电图。结果:治疗组治疗20周后,心率变异性的正常R-R间期标准差、均值标准差、总功率谱、均方根、爱丁堡指数、高频等明显改善。对照组20周后心率变异性无明显变化或反而有降低。结论:有氧运动疗法能提高老年卧床不起患者的心率变异性,尤其是提高患者迷走神经的功能活性,并可能改善其预后。

Objective:To investigate the effects of kinesitherapy on the heart rate variability(HRV) in bedridden elderly patients.Method:45 hospitalized patients,age all above 60 years, according to the Function Independence Measure(FIM). There were partial dependent groups(25 cases) and dependent groups(20 cases). They were further divided into two groups randomly, first group 22 cases (normal treatment) only have a normal treatment, and the 2nd group 23 cases(special treatment) have a normal treatment plus kinesitherapy. Measured items of HRV, were 24 hours standard deviation of successive normal-to-normal R-R interval(SDNN), total power(TP),standard deviation of all means of 5-minutes R-R interval all over 24 hour(SDANN). Result:Some items of HRV, HRV of the special treatment group had increased,they were SDNN,SDANN,TP,MSSD,PNN50 and HF,P<0.01.There were 2 items of HRV of the special treatment group,LF and LF/HF, significantly increased than those of normal treatment group,P<0.01.And HRV of the normal treatment group continued to get decreased insteadly.Conclusion:Kinesitherapy in the elderly bedridden patients might be possiblely increased the HRV and improved the prognosis.Author′s address Beijing Aerospace Central Hospital, Beijing, 100039