主动和被动拉伸对韧带及肌肉组织血氧影响的近红外光谱技术评价
|
摘要
背景:目前虽有众多对不同拉伸方法比如静力性和动力性拉伸效果的评价研究,但是缺乏现代科学标准客观化指标,尤其是能实时检测的生理性指标,另外其疗效机制也尚不明确。目的:利用近红外光谱技术测量验证静力性拉伸的不同拉伸方式——主动与被动拉伸对肌肉组织血流及血氧的影响变化,从生理性缺血及再灌注方面探索拉伸作用的机制。方法:对10名平均年龄为(28±5)岁年轻健康的受试者,3名男性,7名女性,使用集成了三波长LED光源的PortaLite NIRS血氧计分别检测不同方式的静态拉伸(主动拉伸和被动拉伸)处于拉伸和收缩状态肌肉组织血氧变化,包括基线、拉伸干预期间及干预后的氧合血红蛋白、脱氧血红蛋白和总血容量变化。结果与结论:①静态拉伸时处于拉伸状态的肌肉组织通过增加总血容量明显提升血液氧合血红蛋白水平,而处于收缩状态的肌肉组织总血容量、脱氧血红蛋白和氧合血红蛋白抑制效果较明显,且收缩的组织各血液指标上升幅度不如拉伸组织;②主动拉伸运动后上调总血容量和氧合血红蛋白能力优于被动拉伸,有促进血液微循环和血流动力学活性、增强局部组织血氧、增加组织柔韧性以及加速局部组织修复或提升组织功能的可能性;③结果提示近红外光谱检测组织血氧技术有望成为验证组织再生与康复的一个客观指标。
BACKGROUND: There are many evaluation studies on the efficacy of different stretch methods such as static and dynamic stretches, but the objective index of modern scientific standards, especially physiological indicators are absent. Moreover, the underlying mechanism is not yet clear.OBJECTIVE: To measure and verify the effects of static tensions(active and passive stretching) on the muscle blood flow and blood oxygen by using near-infrared spectroscopy, and to explore the mechanism of stretching from the aspect of physiological ischemia/reperfusion.METHODS: Ten young healthy subjects(3 males and 7 females) with a mean age of(28±5) years were enrolled. NIRS Oximeter which integrated three-wavelength LED light sources was used to detect the blood oxygen in the muscle tissue under stretching and contraction under active stretching and passive stretching. The indicators included the oxyhemoglobin, deoxyhemoglobin, and total blood volume at baseline, during stretching and after intervention.RESULTS AND CONCLUSION:(1) The blood oxyhemoglobin level of the muscles in stretched state was obviously increased with total blood volume increasing. The total blood volume, deoxyhemoglobin and oxyhemoglobin in contractile muscles were suppressed significantly and the increasing degree of blood indexes were less than that after the stretching exercise.(2) The increases of total blood volume and oxyhemoglobin after active stretching exercise were higher than those after passive stretching, which could promote blood microcirculation and hemodynamic activity, increase local blood oxygen and the flexibility of tissue, accelerate local tissue repair or enhance the tissue function.(3) These results indicate that near-infrared spectroscopy to detect tissue blood oxygen is expected to be an objective index for verifying tissue regeneration and rehabilitation.
BACKGROUND: There are many evaluation studies on the efficacy of different stretch methods such as static and dynamic stretches, but the objective index of modern scientific standards, especially physiological indicators are absent. Moreover, the underlying mechanism is not yet clear.OBJECTIVE: To measure and verify the effects of static tensions(active and passive stretching) on the muscle blood flow and blood oxygen by using near-infrared spectroscopy, and to explore the mechanism of stretching from the aspect of physiological ischemia/reperfusion.METHODS: Ten young healthy subjects(3 males and 7 females) with a mean age of(28±5) years were enrolled. NIRS Oximeter which integrated three-wavelength LED light sources was used to detect the blood oxygen in the muscle tissue under stretching and contraction under active stretching and passive stretching. The indicators included the oxyhemoglobin, deoxyhemoglobin, and total blood volume at baseline, during stretching and after intervention.RESULTS AND CONCLUSION:(1) The blood oxyhemoglobin level of the muscles in stretched state was obviously increased with total blood volume increasing. The total blood volume, deoxyhemoglobin and oxyhemoglobin in contractile muscles were suppressed significantly and the increasing degree of blood indexes were less than that after the stretching exercise.(2) The increases of total blood volume and oxyhemoglobin after active stretching exercise were higher than those after passive stretching, which could promote blood microcirculation and hemodynamic activity, increase local blood oxygen and the flexibility of tissue, accelerate local tissue repair or enhance the tissue function.(3) These results indicate that near-infrared spectroscopy to detect tissue blood oxygen is expected to be an objective index for verifying tissue regeneration and rehabilitation.
引文
[1]Magnusson SP,Aagard P,Simonsen E,et al.A biomechanical evaluation of cyclic and static stretch in human skeletal muscle.Int JSports Med.1998;19(5):310-316.
[2]Magnusson SP,Simonsen EB,Aagaard P,et al.Mechanical and physiological responses to stretching with and without preisometric contraction in human skeletal muscle.Arch Phys Med Rehabil.1996;77(4):373-378.
[3]Endlich K,Kliewe F,Endlich N.Stressed podocytes-mechanical forces,sensors,signaling and response.Pflugers Arch.2017;469(7-8):937-949.
[4]Wang W,Yu XD,Mo X,et al.Limb ischemic preconditioning attenuates cerebral ischemic injury in rat model.Perfusion.2014;29(3):210-218.
[5]Zhao Y,Li J,Lin A,et al.Improving angiogenesis and muscle performance in the ischemic limb model by physiological ischemic training in rabbits.Am J Phys Med Rehabil.2011;90(12):1020-1029.
[6][Zhao HG,Li WB,Li QJ,et al.Limb ischemic preconditioning attenuates apoptosis of pyramidal neurons in the CA1 hippocampus induced by cerebral ischemia-reperfusion in rats.Sheng Li Xue Bao.2004;56(3):407-412.
[7]Li T,Li Y,Lin Y,et al.Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy.Biomed Opt Express.2017;8(1):223-229.
[8]Munk N,Symons B,Shang Y,et al.Noninvasively measuring the hemodynamic effects of massage on skeletal muscle:a novel hybrid near-infrared diffuse optical instrument.J Bodyw Mov Ther.2012;16(1):22-28.
[9]Shang Y,Lin Y,Henry BA,et al.Noninvasive evaluation of electrical stimulation impacts on muscle hemodynamics via integrating diffuse optical spectroscopies with muscle stimulator.J Biomed Opt.2013;18(10):105002.
[10]Li T,Sun Y,Chen X,et al.Noninvasive diagnosis and therapeutic effect evaluation of deep vein thrombosis in clinics by near-infrared spectroscopy.J Biomed Opt.2015;20(1):10502.
[11]de SáRB,Pessoa MF,Cavalcanti AG L,et al.Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients.Respir Physiol Neurobiol.2017;242:1-7.
[12]Lawand P,Lombardi Júnior I,Jones A,et al.Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain:A randomized controlled trial.Joint Bone Spine.2015;82(4):272-277.
[13]张帆,王长生,叶志强.不同拉伸方式对股后肌群柔韧素质影响的对比试验研究[J].天津体育学院学报,2014,29(1):61-65.
[14]过家兴.运动训练学[M].北京:北京体育学院出版社,1986.
[15]吕乙林,袁运平,刘永东.动静态伸展运动在高校田径技术教学中的实验研究[J].首都体育学院学报,2003,15(1):78-81.
[16]毛志帮,张玲莉,赖小勇,等.静态拉伸与下肢肌力锻炼在老年平衡能力中的意义[J].中国组织工程研究,2015,19(42):6803-6807.
[17]陈蒙.不同组合拉伸方式对股后肌群柔韧素质影响效应的实验比较研究[D].天津:天津体育学院,2016.
[18]Chen HM,Wang HH,Chen CH,et al.Effectiveness of a stretching exercise program on low back pain and exercise self-efficacy among nurses in Taiwan:a randomized clinical trial.Pain Manag Nurs.2014;15(1):283-291.
[19]Leelarungrayub D,Pothongsunun P,Yankai A,et al.Acute clinical benefits of chest wall-stretching exercise on expired tidal volume,dyspnea and chest expansion in a patient with chronic obstructive pulmonary disease:A single case study.J Bodyw Mov Ther.2009;13(4):338-343.
[20]Xiong Y,Berrueta L,Urso K,et al.Stretching Reduces Skin Thickness and Improves Subcutaneous Tissue Mobility in a Murine Model of Systemic Sclerosis.Front Immunol.2017;8:124.
[21]Iwasawa H,Nomura M,Sakitani N,et al.Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats.Clin Orthop Relat Res.2016;474(12):2692-2701.
[22]Gurley K,Shang Y,Yu G.Noninvasive optical quantification of absolute blood flow,blood oxygenation,and oxygen consumption rate in exercising skeletal muscle.J Biomed Opt.2012;17(7):75010.
[23]Otah KE,Otah E,Clark LT,等.在患有外周动脉疾病的患者及正常志愿者中下肢皮肤血流量与踝臂指数的关系[J].世界核心医学期刊文摘:心脏病学分册,2006,2(1):55-56.
[24]Henry B,Zhao M,Shang Y,et al.Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise.J Biomed Opt.2015;20(12):125006.
[25]Jr C,We K,G S,et al.Endothelial cells of hematopoietic origin make a significant contribution to adult blood vessel formation.Circ Res.2000;87(9):728-730.
[26]Hausenloy DJ,Yellon DM.Remote ischaemic preconditioning:underlying mechanisms and clinical application.Cardiovasc Res.2008;79(3):377-386.
[27]SK,Ge A,Kj G,et al.Functional small-diameter neovessels created using endothelial progenitor cells expanded ex vivo.Nature Med.2001;7(9):1035-1040.
[28]Chen WQ,Zhong L,Zhang L,et al.Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels.Br J Pharmacol.2009;156(6):941-951.
[29]Miyamoto N,Hirata K,Miyamoto-Mikami E,et al.Associations of passive muscle stiffness,muscle stretch tolerance,and muscle slack angle with range of motion:individual and sex differences.Sci Rep.2018;8(1):8274.
[2]Magnusson SP,Simonsen EB,Aagaard P,et al.Mechanical and physiological responses to stretching with and without preisometric contraction in human skeletal muscle.Arch Phys Med Rehabil.1996;77(4):373-378.
[3]Endlich K,Kliewe F,Endlich N.Stressed podocytes-mechanical forces,sensors,signaling and response.Pflugers Arch.2017;469(7-8):937-949.
[4]Wang W,Yu XD,Mo X,et al.Limb ischemic preconditioning attenuates cerebral ischemic injury in rat model.Perfusion.2014;29(3):210-218.
[5]Zhao Y,Li J,Lin A,et al.Improving angiogenesis and muscle performance in the ischemic limb model by physiological ischemic training in rabbits.Am J Phys Med Rehabil.2011;90(12):1020-1029.
[6][Zhao HG,Li WB,Li QJ,et al.Limb ischemic preconditioning attenuates apoptosis of pyramidal neurons in the CA1 hippocampus induced by cerebral ischemia-reperfusion in rats.Sheng Li Xue Bao.2004;56(3):407-412.
[7]Li T,Li Y,Lin Y,et al.Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy.Biomed Opt Express.2017;8(1):223-229.
[8]Munk N,Symons B,Shang Y,et al.Noninvasively measuring the hemodynamic effects of massage on skeletal muscle:a novel hybrid near-infrared diffuse optical instrument.J Bodyw Mov Ther.2012;16(1):22-28.
[9]Shang Y,Lin Y,Henry BA,et al.Noninvasive evaluation of electrical stimulation impacts on muscle hemodynamics via integrating diffuse optical spectroscopies with muscle stimulator.J Biomed Opt.2013;18(10):105002.
[10]Li T,Sun Y,Chen X,et al.Noninvasive diagnosis and therapeutic effect evaluation of deep vein thrombosis in clinics by near-infrared spectroscopy.J Biomed Opt.2015;20(1):10502.
[11]de SáRB,Pessoa MF,Cavalcanti AG L,et al.Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients.Respir Physiol Neurobiol.2017;242:1-7.
[12]Lawand P,Lombardi Júnior I,Jones A,et al.Effect of a muscle stretching program using the global postural reeducation method for patients with chronic low back pain:A randomized controlled trial.Joint Bone Spine.2015;82(4):272-277.
[13]张帆,王长生,叶志强.不同拉伸方式对股后肌群柔韧素质影响的对比试验研究[J].天津体育学院学报,2014,29(1):61-65.
[14]过家兴.运动训练学[M].北京:北京体育学院出版社,1986.
[15]吕乙林,袁运平,刘永东.动静态伸展运动在高校田径技术教学中的实验研究[J].首都体育学院学报,2003,15(1):78-81.
[16]毛志帮,张玲莉,赖小勇,等.静态拉伸与下肢肌力锻炼在老年平衡能力中的意义[J].中国组织工程研究,2015,19(42):6803-6807.
[17]陈蒙.不同组合拉伸方式对股后肌群柔韧素质影响效应的实验比较研究[D].天津:天津体育学院,2016.
[18]Chen HM,Wang HH,Chen CH,et al.Effectiveness of a stretching exercise program on low back pain and exercise self-efficacy among nurses in Taiwan:a randomized clinical trial.Pain Manag Nurs.2014;15(1):283-291.
[19]Leelarungrayub D,Pothongsunun P,Yankai A,et al.Acute clinical benefits of chest wall-stretching exercise on expired tidal volume,dyspnea and chest expansion in a patient with chronic obstructive pulmonary disease:A single case study.J Bodyw Mov Ther.2009;13(4):338-343.
[20]Xiong Y,Berrueta L,Urso K,et al.Stretching Reduces Skin Thickness and Improves Subcutaneous Tissue Mobility in a Murine Model of Systemic Sclerosis.Front Immunol.2017;8:124.
[21]Iwasawa H,Nomura M,Sakitani N,et al.Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats.Clin Orthop Relat Res.2016;474(12):2692-2701.
[22]Gurley K,Shang Y,Yu G.Noninvasive optical quantification of absolute blood flow,blood oxygenation,and oxygen consumption rate in exercising skeletal muscle.J Biomed Opt.2012;17(7):75010.
[23]Otah KE,Otah E,Clark LT,等.在患有外周动脉疾病的患者及正常志愿者中下肢皮肤血流量与踝臂指数的关系[J].世界核心医学期刊文摘:心脏病学分册,2006,2(1):55-56.
[24]Henry B,Zhao M,Shang Y,et al.Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise.J Biomed Opt.2015;20(12):125006.
[25]Jr C,We K,G S,et al.Endothelial cells of hematopoietic origin make a significant contribution to adult blood vessel formation.Circ Res.2000;87(9):728-730.
[26]Hausenloy DJ,Yellon DM.Remote ischaemic preconditioning:underlying mechanisms and clinical application.Cardiovasc Res.2008;79(3):377-386.
[27]SK,Ge A,Kj G,et al.Functional small-diameter neovessels created using endothelial progenitor cells expanded ex vivo.Nature Med.2001;7(9):1035-1040.
[28]Chen WQ,Zhong L,Zhang L,et al.Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels.Br J Pharmacol.2009;156(6):941-951.
[29]Miyamoto N,Hirata K,Miyamoto-Mikami E,et al.Associations of passive muscle stiffness,muscle stretch tolerance,and muscle slack angle with range of motion:individual and sex differences.Sci Rep.2018;8(1):8274.