摘要
目的：本研究选取膝关节交叉韧带重建术后患者采用CPET(心肺运动试验,Cardiopulmonary exercise testing)和上肢功率车有氧训练方案对其4周训练前后的心肺功能进行评价,旨在为维持或改善该类人群心肺功能的早期康复训练及其心肺功能评价提供实验依据。
方法：41名行膝关节交叉韧带重建术患者(运动员25名,普通人16名)分为对照组和训练组,运动员训练组.又分为持续训练和间歇训练组；对照组术后第
天起按常规康复训练处方训练,训练组加入上肢功率车有氧训练,共4周训练：受试者均在术前一周内和有氧训练4周后一周完成肺功能、上肢功率车CPET及血VEGF、BFGF含量的测试。
结果：1.普通人对照组V02peak.VO2peak/Kg.MET.02Plus、SV、RQ、VT、 Ca(a-v)02均较4周前显著性降低(p<0.05),BR则显著性增加(p＜0.05)；而有氧训练后V02peak.V02peak/Kg.MFT、02Plus.SV.Ca(a-v)02和VE均显著增加(p<0.005),VO2/△WR显著性降低。2.运动员对照组V02peak、V02peak/Kg、 MET、02Plus、SV及Ca(a-v)02均较4周前显著性降低(p＜0.0)5),且初始V02peak与V02peak变化值呈非常显著负相关；持续训练组仅02Plus显著性降低：间歇训练组V02peak.V02peak/Kg.MET、02Plus、VE、VT及Ca(a—v)02均显著性增加(p<0.05)；3.普通人有氧训练组血清VEGF、BFGF和运动员间歇训练组VEGF较4周前显著性增加。4.有氧训练后运动员V02peak、VO2peak/Kg、MET、02Plus、 SV、Ca(a-v)02的增加值均显著低于普通人(p<0.05)。
结论：1.膝关节交义韧带重建术后普通人进行4周常规康复训练心肺功能显著降低；加入上肢功率车有氧训练则上述指标显著增加。2.运动员术后行4周常规康复训练体重和BM1显著增加；心肺功能显著降低,11V02peak的下降程度与初始V02peak高度负相关。3.上肢功率车大型强度间歇训练较中等强度持续训练更能有效提高术后运动员的有氧耐力和心肺功能水平。4.加入4周有氧训练后普通人血清VEGF、BFGI和运动员VEGI呈高水平表达,提示有氧训练对肌腱韧带修复有积极作用。
Purpose:This research intention to developed the effective programme of evaluated and maintained or improved cardiorespiratory adaptation of patients after reconstruction of cruciate ligaments of knee joint by CPET and the Upper extremity ergometry aerobic training during early rehabilitation (early4weeks).
Method:41patients (with25athletes, ordinary people16)were divided into the control group and the training group respectively, then the athletes training group divided into continuous and intermittent group. Control groups exercised by general training prescription after operation, and training groups added aerobic training for4weeks. All subjects completed the CPET and serum VEGF, BFGF before and after4weeks of rehabilitation training.
Results:1. Ordinary people1of control group diplayed significant reduction (p<0.05)of V02peak, V02peak/Kg, MET,02Plus. SV, RQ, VT, and Ca(a-v)02, while significant increase (p<0.05) of BR after4weeks training. And aerobic training groups showed increased markedly (p<0.05) of V02peak, V02peak/Kg, MET,02Plus, SV, Ca(a-v),02and VE, while significantly reduction of V02/WR.2. Athletes control group expressed significantly reduction of V02peak, V02peak/Kg, MET,02Plus, SV and Ca(a-v)02(p<0.05), and it is a very significant negative correlation between the initial V02pcak and the change of V02neak. At continuing training group diplayed02Plus significantly reduction only, while V02peak, V02peak/Kg, MET,02Plus, VE, VT and Ca(a-v)02are significantly increased (p<0.05) in the athletes interval training group. In continuing training group V02peak, V02peak/Kg, MET,02Plus and SV has decreased but were higher than those of the control group significantly reduced (p<0.05), and the interval training group showed significantly (p<0.05) increases.3. The serum VEGF, BFGFof Ordinary people and athletes training groups and VEGF of interval training group significantly increased after4weeks training.4. The increase of athietes V02peak, V02peak/Kg, MET,02Plus, SV, and Ca(a-v)02are significantly lower than the ordinary people (p<0.05) after aerobic training,
Conclusion:1. Ordinary people is significantly reduced on cardio pulmonary adaptation after4weeks general aerobic training, while it is significant increase after added4weeks aerobic exercise.2. Athletes increased in weight and BMI after4weeks of general training, and cardio-pulmonary adaptation significantly reduced, and the drop of V02peak and initial V02peak showed highly negative correlation.3.It showed more significant improvement of cardio-respiratory adaptation after intermittent training than continuing training in athletes.4. After4weeks of aerobic training ordinary people serum VFGF, BFGF expression and athletes serum VHGF expression showed highly level, which indicates aerobic training played a positive role on repair tendons ligaments.
引文
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