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系統識別號 U0026-1902201102354200
論文名稱(中文) 不同強度阻力訓練對中老年人胰島素敏感性、C反應蛋白、心跳變異度與站姿耐受性之影響
論文名稱(英文) Influences of different intensity of resistance training on insulin sensitivity, CRP, and heart rate variability at rest & responses to orthostasis in middle-aged and older adults
校院名稱 成功大學
系所名稱(中) 體育健康與休閒研究所
系所名稱(英) Institute of Physical Education, Health & Leisure Studies
學年度 99
學期 1
出版年 100
研究生(中文) 陳怡如
研究生(英文) Yi-Ju Chen
學號 rb697102
學位類別 碩士
語文別 英文
論文頁數 60頁
口試委員 指導教授-林麗娟
口試委員-楊宜青
口試委員-吳晉祥
中文關鍵字 肌力訓練  運動強度  胰島素阻抗  自律神經系統  站姿不耐性 
英文關鍵字 strength training  intensity-response  insulin resistance  autonomic nervous system  orthostatic intolerance 
學科別分類
中文摘要 背景:老化及身體活動減少所伴隨的體脂率上升及瘦肉質量減少,會導致許多代謝異常,進而增加心血管疾病危險性。阻力訓練除了對於肌肉系統的效益外,對於心血管疾病因子的影響也漸漸受到重視。目的:探討不同強度阻力訓練對中老年人肌力、身體組成、胰島素敏感度、C反應蛋白、心跳變異度(heart rate variability, HRV)及站姿耐受性的影響。方法:中老年人40位,隨機分為高阻力(80%1-RM,反覆8次) 15位(女11男4,年齡59.7±3.7歲,BMI 22.5±3.1 kg/m2)、中阻力(50%1-RM,反覆13次) 13位(女9男4,年齡61.1±5.3歲,BMI 23.4±1.9 kg/m2)及控制組12位(女8男4,年齡59.8±4.2歲,BMI 23.5±5.1 kg/m2)。運動組進行24週、9種重量機器阻力訓練,每次2組,每週2次。控制組維持平常身體活動、不做阻力訓練。訓練前及24週訓練後全部個案均接受相同的檢測,包括最大肌力(one repetition maximum, 1-RM),身體組成,生化代謝發炎指標,血壓及HRV(平躺及站姿)。統計方法以多因子共變數分析進行三組兩個時間點重複量數檢測,並使用Pearson’s 相關係數檢測主要結果變項改變量間的關係。結果:阻力訓練兩組的1-RM均有顯著增加(p<0.01),控制組則下降。高阻力組的低、高頻power比值(low frequency/high frequency, LF/HF) (Ln ratio)在運動前後有顯著下降(p<0.05)。HRV變項在調整前測值與年齡的共變數分析顯示高阻力組的訓練後高頻power (Ln ms2)顯著高於控制組(p<0.05)。高阻力組的休息心跳率及舒張壓在運動後呈顯著下降(p<0.05)。運動後高阻力組的低頻power (normalized unit)的躺、站姿比率(supine-standing ratio, SSR),顯著高於中阻力組及控制組(p<0.05);而高阻力組的LF/HF SSR則顯著高於控制組(p<0.05)。而身體組成、六分鐘走路測驗、空腹葡萄糖、空腹胰島素、胰島素敏感度指數(QUICKI)、糖化血色素及高敏感C反應蛋白三組在研究前後均無顯著改變,亦無顯著組間差異。關聯性分析則顯示主要結果變項改變量間無顯著相關。結論:中高阻力訓練皆能有效提升中老年人的肌力及改善血壓。高阻力訓練可能可以藉由強化心臟迷走神經反應進一步來達到降低休息心跳率及改善心跳變異度。高阻力訓練對於中老年人的站姿心跳變異度反應亦有正面效果。因此,較高強度的阻力訓練對於強化中老年人自律神經系統的調整,進而減少心血管疾病危險及站姿不耐性,有較佳的效益。
英文摘要 Background: Age- or decreased physical activity-related increases in body fat percent and decreases in lean mass (sarcopenia) have numerous adverse metabolic consequences, which can lead to higher risks of developing cardiovascular diseases. The role of resistance training (RT) in mitigating cardiovascular disease risks is attracting more attention, in addition to its well-known effects on the muscular system. Purpose: The aim of this study was to evaluate the effects of twenty-four weeks of different intensity of RT on muscular strength, body composition, insulin sensitivity, high-sensitive C-reactive protein (hs-CRP), hemodynamic change, and heart rate variability (HRV) both at rest and in response to orthostatic maneuvers in middle-aged and older adults. Methods: Forty middle-aged and older adults were randomized into three groups, including a high-intensity group (HEX) (80% 1-RM, 8 repetitions) (female 11, male 4; age 59.7±3.7 years; BMI 22.5±3.1 kg/m2), middle-intensity group (LEX) (50% 1-RM, 13 repetitions) (female 9, male 4; age 61.1±5.3 years; BMI 23.4±1.9 kg/m2), and control group (CON) (female 8, male 4; age 59.8±4.2 years; BMI 23.5±5.1 kg/m2). The training protocol was nine exercises, two sets, two times per week, for 24 weeks, while the CON maintained their regular lifestyles without doing RT. Data collected pre- and post-study included one repetition maximum (1-RM), body composition, six-min walk test, biochemical and inflammatory markers, and heart rate and blood pressure and HRV both at rest and in response to orthostatic challenges. Results: Both of the LEX and HEX showed significant improvements in 1-RM (p<0.01), while the CON showed decreased muscular strength. The HEX had a significant decrease in low frequency/high frequency (LF/HF) (Ln ratio) from pre- to post-study (p<0.05). At post-study, the HEX had significantly higher HF (Ln ms2) than the CON, adjusted for both pre-study value and age (p<0.05). The HEX showed a significant decrease in resting heart rate and diastolic blood pressure from pre- to post-study (p<0.05). Regarding the supine-standing ratio (SSR), at post-study, the SSR of LFn (normalized unit) in HEX was greater than that in the LEX and CON group, while the SSR of LF/HF in HEX was greater than the CON, adjusted for the pre-study value and age (p<0.05). There was no significant change in body composition, glucose tolerance, insulin sensitivity, hs-CRP and six-min walk test results within or between groups at both pre- and post-study. No significant association was noted between the changes in main outcome variables. Conclusions: High- and middle-intensity RT have positive effects on muscular strength and resting blood pressure. High-intensity RT can further improve resting heart rate and HRV via enhancing cardiac vagal control. High-intensity RT might also improve the orthostatic response in terms of HRV. Therefore, RT with higher intensity might be helpful to enhance the modification of the autonomic nervous system, and perhaps to decrease the risk of cardiovascular disease and orthostatic intolerance.
論文目次 中文摘要 I
Abstract III
Acknowledgement V
Table of Contents VII
List of Tables IX
List of Figures X
Chapter 1 Introduction 1
1.1 Background 1
1.2 Insulin resistance 1
1.3 C-reactive protein 3
1.4 Blood pressure and resting heart rate 5
1.5 Heart rate variability 7
1.6 Orthostatic tolerance 8
1.7 Intensity of resistance training 10
1.8 Purposes of this study 11
Chapter 2 Methods 12
2.1 Subjects 12
2.2 Study design 13
2.3 Body composition 13
2.4 Strength testing 13
2.5 Group assignments 14
2.6 Whole-body resistance training program 14
2.7 Autonomic measurements 15
2.8 Biochemical variables 17
2.9 Submaximal aerobic endurance test (six-minute walk test) 17
2.10 Statistical analyses 18
Chapter 3 Results 19
3.1 Subjects 19
3.2 Muscle strength 20
3.3 Hemodynamic and HRV measures 21
3.4 Autonomic reflex response to orthostatic maneuvers 23
3.5 Body composition and six-minute walk test 29
3.6 Glucose tolerance, insulin sensitivity, hs-CRP 30
3.7 Subgroup analyses and association analyses 30
Chapter 4 Discussion 32
4.1 Heart rate and blood pressure at rest and responses to orthostasis 32
4.2 Vagal tone modulation at rest 35
4.3 HRV response to orthostatic challenge 38
4.4 Resistance training and hs-CRP 42
4.5 Resistance training and insulin sensitivity 43
4.6 Association between outcome variables 43
4.7 Limitation 44
4.8 Conclusions and Perspectives 45
References 46

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