进行最大和次极大耐力运动测试, 测量人类急性运动的生理和生物学反应
Summary
为了评估运动强度对生理和生物反应的影响, 采用了两种不同的运动试验方案。方法概述了循环测力计的运动试验, 即增量式最大耗氧试验和耐力、稳态次极大耐力试验。
Abstract
正常的身体活动对人类健康有积极的影响, 但控制这些影响的机制仍然不清楚。急性运动的生理和生物反应主要受运动方案的持续时间和强度的影响。随着运动越来越被认为是治疗治疗和/或诊断工具, 重要的是要利用 standardizable 方法来了解变异性, 提高运动产出和测量的重现性。对这种方案的反应。为此, 我们描述了两种不同的循环运动方案, 它们产生不同的生理输出。在最大的运动测试中, 运动强度不断增加, 工作负荷增加, 导致心肺和代谢反应 (心率、中风体积、通气量、耗氧量和二氧化碳产量) 上升。与此相反, 在耐力运动测试中, 需求增加从在休息, 但被提高到一个固定的次极大运动强度, 导致心肺和新陈代谢的反应, 通常是高原。除了这些协议, 我们还提供了测量生理输出的建议, 包括但不限于心率、缓慢和强制的重要容量、气体交换指标和血压, 以使运动输出之间的比较研究。然后可以对 Biospecimens 进行取样, 以评估细胞、蛋白质和/或基因表达反应。总的来说, 这种方法可以很容易地适应两个不同的锻炼方案的短期和长期影响。
Introduction
身体活动被定义为骨骼肌肉产生的任何身体运动, 需要能量消耗1。运动是一种身体活动, 涉及重复的身体运动, 以改善或维持身体健康的一个或多个组成部分2。在同一时间, 不建议对那些严重生病的人进行体育活动。对于患有癌症、心力衰竭或甚至怀孕的人, 卧床休息比体力活动更可取。临床实践已经发生了翻天覆地的变化, 因为运动对整体健康的益处已成为不可否认的3。定期运动已被证明有助于减少心血管疾病风险, 全死因死亡率, 癌症风险和高血压, 改善血糖控制, 促进体重减轻或维护, 并防止骨和肌肉损失4,5 ,6,7,8。
运动的广泛好处现在导致许多人利用运动作为一种类型的 “医学” 和替代或辅助治疗选项的各种条件3。舒尔曼等。表明, 跑步机和抵抗运动的结合可以改善步态速度、有氧能力和肌肉力量, 从而提高帕金森病患者的运动控制和整体生活质量9.在心力衰竭患者中, 运动不耐受和药物干预不足导致生活质量低下10。在 HF 行动试验中进行运动训练的心力衰竭患者的初步结果表明, 生活质量提高, 住院和死亡率下降11。此外, 应用运动改变蒽环类化疗的心脏毒性效应 (如阿霉素) 表明, 无论何时启动与患者化疗管理 (之前, 期间或之后), 运动可以提供有益的效果, 如减少有氧能力下降, 减轻左心室功能障碍和减少氧化损伤12。
运动在健康和健康方面的好处不仅在其应用作为药物/治疗, 而且作为诊断工具。例如, 运动测试用于诊断运动不耐受, 心脏缺血, 或了解呼吸急促的原因13。也许更重要的是, 运动测试可以用来识别亚临床功能障碍。人体在大多数情况下 “过度建设”, 这样的功能障碍或病理生理学通常可以保持隐藏和不明显的个人几个月或几年。这一观察可以解释为什么肺动脉高压或胰腺癌等病症在严重程度上会默默地增加, 这样, 由于时间症状被注意到, 这些条件往往是非常先进的, 极难治疗2.在某些情况下, 运动测试可以给身体带来压力刺激, 增加对日常生活的需求, 有时可以识别在休息时没有看到的功能障碍 (心脏、呼吸、新陈代谢), 帮助诊断疾病并及早开始治疗。
为了充分发挥运动的治疗和诊断潜能, 需要标准化的方法来量化对身体活动的反应, 以准确评估运动对整体免疫健康的贡献。工作量、倾角、持续时间、运动类型和样本收集时间的变化都可以影响生理反应的测量。在这里, 我们概述了最大和次极大耐力演习的方法收集生理数据, 同时收集样本的生物反应。该方法用于了解急性运动如何通过流式细胞仪测量运动前后不同时间点的免疫细胞种群对外周血14中白细胞的分布和频率的影响采用10色流量协议, 允许同时对所有主要白细胞亚群进行量化15。以下协议可作为两种不同运动方案的标准化方法, 用于测量生理和生物对运动的反应。
Protocol
Representative Results
Discussion
作为辅助/替代治疗工具, 运动有很大的潜力。事实上, 一个新兴的证据机构强烈建议体育活动促进身体健康。使用运动作为一种药物或诊断工具将需要了解适量或 “剂量” 的运动, 以达到预期的效果。最好的锻炼剂量应该估计, 因为过多的运动可能有害于改善健康。因此, 锻炼方案可能需要为每个个体量身定做, 以达到最佳的锻炼效果。为此目的, 需要理解和控制有助于各种行动反应性质的变数。因此…
Disclosures
The authors have nothing to disclose.
Acknowledgements
这项研究由梅奥诊所的实验室医学和病理学和其他各种内部来源资助。
Materials
| Metabolic cart/portable system | MCG Diagnostics | Mobile Ultima CPX System | The flow calibration syringe, and calibration gases should come with system. There are numerous possible options/alternatives. |
| Pulmonary function software (Breeze Suite) | MCG Diagnostics | Software used will depend on the metabolic system | |
| Upright cycle ergometer | Lode ergoline | 960900 | Numerous possible options/alternatives |
| 12-Lead ECG | GE Healthcare | CASE Exercise Testing System | Used for 12 lead ECG capture, control bike. Having a full 12-lead is ideal for maximal exercise test so can monitor for arhythmias, but alternative for just HR would be a wireless chest strap heart rate monitor |
| Pulse oximeter | Masimo | MAS-9500 | Usually multiple probe options: finger, forehead, ear lobe. Usually avoid finger as tight handlebar grip can cause measurement inaccuracies |
| Pneumotach (preVent Flow Sensor) | MCG Diagnostics | 758100-003 | Alternative systems can use a turbine |
| Nose piece (disposable) | MCG Diagnostics | 536007-001 | Numerous possible options/alternatives |
| Mouthpeice with saliva trap | MCG Diagnostics | 758301-001 | Suggest filling the saliva trap with paper towel/gauze and tape cap to limit dripping |
| Headband | Cardinal Health | 292866 | Used to secure the forehead pulse oximeter and the lines for the cart |
| Stethescope | 3M Littman | 3157SM | Numerous possible options/alternatives |
| Blood pressure cuff | HCS | HCS9005-7 | Cuff size will depend on the population planning to test |
| ECG Electrodes | Cardinal Health | M2570 | only needed with lead based ECG/HR monitoring |
| K2EDTA tube 5mL | Becton Dickinson | 368661 | |
| *The table provides a list of the supplies and equipment utilized in this protocol and comments related to the equipment. Brand name/company is provided, but the use of other brands will not affect the results, key is to keep it consistent throughout testing in a particular study. | |||
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