Aerobic Exercise Training Combined with Local Strength Exercise Restores Muscle Blood Flow and Maximal Aerobic Capacity in Long-Term Hodgkin Lymphoma Survivors

Luciana de Souza Santos, Marília Harumi Higuchi dos Santos Rehder, Marcelo Vailati Negrao, Beatriz R. Goes-Santos, Edgar Toschi-Dias, Camila Jordão Paixão, Ursula Urias, Natali Schiavo Giannetti, Ludhmila A. Hajjar, Roberto Kalil Filho, Carlos E. Negrão
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Abstract

Background: It is unclear whether muscle blood flow (MBF) is altered in long-term Hodgkin Lymphoma (HL) survivors. We test the hypothesis that: 1) MBF response during mental stress (MS) is impaired in long-term HL survivors; 2) Aerobic exercise training combined with local strength exercise (ET) restores MBF responses during MS in these survivors. Methods: Eighteen 5-year HL survivors and 10 aged-paired healthy subjects (HC) were studied. Twenty HL survivors were randomly divided into two groups: Exercise-trained (HLT, n=10) and untrained (HLUT, n=10). Maximal aerobic capacity was evaluated by a cardiopulmonary exercise test and forearm blood flow (FBF) by venous occlusion plethysmography. MS was elicited by Stroop Color Word Test. ET was conducted for four months, three/week for 60 minutes each session. The aerobic exercise intensity corresponded to anaerobic threshold up to 10% below the respiratory compensation point. The strength exercises consisted of 2-3 sets of chest press, pulley and squat exercises, 12-15 repetitions each exercise at 30-50% of the maximal voluntary contraction. Results: Baseline was similar in HL survivors and HC, except peak oxygen consumption (peak VO2, p=0.013) and FBF (p=0.006) that were lower in the HL survivors. FBF responses during MS were lower in HL survivors (p<0.001). ET increased peak VO2 (11.59±3.07%, p=0.002), and FBF at rest (33.74±5.13%, p<0.001) and during MS (24±5.31%, p=0.001). Further analysis showed correlation between the changes in peak VO2 and the changes in FBF during MS (r=0.711, p=0.001). Conclusion: Long-term HL survivors have impaired MBF responses during MS. ET restores MBF responses during MS.
有氧运动训练与局部力量锻炼相结合可恢复霍奇金淋巴瘤长期存活者的肌肉血流量和最大有氧能力
背景:霍奇金淋巴瘤(HL)长期存活者的肌肉血流(MBF)是否会发生变化尚不清楚。我们测试了以下假设1)长期霍奇金淋巴瘤(HL)幸存者在精神压力(MS)期间的肌肉血流反应受损;2)有氧运动训练结合局部力量锻炼(ET)可恢复这些幸存者在精神压力(MS)期间的肌肉血流反应。方法:研究对象为 18 名 5 年的 HL 幸存者和 10 名年龄配对的健康受试者(HC)。20 名 HL 幸存者被随机分为两组:运动训练组(HLT,n=10)和未训练组(HLUT,n=10)。最大有氧能力通过心肺运动测试进行评估,前臂血流量(FBF)通过静脉闭塞胸透进行评估。MS 通过 Stroop 颜色词测试激发。有氧运动持续四个月,每周三次,每次 60 分钟。有氧运动强度与无氧阈值相对应,低于呼吸代偿点 10%。力量练习包括2-3组胸压、滑轮和深蹲练习,每次重复12-15次,最大自主收缩量为30-50%。结果HL 幸存者和 HC 的基线相似,但 HL 幸存者的峰值耗氧量(峰值 VO2,p=0.013)和 FBF(p=0.006)较低。HL 幸存者在 MS 期间的 FBF 反应较低(p<0.001)。ET 增加了峰值 VO2(11.59±3.07%,p=0.002),以及静息时(33.74±5.13%,p<0.001)和 MS 期间(24±5.31%,p=0.001)的 FBF。进一步分析表明,峰值 VO2 的变化与 MS 期间 FBF 的变化之间存在相关性(r=0.711,p=0.001)。结论长期 HL 存活者在 MS 期间的 MBF 反应受损。ET 可恢复 MS 期间的 MBF 反应。
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