慢性卒中运动后低血压是一种方法依赖性现象吗?交叉随机对照试验

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-01-16 DOI:10.1111/cpf.12812

Guilherme F. Fonseca, André C. Michalski, Arthur S. Ferreira, Victor A. B. Costa, Renato Massaferri, Paulo Farinatti, Felipe A. Cunha

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引用次数: 0

摘要

本研究评估了两轮混合循环训练(MCT)后运动后低血压(PEH)检测的可重复性，采用三种方法计算运动前值和/或对照期(CTL)来计算PEH[即，(a1 =运动后−运动前-练习${A}_{1}=\text{post}{\rm{\mbox{-}}}\text{exercise}-\text{pre}{\rm{\mbox{-}}}\text{exercise}$);(a2 = post - exercise - post- CTL)$ ({A}_{2}=\text{post}{\rm{\mbox{-}}}\text{exercise}-\text{post}{\rm{\mbox{-}}}\text{CTL})$;A 3 =(运动后−Pre - exercise−(post .- CTL - pre - CTL)${A}_{3}=(\text{post}{\rm{\mbox{-}}}\text{exercise}-\text{pre}{\rm{\mbox{-}}\text{exercise})-(\text{post}{\rm{\mbox{-}}\text{CTL}-\text{pre}{\rm{\mbox{-}}}\text{CTL})]$治疗慢性中风(即中风后≥6个月)。还比较了使用不同PEH临界值确定的PEH应答者比例(4 mmHg vs最小可检测差异)。方法7例(年龄:56±12岁;脑卒中后时间:91±55个月)进行2次MCT和1次CTL治疗。MCT包括10个练习，每组最多重复15次，每组穿插45秒的步行。收缩压(SBP)和舒张压(DBP)在CTL和MCT前10分钟和后40分钟每10分钟评估一次。结果单次测量的双向随机类内相关系数(ICC2,1)范围为:A1: 0.580 ~ 0.829, A2: 0.937 ~ 0.994, A3: 0.278 ~ 0.774;对于DBP: A1: 0.497−0.916,A2: 0.133−0.969,A3: 0.175−0.930。在97%的分析中，使用4mmhg或最小可检测差异作为临界值检测到PEH应答者的比例没有差异(p > 0.05)，而在3%的分析中，使用4mmhg检测到PEH应答者的比例更高(p = 0.031)。收缩压和舒张压的标准误差分别为47%和40%。结论测定慢性卒中患者PEH最可靠的方法是用运动后的ctl值减去运动后的PEH值。PEH应答者的比例不受临界值的影响。

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Is postexercise hypotension a method-dependent phenomenon in chronic stroke? A crossover randomized controlled trial

Background

This study assessed the reproducibility of postexercise hypotension (PEH) detection after two bouts of mixed circuit training (MCT) using three approaches that accounts the pre-exercise values and/or a control session (CTL) to calculate PEH [i.e., ( $A_{1} = post - exercise - pre - exercise$ ); $(A_{2} = post - exercise - post - CTL)$ ; $A_{3} = (post - exercise - pre - exercise) - (post - CTL - pre - CTL)]$ in chronic stroke (i.e., ≥6 months poststroke). The proportion of PEH responders determined using different cut-off values for PEH was also compared (4 mmHg vs. minimal detectable difference).

Methods

Seven participants (age: 56 ± 12 years; time post-stroke: 91 ± 55 months) performed two bouts of MCT and a CTL. The MCT involved 10 exercises with 3 sets of 15-repetition maximum, with each set interspersed with 45 s of walking. The systolic (SBP) and diastolic (DBP) blood pressures were assessed 10-min before and every 10-min along 40-min after CTL and MCT.

Results

The two-way random intraclass correlation coefficient for single measurements (ICC_2,1) ranges for SBP were: A₁: 0.580−0.829, A₂: 0.937−0.994, A₃: 0.278−0.774; for DBP: A₁: 0.497−0.916, A₂: 0.133−0.969, A₃: 0.175−0.930. The proportion of PEH responders detected using 4 mmHg or the minimal detectable difference as cut-off values was not different in 97% of analyses (p > 0.05), and higher when using 4 mmHg in 3% of analyses (p = 0.031). The standard error of measurement was ≥4 mmHg in 47% of analyses for SBP, and 40% for DBP.

Conclusions

The most reliable approach for determining PEH in chronic stroke was to subtract the postexercise from the post-CTL values. The proportion of PEH responders was not affected by the cut-off values applied.

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.