研究生: |
林怡姿 Lin, Yi-Zih |
---|---|
論文名稱: |
身體活動量對更年期潛在高血壓婦女合併睡眠問題的心血管功能及睡眠品質之影響 Effect of physical activity on cardiovascular functions and sleep quality among menopausal women with prehypertension and sleep problems |
指導教授: |
謝伸裕
Hsieh, Shen-Yu |
學位類別: |
碩士 Master |
系所名稱: |
運動競技學系 Department of Athletic Performance |
論文出版年: | 2015 |
畢業學年度: | 103 |
語文別: | 中文 |
論文頁數: | 64 |
中文關鍵詞: | 自律神經功能 、雲端紀錄 、身體活動 、更年期婦女 、血壓 、睡眠品質 |
英文關鍵詞: | autonomic functions, cloud computing system, physical activity, menopausal women, blood pressure, sleep quality |
論文種類: | 學術論文 |
相關次數: | 點閱:165 下載:8 |
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更年期婦女由於女性荷爾蒙分泌的改變,導致罹患心血管疾病的風險提升;已知運動可改善心血管及睡眠功能等,但過去研究鮮少探討運動訓練過程中更年期婦女之生理變化,且長期的資料收集有一定的困難性。目的:以資料雲端化的方式記錄長時間的生理數值變化,了解身體活動的介入對更年期潛在高血壓婦女在心血管功能及睡眠品質的影響。方法:招募23位更年期潛在高血壓婦女 (收縮壓 > 120 mmHg or 舒張壓 > 80 mmHg),年齡為56-71歲,分為實驗組及控制組。實驗組進行四週有氧運動,每週至少健走三次,每次至少三十分鐘。每天早、晚需量測血壓,每週進行一次24小時自律神經檢測。控制組則不額外做身體活動的介入。統計分析以成對樣本T檢定分析及95%信賴區間做差異比較,顯著水準定為p <.05。結果:實驗組之早上收縮壓與舒張壓皆於身體活動介入後第二週顯著下降,收縮壓下降9.85.3 mmHg、舒張壓下降8.41.3 mmHg;晚上收縮壓與舒張壓則在第三週顯著下降,收縮壓下降9.86.3 mmHg、舒張壓7.30.3 mmHg及心率沒有明顯改變。早上副交感神經活性及晚上交感神經活性於第三週顯著下降;早上交感神經活性及晚上副交感神經活性於第三週顯著上升。睡眠品質PSQI兩組前測與後測結果並無顯著差異,而ESS嗜睡量表則是運動組於第一週後就有顯著下降。結論:四週提升身體活動的介入可以改善更年期潛在高血壓婦女的血壓;心律變異性早晚之差異變大,表示身體狀況變好,越能夠有效適應外在環境的變化。
關鍵詞:自律神經功能、雲端記錄、身體活動、更年期婦女、血壓、睡眠
Purpose: To investigate the effects of physical activity on cardiovascular functions and sleep quality in menopausal women with prehypertension. Also, to understand the changes of physiological parameters during the exercise training process. Methods: Menopausal women (n=23) with prehypertension (systolic blood pressure, SBP > 120 mmHg or diastolic blood pressure, DBP > 80 mmHg) ranging from 56 to 71 yrs were recruited. Participants were be divided into two groups: Control and Experimental (EXP), the EXP group were be asked to follow 3 weeks physical activity (3 times/week, 30 minutes/times). The physiological signals (blood pressure: twice daily, autonomic nervous activity: once per week for 24hrs) were recorded. Paired-sample T test were used to compare the differences ( p <.05). Results: The morning decreased (SBP: 9.85.3 mmHg;DBP: 8.41.3 mmHg, p <.05) and evening (SBP: 9.86.3 mmHg;DBP: 7.30.3 mmHg, p <.05) blood pressure of participants decreased after two and three weeks of physical activity, respectively. The autonomic functions improved at the third week. PSQI sleep quality have no significant in two groups. ESS sleepiness score decreased in EXP group after one week of physical activity. Conclusions: A 4 weeks aerobic exercise can improve cardiovascular functions in menopausal women with prehypertension. The obvious difference between day time and night time heart rate variability reflect physical condition change better and can respond effectively to external changes.
Key words: autonomic functions, cloud computing system, physical activity, menopausal women, blood pressure
一、中文部分
吳鎮守 (2013)。雲端保健系統之建立與成效分析 (未出版碩士論文) 。國立陽明大學,台北市。
二、英文部分
Akselrod, S., Gordon, D., Ubel, F. A., Shannon, D. C., Berger, A. C., & Cohen, R. J. (1981). Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science, 213(4504), 220-222.
Amano, M., Kanda, T., Ue, H., & Moritani, T. (2001). Exercise training and autonomic nervous system activity in obese individuals. Medicine and Science in Sports and Exercise, 33(8), 1287-1291.
Barnabei, V. M., Grady, D., Stovall, D. W., Cauley, J. A., Lin, F., Stuenkel, C. A., . . . Pickar, J. H. (2002). Menopausal symptoms in older women and the effects of treatment with hormone therapy. Obstetrics and Gynecology, 100(6), 1209-1218.
Brunner, R. L., Aragaki, A., Barnabei, V., Cochrane, B. B., Gass, M., Hendrix, S., . . . Stefanick, M. (2010). Menopausal symptom experience before and after stopping estrogen therapy in the Women's Health Initiative randomized, placebo-controlled trial. Menopause, 17(5), 946-954. doi: 10.1097/gme.0b013e3181d76953
Cannarella, R., & Agbayani, E. (2001). Tetanus: a case report, epidemiology review and recommendations for immunization compliance. West Virginia Medical Journal, 97(5), 253-256.
Cappuccio, F. P., Stranges, S., Kandala, N. B., Miller, M. A., Taggart, F. M., Kumari, M., . . . Marmot, M. G. (2007). Gender-specific associations of short sleep duration with prevalent and incident hypertension: the Whitehall II Study. Hypertension, 50(4), 693-700. doi: 10.1161/HYPERTENSIONAHA.107.095471
Carter, J. B., Banister, E. W., & Blaber, A. P. (2003). Effect of endurance exercise on autonomic control of heart rate. Sports medicine, 33(1), 33-46.
Collier, S. R., Kanaley, J. A., Carhart, R., Jr., Frechette, V., Tobin, M. M., Bennett, N., . . . Fernhall, B. (2009). Cardiac autonomic function and baroreflex changes following 4 weeks of resistance versus aerobic training in individuals with pre-hypertension. Acta Physiologica (Oxf), 195(3), 339-348. doi: 10.1111/j.1748-1716.2008.01897.x
Coylewright, M., Reckelhoff, J. F., & Ouyang, P. (2008). Menopause and hypertension: an age-old debate. Hypertension, 51(4), 952-959. doi: 10.1161/HYPERTENSIONAHA.107.105742
Dengel, D. R., Hagberg, J. M., Pratley, R. E., Rogus, E. M., & Goldberg, A. P. (1998). Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. Metabolism, 47(9), 1075-1082.
Driver, H. S., & Taylor, S. R. (2000). Exercise and sleep. Sleep Medicine Reviews , 4(4), 387-402. doi: 10.1053/smrv.2000.0110
Eichling, P. S., & Sahni, J. (2005). Menopause related sleep disorders. Journal of Clinical Sleep Medicine, 1(3), 291-300.
Ekblom, B., Kilbom, A., & Soltysiak, J. (1973). Physical training, bradycardia, and autonomic nervous system. Scandinavian Journal of Clinical and Laboratory Investigation, 32(3), 251-256.
Fensli, R., Gunnarson, E., & Hejlesen, O. (2004). A wireless ECG system for continuous event recording and communication to a clinical alarm station. Conference of the IEEE Engineering in Medicine & Biology Society, 3, 2208-2211. doi: 10.1109/IEMBS.2004.1403644
Flausino, N. H., Da Silva Prado, J. M., de Queiroz, S. S., Tufik, S., & de Mello, M. T. (2012). Physical exercise performed before bedtime improves the sleep pattern of healthy young good sleepers. Psychophysiology, 49(2), 186-192. doi: 10.1111/j.1469-8986.2011.01300.x
Fletcher, G. F., Blair, S. N., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., . . . Pina, I. L. (1992). Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart association. Circulation, 86(1), 340-344.
Gangwisch, J. E. (2014). A review of evidence for the link between sleep duration and hypertension. American Journal of Hypertension , 27(10), 1235-1242. doi: 10.1093/ajh/hpu071
Green, D. J., O'Driscoll, G., Joyner, M. J., & Cable, N. T. (2008). Exercise and cardiovascular risk reduction: time to update the rationale for exercise? Journal of Applied Physiology (1985), 105(2), 766-768. doi: 10.1152/japplphysiol.01028.2007
Guzzetti, S., La Rovere, M. T., Pinna, G. D., Maestri, R., Borroni, E., Porta, A., . . . Malliani, A. (2005). Different spectral components of 24 h heart rate variability are related to different modes of death in chronic heart failure. European Heart Journal, 26(4), 357-362. doi: 10.1093/eurheartj/ehi067
Hagberg, J. M., Park, J. J., & Brown, M. D. (2000). The role of exercise training in the treatment of hypertension: an update. Sports Medicine, 30(3), 193-206.
Hall, M., Vasko, R., Buysse, D., Ombao, H., Chen, Q., Cashmere, J. D., . . . Thayer, J. F. (2004). Acute stress affects heart rate variability during sleep. Psychosomatic Medicine, 66(1), 56-62.
Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. (1996). Circulation, 93(5), 1043-1065.
Hoikkala, H., Haapalahti, P., Viitasalo, M., Vaananen, H., Sovijarvi, A. R., Ylikorkala, O., & Mikkola, T. S. (2010). Association between vasomotor hot flashes and heart rate variability in recently postmenopausal women. Menopause, 17(2), 315-320. doi: 10.1097/gme.0b013e3181c2bb6d
Huang, W. T., Chen, C. H., Chang, Y. J., Chen, Y. Y., Huang, J. L., Yang, C. M., & Yang, T. L. (2008). Exquisite textiles sensors and wireless sensor network device for home health care. Conference of the IEEE Engineering in Medicine & Biology Society, 2008, 546-549. doi: 10.1109/IEMBS.2008.4649211
Huston, T. P., Puffer, J. C., & Rodney, W. M. (1985). The athletic heart syndrome. The New England Journal of Medicine , 313(1), 24-32. doi: 10.1056/NEJM198507043130106
Imeri, L., & Opp, M. R. (2009). How (and why) the immune system makes us sleep. Nature Reviews Neuroscience , 10(3), 199-210. doi: 10.1038/nrn2576
Joffe, H., Massler, A., & Sharkey, K. M. (2010). Evaluation and management of sleep disturbance during the menopause transition. Seminars in Reproductive Medicine , 28(5), 404-421. doi: 10.1055/s-0030-1262900
Jovanov, E., Milenkovic, A., Otto, C., & de Groen, P. C. (2005). A wireless body area network of intelligent motion sensors for computer assisted physical rehabilitation. Journal of NeuroEngineering & Rehabilitation, 2(1), 6. doi: 10.1186/1743-0003-2-6
Julius, S. (1991). Autonomic nervous system dysregulation in human hypertension. American Journal of Cardiology, 67(10), 3B-7B.
Kamel, N. S., & Gammack, J. K. (2006). Insomnia in the elderly: cause, approach, and treatment. American Journal of Medicine, 119(6), 463-469. doi: 10.1016/j.amjmed.2005.10.051
King, A. C., Oman, R. F., Brassington, G. S., Bliwise, D. L., & Haskell, W. L. (1997). Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. Journal of the American Medical Association , 277(1), 32-37.
King, A. C., Pruitt, L. A., Woo, S., Castro, C. M., Ahn, D. K., Vitiello, M. V., . . . Bliwise, D. L. (2008). Effects of moderate-intensity exercise on polysomnographic and subjective sleep quality in older adults with mild to moderate sleep complaints. Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 63(9), 997-1004.
Kuo, T. B., Shaw, F. Z., Lai, C. J., Lai, C. W., & Yang, C. C. (2004). Changes in sleep patterns in spontaneously hypertensive rats. Sleep, 27(3), 406-412.
Lee, J. O., Kang, S. G., Kim, S. H., Park, S. J., & Song, S. W. (2011). The Relationship between Menopausal Symptoms and Heart Rate Variability in Middle Aged Women. Korean Journal of Family Medicine, 32(5), 299-305. doi: 10.4082/kjfm.2011.32.5.299
Padilla, J., Wallace, J. P., & Park, S. (2005). Accumulation of physical activity reduces blood pressure in pre- and hypertension. Medicine & Science in Sports and Exercise, 37(8), 1264-1275.
Parry, B. L. (2007). Sleep disturbances at menopause are related to sleep disorders and anxiety symptoms. Menopause, 14(5), 812-814. doi: 10.1097/gme.0b013e318127188b
Player, M. S., King, D. E., Mainous, A. G., 3rd, & Geesey, M. E. (2007). Psychosocial factors and progression from prehypertension to hypertension or coronary heart disease. Annals of Family Medicine, 5(5), 403-411. doi: 10.1370/afm.738
Reid, K. J., Baron, K. G., Lu, B., Naylor, E., Wolfe, L., & Zee, P. C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Medicine , 11(9), 934-940. doi: 10.1016/j.sleep.2010.04.014
Sawka, M. N., Convertino, V. A., Eichner, E. R., Schnieder, S. M., & Young, A. J. (2000). Blood volume: importance and adaptations to exercise training, environmental stresses, and trauma/sickness. Medicine & Science in Sports and Exercise, 32(2), 332-348.
Schultz, M. G., Otahal, P., Cleland, V. J., Blizzard, L., Marwick, T. H., & Sharman, J. E. (2013). Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: a systematic review and meta-analysis. American Journal of Hypertension , 26(3), 357-366. doi: 10.1093/ajh/hps053
Soares, C. N., Arsenio, H., Joffe, H., Bankier, B., Cassano, P., Petrillo, L. F., & Cohen, L. S. (2006). Escitalopram versus ethinyl estradiol and norethindrone acetate for symptomatic peri- and postmenopausal women: impact on depression, vasomotor symptoms, sleep, and quality of life. Menopause, 13(5), 780-786. doi: 10.1097/01.gme.0000240633.46300.fa
Tamura, T., Mizukura, I., Sekine, M., & Kimura, Y. (2011). Monitoring and evaluation of blood pressure changes with a home healthcare system. The IEEE Transactions on Information Technology in Biomedicine, 15(4), 602-607. doi: 10.1109/TITB.2011.2156804
Thurston, R. C., Blumenthal, J. A., Babyak, M. A., & Sherwood, A. (2006). Association between hot flashes, sleep complaints, and psychological functioning among healthy menopausal women. International Journal of Behavioral Medicine, 13(2), 163-172. doi: 10.1207/s15327558ijbm1302_8
Tulppo, M. P., Makikallio, T. H., Seppanen, T., Laukkanen, R. T., & Huikuri, H. V. (1998). Vagal modulation of heart rate during exercise: effects of age and physical fitness. American Journal of Physiology , 274(2 Pt 2), H424-429.
Vgontzas, A. N., Liao, D., Bixler, E. O., Chrousos, G. P., & Vela-Bueno, A. (2009). Insomnia with objective short sleep duration is associated with a high risk for hypertension. Sleep, 32(4), 491-497.
Vogel, G. W., Buffenstein, A., Minter, K., & Hennessey, A. (1990). Drug effects on REM sleep and on endogenous depression. Neuroscience & Biobehavioral Reviews , 14(1), 49-63.
Wallace, J. P. (2003). Exercise in hypertension. A clinical review. Sports Medicine, 33(8), 585-598.
Yanagimoto, S., Kuwahara, T., Zhang, Y., Koga, S., Inoue, Y., & Kondo, N. (2003). Intensity-dependent thermoregulatory responses at the onset of dynamic exercise in mildly heated humans. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology , 285(1), R200-207. doi: 10.1152/ajpregu.00549.2002
Yang, P. Y., Ho, K. H., Chen, H. C., & Chien, M. Y. (2012). Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. Journal of Physiotherapy, 58(3), 157-163. doi: 10.1016/S1836-9553(12)70106-6
Yildirir, A., Kabakci, G., Yarali, H., Aybar, F., Akgul, E., Bukulmez, O., . . . Oto, A. (2001). Effects of hormone replacement therapy on heart rate variability in postmenopausal women. Annals of Noninvasive Electrocardiology , 6(4), 280-284.
Youngstedt, S. D., O'Connor, P. J., & Dishman, R. K. (1997). The effects of acute exercise on sleep: a quantitative synthesis. Sleep, 20(3), 203-214.