Primerjava učinkovitosti kontinuirane in visoko intenzivne intervalne aerobne vadbe za izboljšanje aerobne kapacitete in ostalih kazalnikov srčno-žilnega zdravja pri bolnikih po srčnem infarktu : magistrsko delo

Piculin, Jana (author), Kacin, Alan (mentor), Jug, Borut (comentor)

Uvod: Zaradi napredka v akutnem zdravljenju miokardnega infarkta vse več bolnikov dogodek preživi. Za izboljšanje kakovosti njihovega življenja in zmanjšanje tveganja za ponovni infarkt je ključnega pomena sekundarna preventiva, ki jo izvajamo v okviru rehabilitacije srčno-žilnih bolnikov. Pomembna komponenta rehabilitacije je strukturiran program telesne vadbe, saj izboljšanje aerobne kapacitete dokazano zmanjša tveganje za umrljivost. Visoko intenzivna intervalna vadba se zaradi dobrih učinkov pri zdravih ljudeh vedno bolj vključuje tudi v fizioterapijo srčno-žilnih bolnikov, vendar njena učinkovitost in varnost še nista zadovoljivo raziskani. Namen: Primerjati učinkovitost visoko intenzivne intervalne in kontinuirane aerobne vadbe za izboljšanje aerobne in delovne kapacitete, avtonomne srčne funkcije in kakovosti življenja bolnikov po infarktu ter na podlagi neželenih dogodkov sklepati o varnosti vadbe. Metode: 45 bolnikov smo naključno razporedili v dve skupini. Vsi so opravili 36 vadbenih enot, v eni skupini so izvajali visoko intenzivno intervalno, v drugi kontinuirano aerobno vadbo. Pred začetkom in po koncu vadbenega programa so bolniki opravili kardio-pulmonalno obremenitveno testiranje, med katerim smo izmerili največjo porabo kisika, porabo kisika pri anaerobnem pragu in največjo izhodno moč. Po zaključenem testu smo merili padec srčne frekvence. Bolniki so izpolnili HeartQol vprašalnik kakovosti življenja. Beležili smo vse neželene dogodke. Rezultati: Pri bolnikih obeh skupin je z vadbo prišlo do statistično pomembnega izboljšanja aerobne kapacitete, izhodne moči in kakovosti življenja. Med skupinama ni bilo statistično pomembnih razlik. Poraba kisika pri anaerobnem pragu in padec srčne frekvence v prvi minuti se v nobeni skupini nista statistično pomembno spremenila. Padec srčne frekvence v tretji minuti se je statistično pomembno izboljšal v skupini, ki je izvajala kontinuirano vadbo, ni pa bilo pomembne razlike med skupinama. Pri nobenem bolniku med vadbo ali neposredno po njej ni prišlo do pomembnega srčno-žilnega dogodka. Razprava in zaključek: Podoben napredek bolnikov obeh skupin lahko pripišemo individualnemu prilagajanju vadbe, zaradi česar sta skupini izvajali vadbo primerljive povprečne intenzitete. Oba vadbena protokola sta varna, odprto pa ostaja vprašanje primernosti visoko intenzivne intervalne vadbe za vse skupine bolnikov, ki so vključeni v rehabilitacijo srčno-žilnih bolnikov.

• Language: Slovenian
• Keywords: kontinuirana vadba, visoko intenzivna intervalna vadba, aerobna kapaciteta, srčno-žilno zdravje, srčni infarkt
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-113196
• COBISS.SI-ID: 5750123
• Publication date in RUL: 12.12.2019

Secondary language

• Language: English
• Title: A comparison of the efficacy of continuous and high-intensity interval training for the improvement of aerobic capacity and other cardiovascular health indicators in patients with acute myocardial infarction : master's thesis

Abstract

Introduction: More and more patients survive myocardial infarction due to the progress in acute management. Secondary prevention carried out in cardiac rehabilitation programs plays an important role in the improvement of the quality of life and risk management in these patients. The key component of cardiac rehabilitation is exercise training, as improvement of the aerobic capacity leads to a reduction of mortality. Due to its effectiveness in healthy populations, high intensity interval training is being increasingly used in cardiac rehabilitation setting, although its effectiveness and safety have not yet been researched enough. Purpose: To compare the effectiveness of high intensity interval training and continuous training for improvement of the aerobic and working capacities, cardiac autonomic function and quality of life in patients after acute myocardial infarction. To record adverse events and infer about the safety of training modalities. Methods: 45 patients were included and randomly assigned to either the high intensity interval training group or the continuous one. They all carried out 36 training sessions. Before and after the training program, a cardiac stress test was performed to obtain the data about peak oxygen uptake, oxygen uptake at the anaerobic threshold and maximal power output. After the test had been finished, heart rate reduction was recorded. The Heart QOL questionnaire was filled in by the participants before and after the interventon. All the adverse events were recorded. Results: There was statistically significant improvement of aerobic capacity, power output and quality of life in both training groups. There were no significant differences between the groups. Oxygen uptake and heart rate recovery in the first minute remained unchanged in both groups. Heart rate recovery in the third minute improved in the continuous training group. The difference between the groups was not statistically significant. No cardiovascular adverse events occurred during or immediately after training. Conclusions: Similar improvement of both training groups can be attributed to an individual adjustment of training intensity to the patients’ abilities. Therefore, both groups trained at similar mean intensities. Both training protocols seem safe, but the question remains whether high intensity interval training is suitable for all patient groups entering cardiac rehabilitation.

• Keywords: continuous training, high-intensity interval training, aerobic capacity, cardiovascular health, acute myocardial infarction