تاثير پروتكل تمرين نظارت شده در خانه بر شاخص هاي قلبي تنفسي و عملكرد بدني جانبازان استان مازندران

The Effect of Home-Based Monitored Exercise Protocol on Cardiorespiratory Parameters and Physical Function of Veterans in Mazandaran Province

اﺳﺘﺮس زﻧﺪﮔﯽ روزﻣﺮه و ﺑﯽﺗﺤﺮﮐﯽ ﺳﺎﻟﻤﻨﺪي ﺑﺮ دﺳﺘﮕﺎه ﻗﻠﺒﯽ ﻋﺮوﻗﯽ اﺛﺮﮔﺬار اﺳﺖ. ﻫﺪف ﻣﻄﺎﻟﻌﮥ ﺣﺎﺿﺮ ﺑﺮرﺳﻰ ﺗﺄﺛﯿﺮ ﭘﺮوﺗﮑﻞ ﺗﻤﺮﯾﻦ ﻧﻈﺎرتﺷﺪه در ﺧﺎﻧﻪ )HBME( ﺑﺮ ﺷﺎﺧﺺﻫﺎي ﻗﻠﺒﯽ ﺗﻨﻔﺴﯽ و ﻋﻤﻠﮑﺮد ﺑﺪﻧﯽ ﺟﺎﻧﺒﺎزان اﺳﺘﺎن ﻣﺎزﻧﺪران ﺑﻮد. ﺑﻪﻋﻼوه، ارﺗﺒﺎط Vo2peak ﺣﺎﺻﻞ از ﺑﺮوس اﺻﻼحﺷﺪه و راﮐﭙﻮرت ﺑﺎ ﺣﺎﺻﻞﺿﺮب دوﮔﺎﻧﻪ و ﭘﺎﻟﺲ اﮐﺴﯿﮋن ﻧﯿﺰ ﺑﺮرﺳﯽ ﺷﺪ. در اﯾﻦ ﻣﻄﺎﻟﻌﮥ ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ 120 ﻧﻔﺮ از ﺟﺎﻧﺒﺎزان 25-49 درﺻﺪ ﺗﺮوﻣﺎﯾﯽ ﺑﻪﻃﻮر ﺗﺼﺎدﻓﯽ ﺑﻪ ﮔﺮوهﻫﺎي ﻣﺪاﺧﻠﮥ ورزﺷﯽ و ﮐﻨﺘﺮل ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﺑﺮﻧﺎﻣﮥ ﺗﻤﺮﯾﻨﺎت ﻫﻮازي و ﻣﻘﺎوﻣﺘﯽ ﺑﻪ ﻣﺪت 8 ﻫﻔﺘﻪ و ﺑﻪﺗﺮﺗﯿﺐ 4 و 2 روز در ﻫﻔﺘﻪ در ﺧﺎﻧﻪ اﺟﺮا ﺷﺪ. ﺷﺎﺧﺺﻫﺎي ﻗﻠﺒﯽ ﻋﺮوﻗﯽ )Vo2peak ﺑﺮوس، Vo2peak راﮐﭙﻮرت، ﻓﺸﺎر ﺧﻮن، ﺿﺮﺑﺎن ﻗﻠﺐ، ﺣﺎﺻﻞﺿﺮب دوﮔﺎﻧﻪ و ﭘﺎﻟﺲ اﮐﺴﯿﮋن( و ﻋﻤﻠﮑﺮد ﺑﺪﻧﯽ )ﻗﺪرت اﻧﺪام ﻓﻮﻗﺎﻧﯽ و ﺗﺤﺘﺎﻧﯽ، ﺗﻌﺎدل و اﻧﻌﻄﺎفﭘﺬﯾﺮي( ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮنﻫﺎي ﻣﯿﺪاﻧﯽ و آزﻣﺎﯾﺸﮕﺎﻫﯽ در اﺑﺘﺪا و اﻧﺘﻬﺎي دورة ﺗﺤﻘﯿﻖ اﻧﺪازهﮔﯿﺮي ﺷﺪﻧﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از t ﺗﺴﺖ و ﻫﻤﺒﺴﺘﮕﯽ ﭘﯿﺮﺳﻮن ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. اﺟﺮاي 8 ﻫﻔﺘﻪ ﺗﻤﺮﯾﻦ ﺗﺮﮐﯿﺒﯽ ﻧﻈﺎرتﺷﺪه در ﺧﺎﻧﻪ ﺑﻪ ﺑﻬﺒﻮد ﻣﻌﻨﺎدار ﻣﻘﺎدﯾﺮ VO2 ﺑﺮوس، VO2 راﮐﭙﻮرت، ﻗﺪرت ﺑﺎﻻﺗﻨﻪ و ﭘﺎﯾﯿﻦﺗﻨﻪ، ﺗﻌﺎدل، اﻧﻌﻄﺎفﭘﺬﯾﺮي و ﺣﺎﺻﻞﺿﺮب دوﮔﺎﻧﮥ ﮔﺮوه ﺗﻤﺮﯾﻨﯽ در ﻣﻘﺎﯾﺴﻪ ﺑﺎ ﭘﯿﺶآزﻣﻮن ﻣﻨﺠﺮ ﺷﺪ )0/001≤ P(. ﺗﻐﯿﯿﺮات Vo2 راﮐﭙﻮرت و ﻓﺸﺎر ﺧﻮن ﺳﯿﺴﺘﻮﻟﯿﮏ ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل ﻣﻌﻨﺎدار و ﺗﻐﯿﯿﺮات ﻗﺪرت ﺑﺎﻻﺗﻨﻪ و ﺿﺮﺑﺎن ﻗﻠﺐ اﺳﺘﺮاﺣﺘﯽ ﻧﯿﺰ ﺑﻪ ﻣﻘﺪار ﻣﻌﻨﺎداري ﻧﺰدﯾﮏ ﺑﻮد. ﺑﻪﻋﻼوه، ﻫﻤﺒﺴﺘﮕﯽ ﻣﻨﻔﯽ ﺑﺎﻻ و ﻣﻌﻨﺎداري ﺑﯿﻦ VO2 ﺑﺮوس و راﮐﭙﻮرت ﺑﺎ ﭘﺎﻟﺲ اﮐﺴﯿﮋن ﻣﺸﺎﻫﺪه ﺷﺪ )ﻣﻘﺪار r ﺑﻪﺗﺮﺗﯿﺐ ﺑﺮاﺑﺮ اﺳﺖ ﺑﺎ 0/926- و 0/335(. ﺑﻪﻃﻮر ﮐﻠﯽ ﻣﯽﺗﻮان ﻧﺘﯿﺠﻪ ﮔﺮﻓﺖ ﮐﻪ اﺟﺮاي ﭘﺮوﺗﮑﻞ ﺗﻤﺮﯾﻨﯽ ﻧﻈﺎرتﺷﺪه در ﺧﺎﻧﻪ از ﻃﺮﯾﻖ ﺑﻬﺒﻮد آﻣﺎدﮔﯽ ﻗﻠﺒﯽ ﺗﻨﻔﺴﯽ و ﻋﻀﻼﻧﯽ ﻣﻤﮑﻦ اﺳﺖ ﻣﻮﺟﺐ ﮐﺎﻫﺶ اﺳﺘﺮس ﻣﯿﻮﮐﺎرد و ﻫﻤﯿﻦﻃﻮر ارﺗﻘﺎي ﻋﻤﻠﮑﺮد ﺑﺪﻧﯽ و ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ در ﺟﺎﻧﺒﺎزان ﺷﻮد

The stress of everyday life and sedentary aging affect the cardiovascular system. The aim of this study was to investigate the effect of home-based monitored exercise protocol (HBME) on cardiorespiratory parameters and physical function of veterans in Mazandaran province. In addition, the relationship of Vo2peak resulting from modified Bruce and Rockport with double product and oxygen pulse was investigated. In this clinical trial study, 120 veterans (25-49% trauma) were randomly divided into intervention and control groups. Aerobic and resistance training programs were performed at home for 8 weeks and 4 and 2 days a week respectively. Cardiovascular parameters (Bruce VO2peak, Rockport VO2peak, blood pressure, heart rate, double product, and oxygen pulse) and physical function (upper and lower trunk strength, balance and flexibility) were measured by field and laboratory tests at the beginning and the end of the study. Data were analyzed using t test and Pearson correlation. 8 weeks of home-based monitored exercise significantly improved Bruce VO2, Rockport VO2, upper and lower trunk strength, balance, flexibility and double product of the training group compared with the pretest (P≤0.001). Rockport VO2 and systolic blood pressure changes were significant compared with the control group and changes in upper trunk strength and resting heart rate were also significantly closer. In addition, there was a significant, high and negative correlation between the Bruce and Rockport VO2 and the oxygen pulse (r= -0.926, r= -0.335). It can be generally concluded that home-based monitored exercise protocol may reduce myocardial stress and also improve physical function and quality of life in veterans through improving cardiorespiratory and muscular fitness.