跳到主要內容

臺灣博碩士論文加值系統

(3.231.230.177) 您好!臺灣時間:2021/07/28 23:31
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:曾凱揚
研究生(外文):Kai-Yang Tseng
論文名稱:超級馬拉松運動後低血壓相關影響因子之探討
論文名稱(外文):The influencing factors of post-exercise hypotension after ultramarathon running
指導教授:陳俊忠陳俊忠引用關係
指導教授(外文):Jin-Jong Chen
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:物理治療暨輔助科技學系
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:125
中文關鍵詞:超級馬拉松運動後低血壓姿勢性低血壓
外文關鍵詞:ultramarathonpost-exercise hypotensionpostural hypotension
相關次數:
  • 被引用被引用:1
  • 點閱點閱:362
  • 評分評分:
  • 下載下載:79
  • 收藏至我的研究室書目清單書目收藏:1
背景: 近十幾年來,隨著參與馬拉松運動人口的增加,促使一些研究轉向運動後生理數值變化以及影響健康情形方向的探討。但相較於馬拉松,超級馬拉松為一項更激烈的運動項目,對於人體所造成的損傷、生理衝擊與影響將更為深遠。然而,卻鮮少針對台灣超級馬拉松選手比賽中與運動後損傷做相關性的研究與探討。在眾多運動相關生理變化中,運動後低血壓一直被認為是有氧耐力型運動後所伴隨而來之健康增益的效果,但是運動後血壓過度下降或甚至造成姿勢性低血壓,則有可能導致選手暈眩、跌倒進而造成頭頸部之損傷。但過去也極少文獻針對超級馬拉松賽事與環境因素之間的互動關係,做較深入的連續觀察與分析探討。因此,本研究的目的為:(1)探討超級馬拉松運動後,選手產生低血壓、姿勢性低血壓以及一些運動傷害的情形。(2)比較選手運動過程中體重、體溫(耳溫)、運動表現及環境條件之間的相關性。方法: 本研究總共招募35位有經驗之超級馬拉松選手,其中19位參加12小時組,16位參加24小時組超級馬拉松比賽。所有的選手在賽前及賽後都會填寫一份家族疾病史、損傷以及訓練量等相關調查問卷。此外,休息時坐著與站著的血壓及心跳也分別會在賽前與賽後測量紀錄,進而換算運動後低血壓與改變量的情形。姿勢變換時所造成之姿勢性低血壓,在賽前與賽後也都會分別計算與記錄。至於選手的體溫(耳溫)與體重部份,除了賽前與賽後會進行測量外,在賽中每隔四小時 (相當於選手在改變跑步方向時) 也會分別測量與記錄。此外,在比賽操場旁亦會設置一環境條件監測器,詳細記錄比賽過程中每一分鐘的環境條件。結果: 在12小時組中,體溫過低的比率為73.68%,脫水比率為78.95%,而在24小時組中,體溫過低的比率為37.5%,且所有的選手都有發生過脫水的情形。在12小時組中,體重在比賽開始後直到結束時都有顯著性下降之情形;然而,在24小時組方面,體重只有在比賽開始後的前八個小時與最後八小時有顯著性下降。至於體溫方面,12小時組在比賽開始後第四到第八小時有顯著性下降,24小時組則是在比賽開始後第八到第二十小時有顯著性下降。收縮壓、舒張壓與平均動脈壓在12小時以及24小時超級馬拉松運動後都有顯著性降低。在兩組參賽者中有超過93%的選手皆發生運動後低血壓的情形,而12小時組選手中有嚴重運動後低血壓者為57.9%,24小時組則為43.8%。在賽前發生姿勢性低血壓的比例為45.7%,而賽後則增為54.3%。在賽後共有31.43%的選手進入醫護站 (其中包含2位12小時組選手,9位24小時組選手)。至於成績表現方面,只有年齡、身體質量指數以及每周練習量與完成公里數有中等程度相關。結論:由此研究資料顯示,兩組在比賽過程中體重與體溫皆有顯著性地下降。12小時超級馬拉松與24小時超級馬拉松運動,對於血壓的影響與變化差異不大,但是所有血壓在賽後都有顯著性地下降。總共在賽後有31%參賽者進入醫護站接受照護,主要損傷除了下肢肌肉骨骼問題外,尚有腸胃道不適、暈眩、脫水及發寒等症狀。而總完成距離則與年齡、身體質量指數以及每周練習公里數呈現中度正相關性。
Background: Increasing participation in marathons in recent decades has stimulated researches into physiologic changes and possible health complications during these events. Comparing to marathon, ultramarathon is an extremely stressful exercise which may cause profound physiological changes or damages to the runners. However, there were few studies concerning about the injuries and health problems during or after the ultramarathon running. The post-exercise hypotension (PEH), one of the most exercise-related physiological changes, has been considered as a health promotion benefit of aerobic exercises; however, dramatic PEH and postural hypotension which may cause falls and head injuries have been reported after ultramarathon. There were deficient studies discussing in depth with the relationships between the physiological stresses, damages and the environmental conditions throughout an ultramarathon competition. Thus, the purposes of the this study were to: (1) investigate the prevalence of post-exercise hypotension (PEH), postural hypotension and exercise-related injuries and health problems after the ultramarathon competition; (2) investigate the relationships between the body weight (BW), tympanic temperature, exercise performance and environmental conditions of the ultramarathon runners during the competition. Methods: Thirty five experienced ultramarathon runners were recruited, 19 subjects participating in the 12 hours ultramarathon racing (12-H) and 16 subjects participating in the 24 hours ultramarathon racing (24-H). All the subjects filled in injuries, health problems and family history questionnaires before and after the race. The static sitting and standing blood pressures and heart rates measured before and immediate after the race were recorded, and the post-exercise hypotension (PEH) was calculated afterward. The prevalence of postural hypotension was also measured before and after the race. Tympanic temperature and total body weight in all subjects were recorded before the race, every four hours during the race, and immediately after the race. Besides, the weather conditions were also recorded at minute intervals throughout the race. Results: The prevalence of hypothermia and dehydration were 73.68% and 78.95% in the 12-h group, and 37.5% and 100% in the 24-H group, respectively. The significant decrements of serial body weight throughout the race were found in the 12-H group, however, in the 24-H group, the significant decrements of body weight loss were found only at the first eight hours and the last eight hours. The tympanic temperatures were significant lower at the 4HR to 8HR in the 12-H group and at the 8HR to 20HR in the 24-H group. The systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) significantly decreased in both groups after the ultramarathon races. The prevalence of post-exercise hypotension in both groups was greater than 93%. The prevalence of severe PEH were 57.9% and 43.8% in the 12-H and 24-H groups. As a result, postural hypotension was found in 54.3% of the runners after the race compared to 45.7% before the race. There were 31.43% of runners (two runners in the 12-H group and nine runners in the 24-H group) transferred to the medical tent after the race. Nevertheless, the distances completed by the runners throughout the race were moderate correlated to the age, BMI, and practicing distance per week. Conclusion: The significant decrements of body weight and tympanic temperature throughout the race were found in both groups. The results of this study showed that the blood pressure changes throughout the race were similar in the 12-H and 24-H ultramarathons, and the blood pressures of all runners significantly decreased after the race. Thirty-one percent of the ultramarathon runners were transferred to the medical tent after the race. The main problems sustained during the race were not only the musculoskeletal problems at the lower extremities, but also digestive problems and other kinds of problems such as dizziness, dehydration and chilling. The distances completed by the runners throughout the race were moderate positive correlated to the age, BMI, and practicing distance per week.
TABLE OF CONTENTS ii
ACKNOWLEDGEMENTS iv
LIST OF TABLES vi
LIST OF FIGURES vii
ABSTRACT ix
摘要 xii
CHAPTER ONE 1
CHAPTER TWO 4
CHAPTER THREE 18
3.1 Study design 18
3.2 Subjects 18
3.3 The competition area and medical care 19
3.4 Pre-race health and training characteristic questionnaire and informed consent 20
3.5 Body weight 20
3.6 Tympanic temperature 21
3.7 Blood pressure and heart rate 21
3.8 Environmental condition monitor 22
3.9 Post-race injuries and health problems questionnaire 23
3.10 Statistical analysis 23
CHAPTER FOUR 25
4.1 Basic data 25
4.2 Body weight and tympanic temperature changes before, at every 4 hour intervals and after ultramarathon 26
4.3 Blood pressure and heart rate changes before and after ultramarathons 26
4.4 The distance completed and the average speeds during 12-H and 24-H ultramarathons 28
4.5 The environmental condition changes during the race 29
4.6 Post-race injuries and health problems 29
CHAPTER FIVE 31
5.1 Ultramarathon runners’ anthropometric and training characteristics 31
5.2 Serial body weight changes and the weather conditions throughout the race 33
5.3 Tympanic temperature regulation and the weather conditions 35
5.4 Blood pressure changes before and after the race 37
5.5 The influencing factors of ultramarathon performance and post-exercise injuries and health problems 41
5.6 Limitations 42
5.7 Future works 43
5.8 Conclusion and clinical relevance 43
REFERENCES 46
APPENDICES 103
1. Satterthwaite P, Norton R, Larmer P, Robinson E. Risk factors for injuries and other health problems sustained in a marathon. Br J Sports Med Feb 1999;33(1):22-26.
2. Sanchez LD, Corwell B, Berkoff D. Medical problems of marathon runners. Am J Emerg Med Sep 2006;24(5):608-615.
3. Ewert GD. Marathon race medical administration. Sports Med 2007;37(4-5):428-430.
4. Kenefick RW, Sawka MN. Heat exhaustion and dehydration as causes of marathon collapse. Sports Med 2007;37(4-5):378-381.
5. Redelmeier DA, Greenwald JA. Competing risks of mortality with marathons: retrospective analysis. BMJ Dec 22 2007;335(7633):1275-1277.
6. 邱榮基, 畢璐鑾. 探討台灣馬拉松運動之發展. 大專體育 2005;80:54-61.
7. Hutson MA. Medical implications of ultra marathon running: observations on a six day track race. Br J Sports Med Mar 1984;18(1):44-45.
8. Koopman R, Pannemans DL, Jeukendrup AE, et al. Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise. Am J Physiol Endocrinol Metab Oct 2004;287(4):E712-720.
9. Skenderi KP, Kavouras SA, Anastasiou CA, Yiannakouris N, Matalas AL. Exertional Rhabdomyolysis during a 246-km continuous running race. Med Sci Sports Exerc Jun 2006;38(6):1054-1057.
10. Hew TD, Chorley JN, Cianca JC, Divine JG. The incidence, risk factors, and clinical manifestations of hyponatremia in marathon runners. Clin J Sport Med Jan 2003;13(1):41-47.
11. Laursen PB, Suriano R, Quod MJ, et al. Core temperature and hydration status during an Ironman triathlon. Br J Sports Med Apr 2006;40(4):320-325; discussion 325.
12. Hew-Butler T, Sharwood K, Boulter J, et al. Dysnatremia predicts a delayed recovery in collapsed ultramarathon runners. Clin J Sport Med Jul 2007;17(4):289-296.
13. Forjaz CL, Matsudaira Y, Rodrigues FB, Nunes N, Negrao CE. Post-exercise changes in blood pressure, heart rate and rate pressure product at different exercise intensities in normotensive humans. Braz J Med Biol Res Oct 1998;31(10):1247-1255.
14. MacDonald JR, Hogben CD, Tarnopolsky MA, MacDougall JD. Post exercise hypotension is sustained during subsequent bouts of mild exercise and simulated activities of daily living. J Hum Hypertens Aug 2001;15(8):567-571.
15. Colivicchi F, Ammirati F, Biffi A, Verdile L, Pelliccia A, Santini M. Exercise-related syncope in young competitive athletes without evidence of structural heart disease. Clinical presentation and long-term outcome. Eur Heart J Jul 2002;23(14):1125-1130.
16. Naschitz JE, Rosner I. Orthostatic hypotension: framework of the syndrome. Postgrad Med J Sep 2007;83(983):568-574.
17. 林孟賢. 國際與台灣超級馬拉松的發展現況. 大專體育 2005;81:61-68.
18. Roberts WO. A 12-yr profile of medical injury and illness for the Twin Cities Marathon. Med Sci Sports Exerc Sep 2000;32(9):1549-1555.
19. 邱榮基, 蔚順華. 馬拉松長跑選手的運動猝死. 大專體育 2005;76:210-214.
20. Place N, Lepers R, Deley G, Millet GY. Time course of neuromuscular alterations during a prolonged running exercise. Med Sci Sports Exerc Aug 2004;36(8):1347-1356.
21. Tokudome S, Kuriki K, Yamada N, et al. Anthropometric, lifestyle and biomarker assessment of Japanese non-professional ultra-marathon runners. J Epidemiol Sep 2004;14(5):161-167.
22. Cheuvront SN, Haymes EM. Thermoregulation and marathon running: biological and environmental influences. Sports Med 2001;31(10):743-762.
23. Pascoe DD, Shanley LA, Smith EW. Clothing and exercise. I: Biophysics of heat transfer between the individual, clothing and environment. Sports Med Jul 1994;18(1):38-54.
24. Mundel T, King J, Collacott E, Jones DA. Drink temperature influences fluid intake and endurance capacity in men during exercise in a hot, dry environment. Exp Physiol Sep 2006;91(5):925-933.
25. Ely MR, Cheuvront SN, Roberts WO, Montain SJ. Impact of weather on marathon-running performance. Med Sci Sports Exerc Mar 2007;39(3):487-493.
26. Gonzalez-Alonso J. Hyperthermia impairs brain, heart and muscle function in exercising humans. Sports Med 2007;37(4-5):371-373.
27. Kenny GP, Periard J, Journeay WS, Sigal RJ, Reardon FD. Effect of exercise intensity on the postexercise sweating threshold. J Appl Physiol Dec 2003;95(6):2355-2360.
28. Mekjavic IB, Eiken O. Contribution of thermal and nonthermal factors to the regulation of tympanic temperature in humans. J Appl Physiol Jun 2006;100(6):2065-2072.
29. Armstrong LE, Casa DJ, Millard-Stafford M, Moran DS, Pyne SW, Roberts WO. American College of Sports Medicine position stand. Exertional heat illness during training and competition. Med Sci Sports Exerc Mar 2007;39(3):556-572.
30. Coyle EF. Physiological regulation of marathon performance. Sports Med 2007;37(4-5):306-311.
31. Byrne C, Lee JK, Chew SA, Lim CL, Tan EY. Continuous thermoregulatory responses to mass-participation distance running in heat. Med Sci Sports Exerc May 2006;38(5):803-810.
32. Saunders PU, Pyne DB, Telford RD, Hawley JA. Factors affecting running economy in trained distance runners. Sports Med 2004;34(7):465-485.
33. Sawka MN, Noakes TD. Does dehydration impair exercise performance? Med Sci Sports Exerc Aug 2007;39(8):1209-1217.
34. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc Feb 2007;39(2):377-390.
35. Kao WF, Shyu CL, Yang XW, et al. Athletic performance and serial weight changes during 12- and 24-hour ultra-marathons. Clin J Sport Med Mar 2008;18(2):155-158.
36. Baker LB, Dougherty KA, Chow M, Kenney WL. Progressive dehydration causes a progressive decline in basketball skill performance. Med Sci Sports Exerc Jul 2007;39(7):1114-1123.
37. Hsieh M, Roth R, Davis DL, Larrabee H, Callaway CW. Hyponatremia in runners requiring on-site medical treatment at a single marathon. Med Sci Sports Exerc Feb 2002;34(2):185-189.
38. Oliver SJ, Laing SJ, Wilson S, Bilzon JL, Walsh N. Endurance running performance after 48 h of restricted fluid and/or energy intake. Med Sci Sports Exerc Feb 2007;39(2):316-322.
39. Achten J, Halson SL, Moseley L, Rayson MP, Casey A, Jeukendrup AE. Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state. J Appl Physiol Apr 2004;96(4):1331-1340.
40. Utter AC, Kang J, Robertson RJ, et al. Effect of carbohydrate ingestion on ratings of perceived exertion during a marathon. Med Sci Sports Exerc Nov 2002;34(11):1779-1784.
41. Dujic Z, Ivancev V, Valic Z, et al. Postexercise hypotension in moderately trained athletes after maximal exercise. Med Sci Sports Exerc Feb 2006;38(2):318-322.
42. MacDonald JR. Potential causes, mechanisms, and implications of post exercise hypotension. J Hum Hypertens Apr 2002;16(4):225-236.
43. Halliwill JR. Mechanisms and clinical implications of post-exercise hypotension in humans. Exerc Sport Sci Rev Apr 2001;29(2):65-70.
44. Fu Q, Witkowski S, Levine BD. Vasoconstrictor reserve and sympathetic neural control of orthostasis. Circulation Nov 2 2004;110(18):2931-2937.
45. Pricher MP, Holowatz LA, Williams JT, Lockwood JM, Halliwill JR. Regional hemodynamics during postexercise hypotension. I. Splanchnic and renal circulations. J Appl Physiol Dec 2004;97(6):2065-2070.
46. Wilkins BW, Minson CT, Halliwill JR. Regional hemodynamics during postexercise hypotension. II. Cutaneous circulation. J Appl Physiol Dec 2004;97(6):2071-2076.
47. Lockwood JM. Postexercise hypotension is not explained by a prostaglandin-dependent peripheral vasodilation. J Appl Physiol 2005;98:447-453.
48. Williams JT, Pricher MP, Halliwill JR. Is postexercise hypotension related to excess postexercise oxygen consumption through changes in leg blood flow? J Appl Physiol Apr 2005;98(4):1463-1468.
49. Holtzhausen LM, Noakes TD. The prevalence and significance of post-exercise (postural) hypotension in ultramarathon runners. Med Sci Sports Exerc Dec 1995;27(12):1595-1601.
50. MacDonald J. Post exercise hypotension is not mediated by the serotonergic system in borderline hypertensive individuals. J Hum Hypertens 2002;16:33-39.
51. MacDonald JR, MacDougall JD, Hogben CD. The effects of exercise duration on post-exercise hypotension. J Hum Hypertens Feb 2000;14(2):125-129.
52. Franklin PJ, Green DJ, Cable NT. The influence of thermoregulatory mechanisms on post-exercise hypotension in humans. J Physiol Oct 1993;470:231-241.
53. Senitko AN, Charkoudian N, Halliwill JR. Influence of endurance exercise training status and gender on postexercise hypotension. J Appl Physiol Jun 2002;92(6):2368-2374.
54. MacDonald J, MacDougall J, Hogben C. The effects of exercise intensity on post exercise hypotension. J Hum Hypertens Aug 1999;13(8):527-531.
55. MacDonald JR, MacDougall JD, Hogben CD. The effects of exercising muscle mass on post exercise hypotension. J Hum Hypertens May 2000;14(5):317-320.
56. Smith GD, Bannister R, Mathias CJ. Post-exertion dizziness as the sole presenting symptom of autonomic failure. Br Heart J Apr 1993;69(4):359-361.
57. Mathias CJ, Kimber JR. Postural hypotension: causes, clinical features, investigation, and management. Annu Rev Med 1999;50:317-336.
58. Raine NM, Cable NT, George KP, Campbell IG. The influence of recovery posture on post-exercise hypotension in normotensive men. Med Sci Sports Exerc Mar 2001;33(3):404-412.
59. Winker R, Barth A, Bidmon D, et al. Endurance exercise training in orthostatic intolerance: a randomized, controlled trial. Hypertension Mar 2005;45(3):391-398.
60. Fallon KE. The acute phase response and exercise: the ultramarathon as prototype exercise. Clin J Sport Med Jan 2001;11(1):38-43.
61. Millet GY, Lepers R, Maffiuletti NA, Babault N, Martin V, Lattier G. Alterations of neuromuscular function after an ultramarathon. J Appl Physiol Feb 2002;92(2):486-492.
62. Mastaloudis A, Traber MG, Carstensen K, Widrick JJ. Antioxidants did not prevent muscle damage in response to an ultramarathon run. Med Sci Sports Exerc Jan 2006;38(1):72-80.
63. Smith JE, Garbutt G, Lopes P, Pedoe DT. Effects of prolonged strenuous exercise (marathon running) on biochemical and haematological markers used in the investigation of patients in the emergency department. Br J Sports Med Jun 2004;38(3):292-294.
64. Petersen K, Hansen CB, Aagaard P, Madsen K. Muscle mechanical characteristics in fatigue and recovery from a marathon race in highly trained runners. Eur J Appl Physiol Oct 2007;101(3):385-396.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top