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[要旨]回復期心筋梗塞患者に対する筋力トレーニングの安全性を検討するため2つの研究を実施した.第1の研究では,15例の回復期心筋梗塞患者における膝伸展筋の筋力増強運動中の心拍血圧反応について検討した.膝伸展筋の筋力増強運動中の収縮期血圧は,40,60,80% 1 repetition maximum(1RM)いずれの負荷強度においても,嫌気性代謝閾値(AT)レベルの有酸素運動中のそれを上回っていた.しかし,2重積はいずれの負荷強度においてもATレベルの有酸素運動中の値と有意な差を認めなかった.
第2の研究では,実際に筋力トレーニングを回復期心筋梗塞患者に応用した際の不整脈や心筋虚血徴候,心不全徴候の出現率について調査した.対象は筋力トレーニングを併用した運動療法を施行した心筋梗塞患者40例と通常の有酸素トレーニングのみを処方した65例である.有酸素トレーニングはATレベルの心拍数を指標として処方し,筋力トレーニングは60% 1RMの負荷強度で膝伸展筋に対して施行した.不整脈や心筋虚血徴候,心不全徴候の出現率は筋力トレーニングを併用した群で25.0%,筋力トレーニングを併用しなかった群で23.1%と群間に差を認めなかった.また,これらによって運動療法が中止となった症例の比率も筋力トレーニングを併用した群で10.0%,筋力トレーニングを併用しなかった群で9.2%と群間で差を認めなかった.
以上のことから,心筋梗塞患者の回復期においても,負荷強度が40~60% 1RM程度の筋力トレーニングであれば,安全に実施できるものと考えられた.
The present two studies were aimed to investigate safety of weight training in the recovery phase of patients with myocardial infarction.
Study 1 assessed hemodynamic responses during muscle strengthening exercise for the knee extensors in the recovery phase of 15 patients with myocardial infarction. At every load level, i. e., 40%, 60%, 80% of the 1 repetition maximum (1 RM), systolic blood pressure during muscle strengthening exercise was greater than during aerobic exercise at the anaerobic threshold (AT). However, the double product was not significantly different at any load level.
Study 2 investigated the incidence of abnormal cardiovascular responses in the recovery phase of patients with myocardial infarction. Forty patients with myocardial infarction undergoing exercise therapy combined with weight training and 65 patients undergoing usual aerobic training alone served as subjects. Aerobic training was prescribed according to the heart rate at the AT level, and weight training of the knee extensors was carried out at a load level of 60% 1 RM. The incidence of arrhythmias, ischemic changes and heart failure was similar in the two groups : 25.0% in the weight training-combined group and 23.1% in the non-weight training group. Exercise therapy was discontinued because of abnormal cardiovascular responses in 10.0% of the weight training-combined group and 9.2% in the non-weight training group, with no significant differences between them. These results suggest that weight training at 40-60% 1 RM could be safely used for exercise therapy in the recovery phase of patients with myocardial infarction.
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