남성 만성기 허혈성 뇌졸중환자의 운동강도 및 시간에 대한 Poor Fibrinolytic Response

Poor Fibrinolytic Response on a Single Bout Exercise Intensity and Time in Male Chronic Ischemic Stroke Patient

  • 강동연 (대구대학교 대학원 재활과학과) ;
  • 이혜영 (대구대학교 대학원 재활과학과) ;
  • 김경 (대구대학교 재활과학대학 물리치료학과)
  • Kang, Dong-Yeon (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Lee, Hye-Young (Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kim, Kyoung (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 투고 : 2013.07.15
  • 심사 : 2013.08.15
  • 발행 : 2013.08.25

초록

Purpose: The purpose of this case study was to investigate three poor fibrinolytic responders with chronic ischemic stroke to acute exercise intensity and time. Methods: Three ischemic stroke patients (male) from the stroke center located at Busan metropolitan area in Republic of Korea volunteered at this study. They performed two single session exercises that were a VO2peak test and a single bout treadmill walking (70-75%HRpeak, 30 min, 50min). Fasting blood samples for determination of tissue Plasminogen Activator (tPA) and Plasminogen Activator Inhibitor-1 (PAI-1) were obtained before, immediately after, 30min after acute exercise. SPSS 12.0 was used for analyzing of data and computing mean and standard deviation, and change rate was conducted between times. Results: In fibrinolytic activity according to the intensity and time of acute exercise, tPA change increased steadily during the recovery stage after the VO2peak in the cases, but PAI-1 activity showed different patterns among the cases. In a single bout treadmill walking (70-75%HRpeak, 30 min, 50min), tPA change increased between 30min and 50min. Conclusion: In conclusion, these results suggest that the exercise prescription for poor fibrinolytic responder with three male chronic ischemic stroke patients without motor disability recommend at 70-75%HRpeak, over 30min.

키워드

참고문헌

  1. Acil T. Atalar E. Sahiner L. et al. Effects of Acute Exercise on Fibrinolysis and Coagulation in Patients With Coronary Artery Disease. Int heart J. 2007;48(3):277-85. https://doi.org/10.1536/ihj.48.277
  2. El-Sayed, MS. El-Sayed Ali Z., Ahmadizad S. Exercise and Training Effects on Blood Haemostasis in Health and Disease. An Update. Sports Med. 2004;34(3):181-200. https://doi.org/10.2165/00007256-200434030-00004
  3. Li N. He S. Blomback M et al. Platelet Activity, Coagulation, and Fibrinolysis During Exercise in Healthy Males. Effects of Thrombin Inhibitation by Argatroban and Enoxaparin. Aterioscler Thromb Vasc Biol. 2007;27(2):407-13.
  4. DeJong AT. Womack CJ. Perrine JA. et al. Hemostatic Responses to Resistance Training in Patients With Coronary Artery Disease. J Cardiopulm Rehabil. 2006;26(2):80-3. https://doi.org/10.1097/00008483-200603000-00005
  5. Hilberg T. Glaser D. Reckhart C. et al. Blood coagulation and fibrinolysis after long-duration treadmill exercise controlled individual anaerobic threshold. Eur J Appl Physiol. 2003;90(5-6):639-42. https://doi.org/10.1007/s00421-003-0907-2
  6. Lee KW. Lip GYH. Effects of Lifestyle on Hemostasis, Fibrinolysis, and Platelet Reactivity: a systemic review. Arch Intern Med. 2003;163(19):2368-92. https://doi.org/10.1001/archinte.163.19.2368
  7. Wang JS. Exercise Prescription and Thrombogenesis. J Biomed Sci. 2006;13(6):753-61. https://doi.org/10.1007/s11373-006-9105-7
  8. Cooper JA. Nagelkirk PR. Coughlin AM. Et al. Temporal Changes in the tPA and PAI-1 after Maximal Exercise. Med Sci sports and Exerc. 2004;36(11):1884-7. https://doi.org/10.1249/01.MSS.0000145447.61736.ED
  9. Smith JE. Effects of Strenuous Exercise on Haemostasis. Br J Sports Med. 2003;37(5):433-5. https://doi.org/10.1136/bjsm.37.5.433
  10. Womack CJ. Rasmussen JM. Vickers DG. et al. Changes in fibrinolysis following exercise above and below lactate threshold. J Thromb Res. 2006; 118(2):263-8. https://doi.org/10.1016/j.thromres.2005.06.016
  11. Ivey FM. Womck CJ. Kulaputana O. et al. A Single Bout of Walking Exercise Enhances Endogenous Fibrinolysis in Stroke Patients. Med Sci sports Exerc. 2003;35(2):193-8. https://doi.org/10.1249/01.MSS.0000048634.89370.06
  12. Stevenson SF. Doubal FN. Shuler K. et al. A Systematic Review of Dynamic Cerebral and Peripheral Endothelial Function in Lacunar Stroke Versus Controls. Stroke. 2010;41(6):434-42. https://doi.org/10.1161/STROKEAHA.109.569855
  13. Rydzewska A. Sakata K. Kobayashi A. Changes in Plasminogen Activator Inhibitor 1 and Tissue-type Plasminogen Activator during Exercise in Patients with Coronary Artery Disease. Haemostasis. 1990;20(5):305-12.
  14. Lambert M. AHA/ASA Guidelines on Prevention of Recurrent stroke. Am Fam Physician. 2011;83(8):993-1001.
  15. Willey JZ, Moon YP, Paik MC et al. Physical Activity and Risk of Ischemic Stroke IN THE Northern Manhattan Study. Neurology. 2009;73(21):1774-9. https://doi.org/10.1212/WNL.0b013e3181c34b58
  16. Womack CJ. Nagelkirik PR. Coughlin AM. Exercise-Induced Changes in Coagulation Fibrinolysis in Healthy Population and Patients with Cardiovascular Disease. Sports Med. 2003;33(11):795-807. https://doi.org/10.2165/00007256-200333110-00002
  17. ACSM. ACSM's Guidelines for Exercise Testing and Prescription.8th. ed. Philadelphia, Lippincott Williams & Wilkins, 2010:102-108.
  18. Baynard T. Jacobs HM. Kessler CM. et al. Fibrinolytic Markers and Vasodilatory Capacity following Acute Exercise among Men of Differing Training Status. Eur J Appl Physiol. 2007;101(5):595-602. https://doi.org/10.1007/s00421-007-0534-4
  19. Fras Z. Keber D. Chandler WL. The Effect of Submaximal Exercise on Fibrinolysis. Blood Coagul Fibrinolysis. 2004;15(3):227-34. https://doi.org/10.1097/00001721-200404000-00005
  20. Brown NJ. Muldowney JA 3rd. Vaughan DE. Endogenous NO Regulates Plasminogen Activator-1 Durin16 Angiotensin- Converting Enzyme Inhibition. Hypertension, 2006;47(3):441-8. https://doi.org/10.1161/01.HYP.0000202478.79587.1a
  21. Francescomarino SD. Sciartlli A. Valerio VD. et al. The Effect of Physical Exercise on Endothelial Function. Sports Med. 2009;3(10):797-812.
  22. Rauramaa R. Li G. Vaisanen SB. Dose-Response Coagulation and Hemostatic Factor. Med Sci sports Exerc., 2001;33(6):516-20. https://doi.org/10.1097/00005768-200106001-00022
  23. El-Sayed MS. Sale C. Jones PG et al. Blood Hemostasis in Exercise and Training. Med Sci sports Exerc. 2000;32(5):918-25.
  24. Stegnar M. Peternel P. Keber D. et al. Poor Fibrinolytic Response to Venous Occlusion by Different Criteria in Patients with Deep Vein Thrombosis. Thromb Res. 1991;64(4):445-53. https://doi.org/10.1016/0049-3848(91)90345-W