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The Effects of High-Intensity Aerobic Interval Training In The Elderly With Myocardial Infarction

노인 심근경색 환자에서 고강도 간헐적 유산소운동의 효과

  • Kim, Ji Hee (Department of Physical Medicine and Rehabilitation, Wonkwang University Hospital)
  • 김지희 (원광대학교병원 재활의학과)
  • Received : 2018.12.14
  • Accepted : 2019.02.01
  • Published : 2019.02.28
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Abstract

To investigate the effect of high-intensity interval training (HIIT) on the outcomes of cardiac rehabilitation(CR) in elderly and younger patients with myocardial infarction(MI). Of the MI patients who received hospital-based CR from 2015 to 2017, we retrospectively reviewed the medical records of the patients who continued follow-up through the outpatient clinic. A total of 39 patients (20 elderly patients (${\geq}60year$($64.1{\pm}3.6$)) and 19 younger patients (< 60 year($55.6{\pm}2.3$)) was included in this study. The HIIT program was composed of 10 minutes of warm-up, 30 minutes of interval aerobic exercise, and 10 minutes of cool down. The aerobic exercise based on their initial exercise tolerance test outcome consisted of 3-minute usual intensity phase (60-70% of heart rate/VO2 reserve) and 4-minute of high-intensity phase (70-90% of heart rate/VO2 reserve). Exercise capacity was measured by exercise tests before and after hospital- based CR. Before CR, elderly group had a significantly lower exercise capacity in Exercise time, peak VO2, METs, Anaerobic threshold, VEmax, 02pulse than younger group. Both group showed similar improvement of cardiopulmonary exercise capacity after CR. And HIIT is safe and effective in elderly patients. It is considered necessary to further expansion for the participation of high intensity interval training in elderly patients.

본 연구는 심근경색 환자에서 고강도 간헐적 운동 프로그램이 나이에 따라 심폐운동 기능에 미치는 효과를 비교하여 노인환자에서의 효과를 알아보고자 하였다. 2015년에서 2017년까지 심장 재활을 실시하였던 환자 중 외래 경과 관찰중인 환자의 기록을 후향적으로 분석하였다. 총 39명 (60세 이상의 노인 20명, 19명의 60세 미만의 젊은 환자군)이 연구에 포함되었다. 고강도 간헐적 심장 재활프로그램은 준비운동 5-10 분, 고강도 간헐적 유산소 운동 28분 및 마무리 운동 5-10분으로 구성되었다. 대상자들은 초기 운동부하 검사 결과를 바탕으로 심장재활 치료실에서 심전도 감시 하에 유산소 운동을 여유 산소 섭취량을 기준으로 70-90%의 고강도의 훈련 4분, 60-70% 로 3 분가량의 일반적인 강도의 훈련을 반복적으로 4 회간 실시하고 마무리운동을 시행하였다. 심폐기능은 심장재활 실시 전, 후로 운동부하 검사에 의해 평가되었다. 심장재활 후 두 군 모두에서 운동기능의 개선의 효과가 있었다. 심장재활을 실시하기 전 시행한 운동 부하 검사에서 최대 산소 소모량, 최대 운동시의 신진대사 해당치, 무산소 역치 등이 60 세 이상의 노인에서 의미 있는 운동 기능 저하가 관찰되었다(p<0.05). 심장 재활 전과 후의 운동 능력을 비교하였을 때, 두 군에서 최대 운동 가능시간, 심근부담률, 최대 심박수, 안정시 심박수, 최대 산소 소모량, 최대 산소소모량 측정시의 최대 환기량, 최대 운동 시 의 신진대사 해당치, 무산소 역치 지표에서 통계학적으로 유의한 변화가 관찰되어(p<0.05), 고강도 간헐적 운동방법은 노인환자에게서도 안전하며 효과적이다. 그러므로 60 세 이상의 노인 환자에서의 효과적인 고강도 간헐적 운동 참여를 확대하는 것이 필요할 것으로 생각된다.

Keywords

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Fig. 1. Protocol of high-intensity interval training

Table 1. Clinical characteristics of the subjects

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Table 2. Comparison of exercise capacity after CR (all patients)

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Table 3. Comparison of exercise capacity before cardiac rehabilitation in 60 group and 60 group

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Table 4. Comparison of exercise capacity after cardiac rehabilitation in 60 group and 60 group

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Table 5. Comparison of percent changes in exercise capacity before and after cardiac rehabilitation in 60 group and 60 group

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