綜合上述討論,本研究可得到以下結論:雖然下肢IPC (3 循環、220 mmHg) 可增 加休息時的肌肉血流量,然而,無論是上肢或下肢IPC,均無法改善高中划船選手的 2000 公尺室內划船時的肌肉氧飽合度與運動表現。
根據本研究的結果與討論,可獲得以下建議以供未來有關IPC 效益的研究作參考:
未來的研究可以招募優秀選手來探討IPC 是否能促進划船運動表現,以及針對 IPC 的劑 量、最佳休息時間長度做進一步的探討。在對照組方面,則宜使用低於 40 mmHg 的偽 實驗處理,以及不綁壓脈帶的控制處理,以進一步釐清IPC 的確實效益。
引用文獻
Addison, P. D., Neligan, P. C., Ashrafpour, H., Khan, A., Zhong, A., Moses, M., ...Pang, C. Y.
(2003). Noninvasive remote ischemic preconditioning for global protection of skeletal muscle against infarction. American Journal of Physiology-Heart and Circulatory Physiology, 285(4), H1435-1443. doi:10.1152/ajpheart.00106.2003
Arroyo-Martínez, E. A., Meaney, A., Gutiérrez-Salmeán, G., Rivera-Capello, J. M., González-Coronado, V., Alcocer-Chauvet, A., ...Meaney, E. (2016). Is local nitric oxide availability responsible for myocardial salvage after remote preconditioning? Arquivos Brasileiros de Cardiologia, 107(2), 154-162. doi:10.5935/abc.20160100
Bailey, T. G., Birk, G. K., Cable, N. T., Atkinson, G., Green, D. J., Jones, H., & Thijssen, D. H.
(2012a). Remote ischemic preconditioning prevents reduction in brachial artery flow-mediated dilation after strenuous exercise. American Journal of Physiology-Heart and Circulatory Physiology, 303(5), H533-H538. doi:10.1152/ajpheart.00272.2012
Bailey, T. G., Jones, H., Gregson, W., Atkinson, G., Cable, N. T., & Thijssen, D. H. (2012b).
Effect of ischemic preconditioning on lactate accumulation and running performance.
Medicine and Science in Sports and Exercise, 44(11), 2084-2089.
doi:10.1249/MSS.0b013e318262cb17
Barbosa, T. C., Machado, A. C., Braz, I. D., Fernandes, I. A., Vianna, L. C., Nobrega, A. C., &
Silva, B. M. (2015). Remote ischemic preconditioning delays fatigue development during handgrip exercise. Scandinavian Journal of Medicine and Science in Sports, 25(3), 356-364. doi:10.1111/sms.12229
Clevidence, M. W., Mowery, R. E., & Kushnick, M. R. (2012). The effects of ischemic preconditioning on aerobic and anaerobic variables associated with submaximal cycling performance. European Journal of Applied Physiology, 112(10), 3649-3654.
doi:10.1007/s00421-012-2345-5
Cocking, S., Wilson, M. G., Nichols, D., Cable, N. T., Green, D. J., Thijssen, D. H. J., & Jones, H. (2017). Is there an optimal ischaemic preconditioning dose to improve cycling performance? International Journal of Sports Physiology and Performance, 1-25.
doi:10.1123/ijspp.2017-0114
Costa, J. F., Fontes-Carvalho, R., & Leite-Moreira, A. F. (2013). Myocardial remote ischemic preconditioning: From pathophysiology to clinical application. Revista Portuguesa de Cardiologia, 32(11), 893-904. doi:10.1016/j.repc.2013.02.012
Crisafulli, A., Tangianu, F., Tocco, F., Concu, A., Mameli, O., Mulliri, G., & Caria, M. A. (2011).
Ischemic preconditioning of the muscle improves maximal exercise performance but not maximal oxygen uptake in humans. Journal of Applied Physiology (1985), 111(2), 530-536. doi:10.1152/japplphysiol.00266.2011
Cruz, R. S., de Aguiar, R. A., Turnes, T., Pereira, K. L., & Caputo, F. (2015). Effects of ischemic preconditioning on maximal constant-load cycling performance. Journal of Applied Physiology (1985), 119(9), 961-967. doi:10.1152/japplphysiol.00498.2015
de Groot, P. C., Thijssen, D. H., Sanchez, M., Ellenkamp, R., & Hopman, M. T. (2010).
Ischemic preconditioning improves maximal performance in humans. European Journal of Applied Physiology, 108(1), 141-146. doi:10.1007/s00421-009-1195-2
DeLorey, D. S., Kowalchuk, J. M., & Paterson, D. H. (2003). Relationship between pulmonary O2 uptake kinetics and muscle deoxygenation during moderate-intensity exercise.
Journal of Applied Physiology (1985), 95(1), 113-120.
doi:10.1152/japplphysiol.00956.2002
DeLorey, D. S., Kowalchuk, J. M., & Paterson, D. H. (2004). Effects of prior heavy-intensity exercise on pulmonary O2 uptake and muscle deoxygenation kinetics in young and older adult humans. Journal of Applied Physiology (1985), 97(3), 998-1005.
doi:10.1152/japplphysiol.01280.2003
Enko, K., Nakamura, K., Yunoki, K., Miyoshi, T., Akagi, S., Yoshida, M., ...Ito, H. (2011).
Intermittent arm ischemia induces vasodilatation of the contralateral upper limb. The Journal of Physiological Sciences, 61(6), 507-513. doi:10.1007/s12576-011-0172-9
Foster, G. P., Giri, P. C., Rogers, D. M., Larson, S. R., & Anholm, J. D. (2014). Ischemic preconditioning improves oxygen saturation and attenuates hypoxic pulmonary vasoconstriction at high altitude. High Altitude Medicine and Biology, 15(2), 155-161.
doi:10.1089/ham.2013.1137
Foster, G. P., Westerdahl, D. E., Foster, L. A., Hsu, J. V., & Anholm, J. D. (2011). Ischemic preconditioning of the lower extremity attenuates the normal hypoxic increase in pulmonary artery systolic pressure. Respiratory Physiology and Neurobiology, 179(2-3), 248-253. doi:10.1016/j.resp.2011.09.001
Gandra, P. G., Nogueira, L., & Hogan, M. C. (2012). Mitochondrial activation at the onset of contractions in isolated myofibres during successive contractile periods. The Journal of Physiology, 590(15), 3597-3609. doi:10.1113/jphysiol.2012.232405
Gho, B. C., Schoemaker, R. G., van den Doel, M. A., Duncker, D. J., & Verdouw, P. D. (1996).
Myocardial protection by brief ischemia in noncardiac tissue. Circulation, 94(9), 2193-2200.
Gibson, N., Mahony, B., Tracey, C., Fawkner, S., & Murray, A. (2015). Effect of ischemic preconditioning on repeated sprint ability in team sport athletes. Journal of Sports Sciences, 33(11), 1182-1188. doi:10.1080/02640414.2014.988741
Gibson, N., White, J., Neish, M., & Murray, A. (2013). Effect of ischemic preconditioning on land-based sprinting in team-sport athletes. International Journal of Sports Physiology and Performance, 8(6), 671-676.
Heinonen, I., Wendelin-Saarenhovi, M., Kaskinoro, K., Knuuti, J., Scheinin, M., & Kalliokoski, K. K. (2013). Inhibition of alpha-adrenergic tone disturbs the distribution of blood flow in the exercising human limb. American Journal of Physiology-Heart and Circulatory Physiology, 305(2), H163-172. doi:10.1152/ajpheart.00925.2012
Hittinger, E. A., Maher, J. L., Nash, M. S., Perry, A. C., Signorile, J. F., Kressler, J., & Jacobs, K. A. (2015). Ischemic preconditioning does not improve peak exercise capacity at sea level or simulated high altitude in trained male cyclists. Applied Physiology, Nutrition, and Metabolism, 40(1), 65-71. doi:10.1139/apnm-2014-0080
Horiuchi, M., Endo, J., & Thijssen, D. H. (2015). Impact of ischemic preconditioning on functional sympatholysis during handgrip exercise in humans. Physiological Reports, 3(2), e12304. doi:10.14814/phy2.12304
Incognito, A. V., Burr, J. F., & Millar, P. J. (2016). The effects of ischemic preconditioning on human exercise performance. Sports Medicine, 46(4), 531-544. doi:10.1007/s40279-015-0433-5
Jean-St-Michel, E., Manlhiot, C., Li, J., Tropak, M., Michelsen, M. M., Schmidt, M.
R., ...Redington, A. N. (2011). Remote preconditioning improves maximal performance in highly trained athletes. Medicine and Science in Sports and Exercise, 43(7), 1280-1286. doi:10.1249/MSS.0b013e318206845d
Keramidas, M. E., Kounalakis, S. N., Eiken, O., & Mekjavic, I. B. (2011). Muscle and cerebral oxygenation during exercise performance after short-term respiratory work. Respiratory Physiology and Neurobiology, 175(2), 247-254. doi: 10.1016/j.resp.2010.11.009
Kido, K., Suga, T., Tanaka, D., Honjo, T., Homma, T., Fujita, S., ...Isaka, T. (2015). Ischemic preconditioning accelerates muscle deoxygenation dynamics and enhances exercise endurance during the work-to-work test. Physiological Reports, 3(5), e12395.
doi:10.14814/phy2.12395
Kilduff, L. P., Finn, C. V., Baker, J. S., Cook, C. J., & West, D. J. (2013). Preconditioning strategies to enhance physical performance on the day of competition. International Journal of Sports Physiology and Performance, 8(6), 677-681.
Kjeld, T., Rasmussen, M. R., Jattu, T., Nielsen, H. B., & Secher, N. H. (2014). Ischemic preconditioning of one forearm enhances static and dynamic apnea. Medicine and Science in Sports and Exercise, 46(1), 151-155. doi:10.1249/MSS.0b013e3182a4090a
Kraus, A. S., Pasha, E. P., Machin, D. R., Alkatan, M., Kloner, R. A., & Tanaka, H. (2015).
Bilateral upper limb remote ischemic preconditioning improves anaerobic power. The Open Sports Medicine Journal, 9(1), 1-6.
Lalonde, F., & Curnier, D. Y. (2015). Can anaerobic performance be improved by remote ischemic preconditioning? The Journal of Strength & Conditioning Research, 29(1), 80-85. doi:10.1519/jsc.0000000000000609
Lintz, J. A., Dalio, M. B., Joviliano, E. E., & Piccinato, C. E. (2013). Ischemic pre and postconditioning in skeletal muscle injury produced by ischemia and reperfusion in rats.
Acta Cirurgica Brasileira, 28(6), 441-446.
Loukogeorgakis, S. P., Williams, R., Panagiotidou, A. T., Kolvekar, S. K., Donald, A., Cole, T.
J., ...MacAllister, R. J. (2007). Transient limb ischemia induces remote preconditioning and remote postconditioning in humans by a K(ATP)-channel dependent mechanism.
Circulation, 116(12), 1386-1395. doi:10.1161/circulationaha.106.653782
Mäestu, J., & Jürimäe, T. (2005). Monitoring of performance and training in rowing. Sports Medicine, 35(7), 597-617.
Marocolo, M., da Mota, G. R., Pelegrini, V., & Appell Coriolano, H. J. (2015a). Are the beneficial effects of ischemic preconditioning on performance partly a placebo effect?
International Journal of Sports Medicine, 36(10), 822-825. doi:10.1055/s-0035-1549857
Marocolo, M., Ribeiro da Mota, G., & Simim, M. A. (2015b). Myths and facts about the effects of ischemic preconditioning on performance. International Journal of Sports Medicine.
doi:10.1055/s-0035-1564253
Murry, C. E., Jennings, R. B., & Reimer, K. A. (1986). Preconditioning with ischemia: A delay of lethal cell injury in ischemic myocardium. Circulation, 74(5), 1124-1136.
Paixão, R. C., da Mota, G. R., & Marocolo, M. (2014). Acute effect of ischemic preconditioning is detrimental to anaerobic performance in cyclists. International Journal of Sports Medicine, 35(11), 912-915. doi:10.1055/s-0034-1372628
Pang, C. Y., Yang, R. Z., Zhong, A., Xu, N., Boyd, B., & Forrest, C. R. (1995). Acute ischaemic preconditioning protects against skeletal muscle infarction in the pig. Cardiovascular Research, 29(6), 782-788.
Paradis-Deschênes, P., Joanisse, D. R., & Billaut, F. (2016). Ischemic preconditioning increases muscle perfusion, oxygen uptake, and force in strength-trained athletes. Applied Physiology, Nutrition, and Metabolism, 41(9), 938-944. doi:10.1139/apnm-2015-0561
Patterson, S. D., Bezodis, N. E., Glaister, M., & Pattison, J. R. (2015). The effect of ischemic preconditioning on repeated sprint cycling performance. Medicine and Science in Sports and Exercise, 47(8), 1652-1658. doi:10.1249/mss.0000000000000576
Pickard, J. M., Botker, H. E., Crimi, G., Davidson, B., Davidson, S. M., Dutka, D., ...Hausenloy, D. J. (2015). Remote ischemic conditioning: From experimental observation to clinical application: Report from the 8th Biennial Hatter Cardiovascular Institute Workshop.
Basic Research in Cardiology, 110(1), 453. doi:10.1007/s00395-014-0453-6
Przyklenk, K., Bauer, B., Ovize, M., Kloner, R. A., & Whittaker, P. (1993). Regional ischemic 'preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation, 87(3), 893-899.
Rossow, L. M., Fahs, C. A., Loenneke, J. P., Thiebaud, R. S., Sherk, V. D., Abe, T., & Bemben, M. G. (2012). Cardiovascular and perceptual responses to blood-flow-restricted resistance exercise with differing restrictive cuffs. Clinical Physiology and Functional Imaging, 32(5), 331-337. doi:10.1111/j.1475-097X.2012.01131.x
Salvador, A. F., De Aguiar, R. A., Lisboa, F. D., Pereira, K. L., Cruz, R. S., & Caputo, F. (2016).
Ischemic preconditioning and exercise performance: A systematic review and meta-analysis. International Journal of Sports Physiology and Performance, 11(1), 4-14.
doi:10.1123/ijspp.2015-0204
Schroeder, C. A., Jr., Lee, H. T., Shah, P. M., Babu, S. C., Thompson, C. I., & Belloni, F. L.
(1996). Preconditioning with ischemia or adenosine protects skeletal muscle from ischemic tissue reperfusion injury. Journal of Surgical Research, 63(1), 29-34.
Sharma, V., Cunniffe, B., Verma, A., Cardinale, M., & Yellon, D. (2014). Characterization of acute ischemia-related physiological responses associated with remote ischemic preconditioning: A randomized controlled, crossover human study. Physiological Reports, 2(11), e12200. doi:10.14814/phy2.12200
Sloth, A. D., Schmidt, M. R., Munk, K., Kharbanda, R. K., Redington, A. N., Schmidt, M., ...Botker, H. E. (2014). Improved long-term clinical outcomes in patients with ST-elevation myocardial infarction undergoing remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention. European Heart Journal, 35(3), 168-175. doi:10.1093/eurheartj/eht369
Smith, K. J., & Billaut, F. (2010). Influence of cerebral and muscle oxygenation on repeated-sprint ability. European Journal of Applied Physiology, 109(5), 989-999.
Smith, T. B., & Hopkins, W. G. (2012). Measures of rowing performance. Sports Medicine, 42(4), 343-358. doi:10.2165/11597230-000000000-00000
Tocco, F., Marongiu, E., Ghiani, G., Sanna, I., Palazzolo, G., Olla, S., ...Crisafulli, A. (2015).
Muscle ischemic preconditioning does not improve performance during self-paced exercise. International Journal of Sports Medicine, 36(1), 9-15. doi:10.1055/s-0034-1384546
TMU-Joint Institutional Review Board
,每次實驗時間約2小時。
2.試驗/研究目的
本研究主要是想了解划船選手在接受缺血預處理 (ischemic preconditioning, IPC)
後,是否能促進2000公尺室內划船的測驗成績。另外也會比較雙上肢高壓IPC、雙下
值,詢問自覺疼痛強度及運動自覺強度量表。
1. 缺血預處理 (ischemic preconditioning, IPC):在IPC的過程中,因為壓脈帶加壓的
,您可能會感受到肢體緊蹦感、麻木或疼痛,這些不適感將在鬆開壓脈帶時緩解
(6)每次實驗前 24 小時,不可進行激烈運動、包括比賽、高強度訓練或阻力訓練。
疑因參與試驗/研究而受害時,請隨時與臺北醫學大學暨附屬醫院聯合人體研究倫 理委員會聯絡,電話:(02)66382736分機1728或Email:[email protected]。
(5)除上述情形外,受試者或其法定代理人,對目前、未來或過去的研究有任何不了 解、熟悉之處,想要討論及解答疑問,請隨時與臺北醫學大學暨附屬醫院聯合人 體研究倫理委員會聯絡,我們將會提供一位與研究無關係的人員來提供資訊,如 有需要,請與臺北醫學大學暨附屬醫院聯合人體研究倫理委員會聯絡(電話
:(02)66382736分機1728或Email:[email protected])。
第5頁 同意書版本編號:2.0 日期:2017/05/07
TMU-JIRB Form054/20160306