阻力運動對於中風防治之應用

The Application of Resistance Exercise for Stroke Prevention

10.3966/102473002015092903010

張純嘉(Chung-Chia Chang)；鍾寶弘(Pao-Hung Chung)

中風復健 ； 高血壓 ； 漸進式強度 ； stroke rehabilitation ； high blood pressure ； progressive exercise

中華體育季刊

29卷3期（2015 / 09 / 01）

247 - 254

繁體中文

腦中風是造成國人嚴重失能的重要原因，預防此疾病的發生儼然成為一個重要的課題。阻力運動不僅可以控制體重、血糖、膽固醇和血壓，長期運動下更能有增加肌肉質量改善心血管功能的效果，因此臨床上也常被應用在中風的復健。但是若以預防中風發生為目的，如何擬訂有效的阻力運動策略，尚未有相關的討論。本文經統整中風復健的課程後發現：使用漸進式強度20%-80%，每周3次，每次3回合、每回合10下的阻力運動，才能對身體功能有幫助。在預防策略上，由於尚未出現中風現象，因此運動強度可較復健課程提高，建議可以從中強度的60%開始，並採用漸進式強度至80%。未來亦可以針對阻力運動的儀器從神經肌肉運動與訓練的理論進行改良，使得運動傷害風險降低，又可增加對肌肉的刺激，相信必能成為中風高風險者的一大福音。

Stroke is one of the main reason for disability in Taiwan. Therefore, to prevent the occurrence of stroke has become an important issue. Resistance exercise can keep lower body weight, blood sugar, cholesterol and blood pressure, and the long-term resistance exercise was demostrated effectively to increase muscle mass and then to improve cardiovascular function, which has been used in chinical stroke rehabilitation. In order to prevent stroke by resistance exercise, no study had demostrated the valid strategy. After the system review of stroke rehabilitation programs, this study were found: the resistance exercise with the progressive intensity 20%-80%, 10 repetitions per round, 3 rounds per time and 3 times per week, would be effective to enhance the body function. Because stroke has not occured yet, the strategy of resistance exercise for prevention purpose can be started from 60% of intensity, and progressively increased up to 80%. We also suggested that the exercise equipment could be improved in order to comform to the neuromuscular training theories, and thus to induce more muscle stimulation and to reduce the risk of injury for the stroke reasons.

1. 王瑱瑄(2009)。運動對缺血性腦中風之保護機制。大專體育，101，224-229。
   連結：
2. 余育蘋(2005)。阻力訓練教學課程對身體組成及體適能之影響。臺大體育學報，7，179-193。
   連結：
3. 余祥義、曾建興(2011)。綜合性運動訓練對改善老年人跌倒因素之成效。大專體育，114，76-84。
   連結：
4. 高祥傑(2013)。阻力訓練對第二型糖尿病血液生理之影響。中原體育學報，2，35-41。
   連結：
5. 崔凌震、宋壬夫(2007)。運動與高血壓。臺中學院體育，4，6-16。
   連結：
6. 張世錫、駱明瑤(2010)。阻力運動對高血壓族群之效益。體育學系系刊，10，65-75。
   連結：
7. 郭世傑、賴韻如、楊子孟(2014)。中年及老年人不同休閒時間身體活動量效關係與中風發生率之關聯。大專體育學刊，16(3)，342-352。
   連結：
8. 劉宗翰、梁玉秋、江政凌、吳龍山(2011)。健力專項動作、體型特徵與訓練的生理影響。大專體育，115，26-32。
   連結：
9. 蔡政霖、周峻忠(2008)。老年人從事阻力訓練的原則與處方。中華體育季刊，22(4)，40-50。
   連結：
10. American College of Sports Medicine. (2013). Resistance Training for Health and Fitness. Retrieved from American College of Sports Medicine Web site: http://www.acsm.org/docs/brochures/resistance-training.pdf
11. 黃瑞雄 (2012)。糖尿病與腦中風的關係。取自http://www.ntuh.gov.tw/ccnb/CVA/Lists/List/DispForm.aspx?ID=7&Source=http://www.ntuh.gov.tw/ccnb/CVA/DocLib/lecture.aspx
12. 簡文芳 (2012) 高血壓症與腦中風的關係。取自http://www.ntuh.gov.tw/ccnb/CVA/Lists/List/DispForm.aspx?ID=4&Source=http://www.ntuh.gov.tw/ccnb/CVA/DocLib/lecture.aspx
13. 行政院衛生福利部 (2013)。102 年死因統計結果分析。衛生福利部：統計處
14. Ada, L.,Dorsch, S.,Canning, C. G.(2006).Strengthening interventions increase strength and improve activity after stroke: A systematic review.Australian Journal of Physiotherapy,52(4),241-248.
15. Bale, M.,Strand, L. I.(2008).Does functional strength training of the leg in subacute stroke improve physical performance? A pilot randomized controlled trial.Clinical Rehabilitation,22(10-11),911-921.
16. Brazzelli, M.,Saunders, D. H.,Greig, C. A.,Mead, G. E.(2011).Physical fitness training for stroke patients.Cochrane Database Syst Rev.,Nov 9
17. Cramp, M. C.,Greenwood, R. J.,Gill, M.,Rothwell, J. C.,Scott, O. M.(2006).Low intensity strength training for ambulatory stroke patients.Disability and Rehabilitation,28(13-14),883-889.
18. Ding, Y. H.,Li, J.,Yao, W. X.,Rafols, J. A.,Clark, J. C.,Ding, Y.(2006).Exercise preconditioning upregulates cerebral integrins and enhances cerebrovascular integrity in ischemic rats.Acta Neuropathologica,112(1),74-84.
19. Ding, Y.,Li, J.,Luan, X.,Ding, Y. H.,Lai, Q.,Rafols, J. A.,Diaz, F. G.(2004).Exercise pre-conditioning reduces brain damage in ischemic rats that may be associated with regional angiogenesis and cellular overexpression of neurotrophin.Neuroscience,124(3),583-591.
20. Dobkin, B. H.,Dorsch, A.(2013).New evidence for therapies in stroke rehabilitation.Current Atherosclerosis Reports,15(6),331.
21. Farooqui, A. A.,Farooqui, T.,Panza, F.,Frisardi, V.(2012).Metabolic syndrome as a risk factor for neurological disorders.Cellular and Molecular Life Sciences,69(5),741-762.
22. Flansbjer, U. B.,Miller, M.,Downham, D.,Lexell, J.(2008).Progressive resistance training after stroke: Effects on muscle strength, muscle tone, gait performance and perceived participation.Journal of Rehabilitation Medicine,40(1),42-48.
23. Gallagher, K. M.,Fadel, P. J.,Smith, S. A.,Norton, K. H.,Querry, R. G.,Olivencia-Yurvati, A.,Raven, P. B.(2001).Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise.Journal of Applied Physiology,91(5),2351-2358.
24. Haskell, W. L.,Lee, I. M.,Pate, R. R.,Powell, K. E.,Blair, S. N.,Franklin, B. A.,Bauman, A.(2007).Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.Medicine and Science in Sports and Exercise,39(8),1423-1434.
25. Kim, T. H.,Yoon, J. S.,Lee, J. H.(2013).The effect of ankle joint muscle strengthening training and static muscle stretching training on stroke patients' C.o.p sway amplitude.Journal of Physical Therapy Science,25(12),1613-1616.
26. Li, J.,Ding, Y. H.,Rafols, J. A.,Lai, Q.,McAllister, J. P.,Ding, Y.(2005).Increased astrocyte proliferation in rats after running exercise.Neuroscience letters,386(3),160-164.
27. Lovell, D. I.,Cuneo, R.,Gass, G. C.(2009).Resistance training reduces the blood pressure response of older men during submaximum aerobic exercise.Blood Pressure Monitoring,14(4),137-144.
28. Moreland, J. D.,Goldsmith, C. H.,Huijbregts, M. P.,Anderson, R. E.,Prentice, D. M.,Brunton, K. B.,Torresin, W. D.(2003).Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial.Archives of Physical Medicine and Rehabilitat,84(10),1433-1440.
29. Morris, S. L.,Dodd, K. J.,Morris, M. E.(2004).Outcomes of progressive resistance strength training following stroke: A systematic review.Clinical Rehabilitation,18(1),27-39.
30. O'Sullivan, S. B.,Schmitz, T. J.(2006).Physical rehabilitation : Assessment and treatment.Philadelphia:F.A. Davis Co..
31. Ouellette, M. M.,LeBrasseur, N. K.,Bean, J. F.,Phillips, E.,Stein, J.,Frontera, W. R.,Fielding, R. A.(2004).High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors.Stroke,35(6),1404-1409.
32. Pak, S.,Patten, C.(2008).Strengthening to promote functional recovery poststroke: An evidence-based review.Topics in Stroke Rehabilitation,15(3),177-199.
33. Sawner, K. A.,LaVigne, J. M.,Brunnstrom, S.(1992).Brunnstrom's movement therapy in hemiplegia: A neurophysiological approach.Lippincott.
34. Weiss, A.,Suzuki, T.,Bean, J.,Fielding, R. A.(2000).High intensity strength training improves strength and functional performance after stroke.American Journal of Physical Medicine & Rehabilitation,79(4),369-376.
35. Yang, Y. R.,Wang, R. Y.,Lin, K. H.,Chu, M. Y.,Chan, R. C.(2006).Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke.Clinical Rehabilitation,20(10),860-870.
36. 江瑞峰(2009)。高血脂患者之運動處方。屏東教大體育，12，123-131。
37. 李悌愷(1996)。缺血性中風的治療與預防。當代醫學，273，521-524。
38. 國民健康局(2004)。高血壓防治手冊。行政院衛生署國民健康局。
39. 曹汶龍(2006)。缺血性腦中風的症狀與診斷。慈濟醫學雜誌，18(5)，1-3。
40. 許妙如、廖麗君、張雅如(2012)。代謝症候群與中風。物理治療，37(2)，136-145。
41. 謝宛玲、陳亮恭、何鍾佑、胡曼文、高崇蘭(2010)。老年人運動原則。臺灣老年醫學暨老年學雜誌，5(2)，83-93。
42. 羅文傑、陳一中、謝從閭(2007)。腦中風的治療與預防。臺北市醫師公會會刊，51(2)，10-11。

1. 潘定均,李昭慶,李俞麟(2019)。體育課程介入對於大專學生身體質量、體脂肪及肌肉量影響研究。臺大體育學報，36，43-53。
2. 楊鳳年、陳靜修、方郁棻(2019)。運用彈力帶協助一位初次腦中風患者復健之護理經驗。長庚護理，30(1)，101-111。