起立性低血圧に伴うめまいの循環動態の評価と加圧トレーニングによる治療

• Project/Area Number: 21659390
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Single-year Grants
• Research Field: Otorhinolaryngology
• Research Institution: The University of Tokyo
• Principal Investigator: 山岨 達也 東京大学, 医学部附属病院, 教授 (60251302)
• Co-Investigator(Kenkyū-buntansha): 中島 敏明 東京大学, 医学部附属病院, 特任准教授 (50227790) ; 岩崎 真一 東京大学, 医学部附属病院, 准教授 (10359606)
• Project Period (FY): 2009 – 2010
• Project Status: Completed (Fiscal Year 2010)
• Budget Amount: ¥3,000,000 (Direct Cost: ¥3,000,000); Fiscal Year 2010: ¥700,000 (Direct Cost: ¥700,000); Fiscal Year 2009: ¥2,300,000 (Direct Cost: ¥2,300,000)
• Keywords: 起立性低血圧 / めまい / 加圧 / 酸化ストレス

Research Abstract

高強度トレーニングは、活性酸素の産生を高め、酸化ストレスを亢進することが知られている。低強度加圧筋力トレーニングは、高強度トレーニングに匹敵する筋肥大効果をみとめると報告されており、起立性低血圧の治療に応用した。また加圧トレーニングならびに種々な運動様式の血中酸化ストレス指標に及ぼす影響につき健常人ならびに患者で検討した。各種目において、血中の酸化ストレス指標として活性酸素代謝産物濃度(dROMs test)と抗酸化力指標(BAP test)を測定した。加圧下での低負荷エルゴメーター運動及び筋力トレーニングは、非加圧時に比し、有意なdROMs、BAP上昇を認めた。さらに、健常人では、BAPは、乳酸、WBC、ノルアドレナリン(NOR)と有意な相関をみとめたが、dROMsとは相関は見られなかった。一方、起立性低血圧群では、dROMsは、乳酸、WBC、NORと有意な相関をみとめ、BAPも乳酸、WBCと相関を認めた。このように、加圧トレーニングでは、酸化ストレス・抗酸化力の亢進が見られた。健常人では、運動強度、血流制限に依存して抗酸化力が活性化し、酸化ストレスの上昇を抑制するが、疾患群では、運動強度、血流制限によって依存して酸化ストレスが亢進すると思われ、加圧トレーニングを応用する際には、負荷強度、血流制限の程度などを十分考慮する必要があると思われた。我々は、重篤な起立性低血圧患者においてマシンが使用できない場合は、elastic bandを用いた加圧トレーニング、加圧ウォークなどの負荷の軽い加圧トレーニングも実施している。そこで、高齢者の加圧ウォークの下肢筋力、筋肥大ならびにQOL改善効果についても検討した。加圧ウォークは、高齢者の下肢筋力を改善するとともに、静脈コンプライアンスを改善した。今後、起立性低血圧患者において、加圧トレーニングの効果とともに、安全で効果的なトレーニングメニューの作成につき、酸化ストレス、炎症の面からも研究を継続する予定である。

Research Products

• [Journal Article] Effects of 1.0- Weeks Walk Training With Leg Blood Flow Reduction on Carotid Arterial Compliance and Muscle Size in the Elderly Adults. (2011)
  • Author(s): Ozaki H, Miyachi M, Nakajima T, Abe T.
  • Journal Title: Angiology. Volume: 62 Pages: 81-86
  • Peer Reviewed
• [Journal Article] Increases in thigh muscle volume and strength by walk training with leg blood flow reduction in older participants. (2011)
  • Author(s): Ozaki H, Sakamaki M, Yasuda T, Fujita S, Ogasawara R, Sugaya M, Nakajima T, Abe T.
  • Journal Title: J Gerontol A Biol Sci Med Sci. Volume: 66 Pages: 257-263
  • Peer Reviewed
• [Journal Article] Pentraxin3 and hsCRP are independent inflammatory markers released during high-intensity exercise. (2010)
  • Author(s): Nakajima T, Kurano M, Hasegawa T, Takano H, Iida H, Yasuda T, Fukuda T, Madarame H, Uno K, Meguro K, Shiga T, Sagara M, Nagata T, Maemuta K, Hirata Y, Yamasoba T, Nagai
  • Journal Title: Eur J Appl Physiol Volume: 110 Pages: 905-913
  • Peer Reviewed
• [Journal Article] Effects of low-intensity resistance exercise With blood flow restriction on coagulation system in healthy subjects. (2010)
  • Author(s): Madarame H, Kursno M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T.
  • Journal Title: Clinicat Physiology and Fuuctional Imaging Volume: 30 Pages: 210-213
  • Peer Reviewed
• [Journal Article] Effects of Acute Hypoxia at Moderate Altitude on Stroke Volume and Cardiac Output During Exeroise. (2010)
  • Author(s): Fukuda T, Maegawa T, Matsumoto A, Komatsu Y, Nakajima T, Nagai R, Kawahara T.
  • Journal Title: Int Heart J. Volume: 51 Pages: 170-175
  • Peer Reviewed
• [Journal Article] Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression (2010)
  • Author(s): Yasuda T, Abe T. Brechue WF, Iida H, Takano H, Meguro K, Kurano M, Fujita S, Nakajima T.
  • Journal Title: Metabolism Volume: 59 Pages: 1510-1519
  • Peer Reviewed
• [Journal Article] Muscle volume and strength and arterial compliance after walk training with blood flow restriction in elederly women. (2010)
  • Author(s): Ozaki H, Miyauchi M, Nakajima T, Abe T.
  • Journal Title: J Am Geriatr Soc. Volume: 58 Pages: 1597-1598
  • Peer Reviewed
• [Journal Article] Effects of low-intensity KAATSU resistance training on skeletal muscle size/strength and endurance capacity in patients with ischemic heart disease. (2010)
  • Author(s): T.Nakajima, M.Kurano, F.Sakagami, H.Iida, K.Fukumura, T.Fukuda, H.Takano, H.Madarame, T.Yasuda, T.Nagata, Y.Sata, T.Yamasoba, T.Morita.
  • Journal Title: Int J KAATSU Training Res Volume: (掲載確定)(In press)
  • Peer Reviewed
• [Journal Article] Effects of low-intensity cycle training with restricted leg blood flow on thigh muscle volums and VO_<2max> in young men. (2010)
  • Author(s): Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, Ogasawara R, Sugaya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, lshii N
  • Journal Title: Journal of Sports Science and Medicine Volume: (掲載確定)(In press)
  • Peer Reviewed
• [Journal Article] 最大負荷運動と持続運動による血管内皮前駆細胞およびサイトカインに及ぼす急性効果の違い (2010)
  • Author(s): 目黒健太郎、目黒美葉、安田智洋、高橋昇子、高橋政夫、高野治人、森田敏宏、佐田政隆、平田恭信、永井良三、中島敏明
  • Journal Title: 日本心臓リハビリテーション(JJCR) Volume: 15 Pages: 160-164
  • Peer Reviewed
• [Journal Article] Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in elderly subjects. (2010)
  • Author(s): Abe T, Sakamaki M, Fujita S, Ozaki H, Sugaya M, Sato Y, Nakajima T.
  • Journal Title: J Geriatr Phy Ther (in press)
  • Peer Reviewed
• [Journal Article] Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects. (2010)
  • Author(s): Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T.
  • Journal Title: Clinical Physiology and Functional Imaging (in press)
  • Peer Reviewed
• [Journal Article] Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression. (2010)
  • Author(s): Yasuda T, Abe T, Brechue WF, Iida H, Takano H, Meguro K, Kurano M, Fujita S, Nakajima T.
  • Journal Title: Metabolism. (in press)
  • Peer Reviewed
• [Journal Article] Effects of 42 weeks walk training with blood flow reduction on muscle size and strength in the elderly. (2009)
  • Author(s): Abe T, Ozaki H, Sugaya M, Fujita S, Sakamaki M, Sato Y, Bembem MG, Nakajima T.
  • Journal Title: Proceedings of the ICSES Pages: 336-341
  • Peer Reviewed
• [Journal Article] Cardiovascular and metabolic responses to walking with and without leg blood flow reduction. (2009)
  • Author(s): Ozaki H, Kusuhara K, Sato Y, Brechue WF, Ogita F, Nakajima T, Abe T.
  • Journal Title: Proceedings of the ICSES Pages: 342-347
  • Peer Reviewed
• [Presentation] Low-intensity resistance exercise with blood flow restriction does not activate coagulation system in young men. (2010)
  • Author(s): Madarame H Kurano M, Takano H, Iida H, Sato Y, Ohshima H, Abe T, Ishii N, Morita T, Nakajima T.
  • Organizer: The 57^<th> Ameriean College of Sports Medicine
  • Place of Presentation: Baltimore, Maryland, USA:
• [Presentation] Low-intensity walk training with blood-flow reduction concurrently improved VO2peak and musclular function in elderly women. (2010)
  • Author(s): Ozaki H, Sakamaki M, Ogasawara R, Suguya M, Yasuda T, Sato Y, Nakajima. T, Abe T.
  • Organizer: The 57^<th> American College of Sports Medicine
  • Place of Presentation: Baltimore, Maryland, USA:
• [Presentation] Concurrent improvement in muscle volume and VO2max in response to blood flow restricted. cycle training. (2010)
  • Author(s): Abe T, Fujita S, Nakajima T, Sakamaki M, Ozaki H, Ogasawara R, Sugiya M, Kudo M, Kurano M, Yasuda T, Sato Y, Ohshima H, Mukai C, Ishii N.
  • Organizer: The 57^<th> American College of Sports Medicine
  • Place of Presentation: Baltimore, Maryland, USA:
• [Presentation] Effects of low-intensity KAATSU resistanee training on skeletal muscle size and muscle strength/endurance capacity in patients with ischemic heart diseases. (2010)
  • Author(s): Nakajima T, Kurano M, Iida H, Takano H, Madarame H, Yasuda T, Sato Y, Morita T.
  • Organizer: The 57^<th> Ameriean College of Sports Medicine
  • Place of Presentation: Baltimore, Maryland, USA:
• [Presentation] Acute high-intensity exercise releases myeloperoxidase and pentraxin3 from peripheral neutrophils in healthy subjects. (2010)
  • Author(s): Nakajima T, Kurano M, Takano H, Iida H, Fukuda T, Meguro K, Shiga T, Sagara M, Maemura K, Hirata Y, Yamasoba T, Nagai R.
  • Organizer: The Scientific Sessions, American Heart Association
  • Place of Presentation: Chicago, Ilinois, USA:
• [Book] リハ医とコメディカルのための最新リハビリテーション医学。編集主幹 上月正博、芳賀信彦、生駒一憲。先端医療シリーズ40. (2010)
  • Author(s): 中島敏明
  • Publisher: 先端医療技術研究所