摘要

目的: 血流限制(Blood flow restriction, BFR)產生局部缺氧、細胞內代謝壓
力增加，啟動身體乳酸機制，合併低阻力訓練也能夠促進肌力增加、肌肉肥大；但是
少有研究探討其對認知功能的潛在幫助，甚至在雙重作業的立即性增益。本研究探討
血流限制對跑步機行走訓練時前額葉血紅素氧合能力、膚電反應(skin conductance
response, SCR)、心率變異性(heart rate variability, HRV)的改變，同時探討單
次跑步機行走搭配血流限制對於姿勢性雙重任務(posture dual-task)的立即性效果。

方法: 28 名健康成年人(平均年齡: 25.25 ± 2.59 歲，14 男，14 女)參與實驗。
受試者隨機分派至 BFR 合併跑步機行走組(BFR 組，n = 14 人)或一般跑步機行走組
(控制組，n = 14 人)。實驗程序共有三個部分：前測、跑步機介入、後測。前、後測
的項目有生理量測、路徑描繪測試(Trail Making Test A & B, TMT A & B)、姿勢雙
重任務等。生理量測包含：坐姿閉眼五分鐘休息時的心率變異性、膚電反應、以及前
額葉的血紅素氧合能力。姿勢雙重任務是受試者站在力板的軟墊上，以最快的速度拍
打感應燈系統(BlazePod system)所顯示的目標燈號。BFR 組的介入是在兩側大腿近
端綁加壓帶(100 毫米汞柱的壓力)進行跑步機行走到目標速度 5 Km/hr，總計 20 分
鐘。控制組不使用加壓帶，以相同方式行走 20 分鐘。以配對 t 檢定比較兩組受試者
前後測的表現差異(包含:拍打反應燈的反應時間(reaction time, RT)、正確拍擊數
(accurate hits)、壓力中心(center of pressure, COP)的移動面積、樣本熵(sample
entropy, SampEn)、TMT A & B、血紅素氧合能力、膚電反應、心率變異性)，以獨立
t 檢定比較上述參數之標準化訓練增益((後測−前測)／前測)的組間差異。獨立 t 檢
定亦用於比較兩組受試者在跑步機行走時，心率變異性參數、膚電反應參數、以及前
額葉血紅素氧合能力變化的差異。

結果: 在姿勢上作業方面，反應時間的標準化訓練增益在 BFR 組與控制組間具
有顯著差異，相較於控制組，BFR 組的正確拍擊數顯著提升(p = 0.023)且反應時間
縮短(p = 0.002)。在姿勢作業方面，壓力中心移動面積與樣本熵的標準化增益並沒
有顯著的差異(p > 0.05)。認知測試方面，TMT A 與 B 在介入前後的標準化增益並沒
有顯著的組間差異(p > 0.05)。在跑步機行走時，除了平均心率(HRmean)較低之外，BFR
組心率變異的 SD1 與 RMSSD 也顯著高於控制組(p = 0.024)。但是兩組膚電反應並沒
有顯著的不同(p > 0.05)；在血紅素氧合能力的變化方，BFR 組ΔHbO2 數值顯著小
於控制組(p = 0.013)，但是兩組的ΔHHb 並未出現顯著差異(p > 0.05)。

結論: 跑步機行走搭配血流限制在姿勢雙重任務表現有更好的表現，特別是姿
勢上作業，其原因可能與血流限制帶來迷走神經的調控增強有關；本研究結果支持下
肢有氧訓練搭配下肢血流限制可以促進姿勢雙重作業表現，潛在對平衡障礙族群的防
跌訓練具有價值。

關鍵詞: 血流限制、跑步機行走、雙重任務、膚電反應、心率變異分析、氧合能力

Abstract

Objectives: Blood flow restriction (BFR) produces local hypoxia during exercise
training. Low-load exercise combined with BFR can effectively increase power and
hypertrophy of the muscle, attributable to the increases in systematic lactate level and intracellular metabolic pressure. However, the acute effects of treadmill walking with BFR on cognitive function, especially for posture dual-task, have not been systematically investigated. The purposes of this study were to investigate 1) the differences in SCR level, HRV kinetics, and prefrontal hemoglobin/dehemoglobin dynamics during treadmill walking with or without BFR, and 2) the immediate effect of single-bout treadmill walking with BFR on the performance of a designated posture dual-task for young adults.

Methods: Twenty-eight healthy young adults (mean age: 25.25 ± 2.59 years; 14 men and 14 women, ranging from 22 to 34 years old) were recruited in this study. All participants were randomly assigned to either treadmill walking with BFR (the BFR group, n = 14) or the treadmill walking alone (the control group, n = 14). The experimental procedure included pre-test, intervention session, and post-test. The pre-test and post-test consisted of physiological measurements (PM), Trail Making Test A and B (TMT A & B), and a posture dual-task (DT). For the PM, the participants sat in a comfortable position with their eyes closed for 5 minutes, during which baseline heart rate variability (HRV), skin conductance response (SCR), and oxygenation capacity & hemodynamics (OCH) of the left prefrontal lobe were monitored. During the intervention session, the BFR group was instructed to walk
on the treadmill at a target speed of 5 Km/hour for 20 minutes, wearing the inflated pneumatic cuffs at 100 mmHg around the proximal portion of their bilateral thighs. The control group did not receive vascular constraints during the treadmill walking. Independent samples t-test was used to contrast normalized differences ((post-test-pre-test)/pre-test) in scores of TMT-A and B and task performances of posture and supraposture tasks (e.g., reaction time (RT), accurate hits, area of the center of pressure (COP-area), and sample entropy of the center of pressure (COP-SampEn)) between the two groups. Furthermore, independent samples t-test was used to contrast HRV variables, SCR variables, and ∆HbO2/∆HHb during treadmill walking.

Results: For the significant normalized changes in the supraposture task performance, the BFR group revealed a greater increase in the number of accurate hits (p = 0.023) and shorter reaction time (RT) (p =0.002) in the post-test than the control group, despite an insignificant group difference in normalized changes in the COP-area. For the cognitive tests, there were no significant differences in normalized change in TMT A & B between the two groups (A: p = 0.882, B: p = 0.648). For the HRV during treadmill walking, the BFR group exhibited higher SD1 and RMSSD than the control group (p = 0.024). The SCR level during treadmill walking did not significantly differ for the BFR and control groups (p > 0.05). The
control group exhibited a higher relative increase in oxygenated hemoglobin (ΔHbO2) during treadmill walking than the BFR group (p = 0.013), despite that relative increase in deoxygenated hemoglobin (ΔHHb) was not different between the two groups (p > 0.05).

Conclusion: Treadmill walking with BFR is helpful to improve posture dual-task
performance, especially for supraposture task component. The performance gain possibly relates to enhanced vagal modulation with BFR. This study supports the concept that aerobic training combined with lower extremity BFR can promote posture dual-task performance, with potential training benefit to prevent falls for the subjects with postural destabilization.

Keywords: blood flow restriction, treadmill walking, dual-task, skin conductance
response, heart rate variability, oxygenation capacity

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