研究目的：采用不同的干预手段，从心血管生理、心率变异性、脑血流和血容量变化的特点来探讨不同重力应激和运动锻炼模式对人体立位耐力的影响及可能机制，探寻更为有效的基于重力应激和运动锻炼的立位耐力提升方案，以期为立位耐力不良人群的防治提供参考，同时为健康人群制定科学的锻炼计划提供借鉴意义以及提升现有的基于重力应激和运动锻炼的对抗效果。

研究方法：对40名受试者随机分为重力应激组G-1和G-2组、运动锻炼E-1和E-2组、重力应激联合运动锻炼E-g组，每组8人，G-1组采用旋转床进行HUT15°/HUT75°交替改变，G-2组采用HDT15°/HUT75°交替改变，每个体位持续时间均为2min，反复10次，E-1组采用中等强度的跑步锻炼，E-2组采用中等强度的深蹲和提踵锻炼，E-g组采用波比跳锻炼方式，各组干预三周，干预前后进行OTT测试，测试过程中实时监控受试者的心率（HR），血压（SBP，DBP）指标和大脑中动脉血流速度（MCAV）和搏动指数（PI），同时对OTT测试过程中受试者心率变异性（HRV）进行分析。

研究结果：

（1）对于立位耐受时间，相较干预前，G-1组提升13.9%（14.3±3.4min VS 16.7±4.6min，P<0.05)、E-2组提升33.1%（14.2±1.7min VS 18.9±3.1min，P<0.01）、E-g组提升28.3%（13.4±2.6min VS 17.2±3.3min，P<0.05），G-2组和E-1组有上升趋势，但无显著性差异；

（2）相较于干预前，在进行OTT时，G-1组在平卧位，DBP下降，HF上升，立位时SBP，HF、LF、MCAV、PI显著升高；G-2组平卧位时，DBP下降，HR、HF上升，立位时SBP、DBP、PI显著降低，HF、LF显著升高；E-1平卧位时，SBP、DBP、HR下降，HF、MCAV上升，立位时SBP、DBP、HR、LF、PI显著下降，HF、MCAV显著升高；E-2组平卧位时，SBP、DBP下降，LF、MCAV上升，立位时SBP、DBP、HR、LF、MCAV显著上升；E-g组平卧位时，SBP、DBP、HR下降，HF、LF、MCAV上升，立位时SBP、DBP显著下降，HR、HF、LF、MCAV、PI显著升高。

（3）G-1组和G-2组干预前后HGB、HCT、PV均无显著性变化，E-1和E-g组干预后HGB、PV显著提升，HCT显著下降，E-2组HGB显著上升，HCT、PV无明显变化。

研究结论：

（1）三周的HUT15°/HUT75°的干预方式有效提升了健康人群的立位耐力，而HDT15°/HUT75°干预方式对于立位耐力没有显著影响，两种不同的初始角度干预对于立位耐力的影响不同，主要表现在面对立位应激时心血管自主神经和脑血流指标变化的差异。

（2）三周中等强度的有氧锻炼对健康人群的立位耐力提升并无显著影响，但对于心血管、脑血流和血液指标的改变有利于立位耐力的提升。

（3）三周中等强度的下肢抗阻锻炼对于健康人群立位耐力提升效果最为明显。

（4）重力应激的运动锻炼提升立位耐力的效果介于单纯重力应激和抗阻锻炼之间，未来还需继续探索不同的组合模式，但对于立位耐力不良人群的干预效果还需要进一步验证。

Research Objectives: To explore the effects and possible mechanisms of different gravity stress and exercise patterns on human orthostatic endurance from the characteristics of cardiovascular physiology, heart rate variability, cerebral blood flow and blood volume changes by using different intervention methods, and to explore a more effective orthostatic endurance improvement scheme based on gravity stress and exercise, in order to lay a scientific foundation for the prevention and treatment of people with poor orthostatic endurance. At the same time, it provides reference for healthy people to develop scientific exercise plans and improves the existing anti-confrontation effect based on gravity stress and exercise.

 

Methods: The 40 subjects were randomly assigned to gravity stress groups G-1 and G-2, exercise E-1 and E-2, and gravity stress combined with exercise E-g, Of 8 persons in each group, Group G-1 group an HUT15 / HUT75 alternating changes a rotating bed, The G-2 group was changed by alternating HDT15 / HUT75, Each position duration was 2min, Repeated for 10 times, E-1 group with moderate intensity running exercise, The E-2 group used moderate-intensity squat and heel lifts, In the E-g group, the Bobby jump exercise mode, Each group intervention for three weeks, The OTT test performed before and after the intervention, The subject's heart rate (HR) was monitored in real time during the test, blood pressure (SBP, DBP) index and middle cerebral artery blood flow velocity (MCAV) and beat index (PI), And analyze the subject heart rate variability (HRV) during the OTT test. 

 

Results:(1) Compared with the pre-intervention time, G-1 increased by 13.9% (14.3±3.4min VS 16.7±4.6min, P<0.05), E-2 increased by 33.1% (14.2±1.7min VS 18.9±3.1min, P<0.01), E-g increased by 28.3% (13.4±2.6min VS 17.2±3.3min, P<0.05), There was an upward trend between the G-2 group and the E-1 group, but there was no significant difference;(2) Compared with before the intervention, when OTT was performed, the DBP decreased in the G-1 group, HF increased, and SBP, HF, LF, MCAV, and PI increased significantly in the upright position; In the supine position of G-2 group, DBP decreased, HR and HF increased, SBP, DBP and PI decreased significantly in the upright position, and HF and LF increased significantly. When E-1 is lying flat, SBP, DBP, and HR decrease, HF and MCAV rise, and when E-1 is in the lying position, SBP, DBP, HR, LF, and PI decrease significantly, and HF and MCAV increase significantly. In the flat position of E-2 group, SBP and DBP decreased, LF and MCAV increased, and SBP, DBP, HR, LF and MCAV increased significantly in the standing position. In the supine position of the E-g group, SBP, DBP and HR decreased, HF, LF, and MCAV increased, and SBP and DBP decreased significantly when standing upright, and HR, HF, LF, MCAV, and PI increased significantly.(3) There were no significant changes in HGB, HCT and PV before and after the intervention of G-1 group and G-2 group, significant increase in HGB and PV and significant decrease in HCT after intervention in E-1 and E-g groups, significant increase in HGB in E-2 group, and no significant change in HCT and PV.

 

Conclusions: (1) The three-week HUT15°/HUT75° intervention effectively improved the standing endurance of healthy people, while the HDT15°/HUT75° intervention had no significant effect on standing endurance, and the effects of two different initial angle interventions on standing endurance were different, mainly manifested in the difference in cardiovascular autonomic nerve and cerebral blood flow indicators in the face of standing stress.(2) Three weeks of moderate-intensity aerobic exercise had no effect on the standing endurance of healthy people, but the changes in cardiovascular, cerebral blood flow and blood indicators were conducive to the improvement of standing endurance.(3) Three weeks of moderate-intensity lower limb resistance exercise has the most obvious effect on improving endurance in healthy people.(4) The effect of gravity stress exercise in improving standing endurance is between pure gravity stress and resistance exercise, and different combination modes need to be explored in the future, but the intervention effect of people with poor standing endurance needs to be further verified.

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