缺血預處理，對阻力運動表現之影響：系統性回顧

The effects of ischemic preconditioning on resistance exercise performance: A systematic review

缺血預處理 （ischemic preconditioning, IPC） 是一種非侵入性的方法，利用充氣式止血帶綑綁至近端肢段，反覆進行周邊組織缺血和再灌注，可增強組織對缺氧狀態的耐受性，進而可提升有氧與無氧運動表現。IPC 可以延長運動至衰竭的時間，並提升運動耐受性，而這似乎與增進阻力運動表現有關。因此，本研究透過PubMed、Scopus 與MEDLINE 資料庫蒐集相關文獻，並根據系統性回顧和統合分析的偏好描述項目 （preferred reporting items for systematic reviews and meta-analyses） 指南所定義之步驟進行系統性回顧，檢視IPC 對阻力運動之影響。文獻整理結果得知，共收錄了23篇文獻，文獻品質屬於良好 （6.6 ± 0.7 分）。在等長收縮運動中，IPC 無法改善最大自主收縮的動力學參數，但是，相較於控制處理和偽處理，IPC 能延長非最大自主收縮的運動至衰竭時間分別約29%和27%；在等速收縮運動中，相較於偽處理，IPC 能提升膝伸展與膝屈曲的平均力量和總力量約13%；在等張收縮運動中，相較於控制處理，IPC 能提升單關節運動的反覆次數約14%和訓練量約20%，也能提升多關節運動的反覆次數約39%和訓練量約36%。除此之外，相較於偽處理，IPC 能提升單關節運動的反覆次數約19%，也能提升多關節運動的反覆次數約32%和訓練量約33%。整體而言，在阻力運動前5-30 分鐘，將壓脈帶綑綁在上肢或下肢，使用220-250 mmHg 的壓力進行3-4 循環5分鐘的IPC，似乎能延長等長收縮運動時的衰竭時間，以及等速收縮運動時的力量輸出，並且能提升等張收縮運動時的反覆次數和訓練量。

Ischemic preconditioning (IPC) is a non-invasive technique that alternately performs blood flow occlusion and reperfusion by applying a pneumatic tourniquet to the proximal limbs. IPC could create a hypoxia environment, and thus improving aerobic and anaerobic exercise performance. IPC has been reported to improve exercise tolerance, e.g., time to exhaustion, therefore, IPC has been considered to increase resistance exercise performance. The purpose of this study was to investigate the effects of IPC on resistance exercise performance through reviewing previous studies from PubMed, Scopus, and MEDLINE databases. Previous studies were analyzed in according to the preferred reporting items for systematic reviews and meta-analyses guidelines. In this review, 24 studies were collected, and the average study quality was good (6.6 ± 0.7). For the isometric exercise, IPC could not improve the kinetic parameters of maximum voluntary contraction, but it could extend the time to exhaustion of non-maximum voluntary contraction by 29% and 27%, respectively, while comparing with control and sham treatment. For the isokinetic exercise, IPC could increase the average and total force of knee extension and flexion by 13%, while comparing with sham. For the isotonic exercise, IPC could improve the number of repetitions and the training volume of single-joint resistance exercises by 14% and 20%, respectively, while comparing with control treatment. For the multi-joint resistance, IPC could also increase the number of repetitions and the training volume by 39% and 36%, respectively, compared with control treatment. When compared with sham treatment, IPC could enhance the training volume of single-joint resistance exercises by approximately 19%, and could increase the number of repetitions and the training volume of multi-joint resistance exercises by 32% and 33%, respectively. Overall, performing IPC (cuff pressure set at 220-250 mmHg, 3-4 cycles of 5 minutes occlusion and 5 minutes reperfusion) on the upper or lower limbs 5-30 minutes before resistance exercise might improve the time to exhaustion of isometric exercise and the force of isokinetic exercise, as well as the number of repetitions and total training volume of isotonic exercise.