2. Nh xut bn Y hc H Ni, nm 2012 Hot ng th lc trong phng v iu tr
bnh
3. 5 Hotngthlctrongphngviutrbnh IU PHI DCH V BIN SON PGS. TS.
Nguyn c Hinh Trng i hc Y H Ni TS. Trn Th Thanh Hng Trng i hc Y H Ni
CC CHUYN GIA HIU NH ThS. Trn Quc Bo Cc Y t d phng, B Y t1. PGS. TS.
ng Th Ngc Dung Trng i hc Y H Ni2. TS. Nguyn Quang Dng Vin dinh dng
quc gia3. ThS. Nguyn Thu Hoi Trng i hc Y H Ni4. PGS. TS. Nguyn c
Hinh - Trng i hc Y H Ni5. TS. Nguyn Th Thanh Hng Trng i hc Y H Ni6.
TS. Trn Th Thanh Hng Trng i hc Y H Ni7. PGS.TS. Phan Trng Ln Cc Y t
d phng, B Y t8. ThS. Nguyn Vn Ph Bnh vin Th thao Vit Nam9. ThS. H
Th Kim Thanh Trng i hc Y H Ni10. PGS.TS. Nguyn Vn Tng Trng i hc Y H
Ni11. TS. Nguyn Vn Tun Trng i hc Y H Ni12.
4. 6 Hotngthlctrongphngviutrbnh CC DCH GI BS. Phm Th Hng Dng1.
BS. o Vit Hng2. Th.s. BS. Nguyn Thu Hoi3. ThS. H Phm Thc Lan4. BS.
u Ly Na5. BS. Li Quc Thi6. BS. H Huy Thin Thanh7. BS. Trnh Xun
Thng8. BS. m Thy Trang9. v cc thnh vin nhm FSH TH K BIN SON BS.
Nguyn Thu Hoi Trng i hc Y H Ni Hiu nh ngn ng: Cng ty Quc t
D&N
5. 7 Hotngthlctrongphngviutrbnh CC TC GI GS.TS.BS. Jan
Henriksson, Khoa Sinh l v Dc l, Vin Karolinska, Stock-1. holm, Thy
in. PGS.TS.BS. Carl Johan Sundberg, Khoa Sinh l v Dc l, Vin
Karolin-2. ska, Stockholm, Thy in. GS.TS.BS. Eva Jansson, B mn Y hc
thc nghim, Khoa Sinh l lm3. sng, Vin Karolinska, Bnh vin i hc
Karolinska, Stockholm, Thy in. GS.TS. Sigmund A Anderssen, Trng i
hc Khoa hc Th thao Na Uy,4. Oslo, Na Uy. TS.ThS. Y t cng cng Matti
E. Leijon, Trung tm nghin cu chm soc5. sc khoe ban u, ai hoc Lund/
Khu vc Skne, Malm, Thuy in. TS. Chuyn gia y t cng cng Lena
Kallings, Khoa Y t cng cng va6. Khoa hoc iu dng, ai hoc Uppsala,
Uppsala, Vin Y t Cng cng Quc gia Thuy in, tersund, Thuy in. TS.
Johan Faskunger, Trung tm Y hoc Gia inh va Cng ng, Vin7.
Karolinska, Hi ng Stockholm, Stockholm, Thuy in. Chuyn gia t vn,
Chuyn gia vt ly tri liu, Chuyn gia Y t cng cng8. Geir Lrum, thanh
ph Norland, Bod, Na Uy. PGS. TS. BS. Mats Brjesson, Khoa Y hc, Bnh
vin ai hoc Sahlgrenska,9. Gothenburg, Thuy in. PGS.TS. Chuyn gia vt
ly tri liu Agneta Sthle, B mn Sinh hoc Thn10. kinh, khoa hoc iu dng
va Xa hi, Khoa Vt ly tri liu, Vin Karolinska, Stockholm, Thuy in.
TS. Chuyn gia tm ly hoc Anita Wester, y ban Gio dc Quc gia,11.
Stockholm, Thuy in. ThS. Lina Wahlgren, Trng Khoa hoc Th thao va Sc
khoe Thuy in,12. Stockholm, Khoa Khoa hoc Sc khoe, ai hoc rebro,
rebro, Thuy in.
6. 8 Hotngthlctrongphngviutrbnh GS.TS. Ingemar Wedman, Trng
Khoa hoc Th thao va Sc khoe Thuy13. in, Stockholm, ai hoc Vxj, Vxj
va ai hoc Gvle, Gvle, Thuy in. Chuyn gia tm ly hoc Barbro Holm
Ivarsson, Stockholm, Thuy in.14. Chuyn gia tm ly hoc Peter
Prescott, Bergen, Na Uy.15. PGS.TS. Chuyn gia vt l tr liu Maria
Hagstrmer, B mn Sinh hc16. Thn kinh, Khoa hc iu dng v X hi, Khoa Vt
l tr liu, Vin Karolinska, Stockholm, Thy in. GS.TS. Peter Hassmn,
Khoa Tm thn, i hc Ume, Ume, Thy17. in. PGS.TS. Monica Klungland
Torstveit, Khoa Th thao v Sc khe, i hc18. Agder, Kristiansand, Na
Uy. GS.TS. Chuyn gia tr liu Kari B, Khoa Y hc Th thao, Trng Khoa
hc19. th thao Na Uy, Oslo, Na Uy. GS.TS.BS. Ulrik Wislff, Khoa Tim
mch v Chn on hnh nh, i hc20. Khoa hc v Cng ngh Na Uy, Trondheim, Na
Uy. ThS. Dorthe Stensvold, Khoa Tim mch v Chn on hnh nh, i hc21.
Khoa hc v Cng ngh Na Uy, Trondheim, Na Uy. GS.TS.BS. Gran Friman,
Khoa Truyn nhim, Bnh vin i hc Upp-22. sala, Uppsala, Thy in. BS.
Lars Wessln, Khoa Truyn nhim, Bnh vin Gvle, Gvle, Thy23. in. BS.
Ola Rnsen, Trng on Y t i tuyn Olympic Na Uy, Olympiatop-24. pen,
Oslo, Na Uy. GS.TS.BS. Eva Nylander, n v Y khoa Tim mch, Bnh vin i
hc25. Linkping, Linkping, Thy in. TS.BS. Erik Ekker Solberg, Bnh
vin Diakonhemmet, Oslo, Na Uy.26. TS.BS. Ulrika Berg, B mn Sc khe
Ph n v Tr em, Khoa Ni tit Nhi27. khoa, Vin Karolinska v Bnh vin Nhi
Astrid Lindgren, Stockholm, Thy in.
7. 9 Hotngthlctrongphngviutrbnh TS.BS. Ann Josefsson, Khoa Sn,
Bnh vin i hc Linkping, Linkping,28. Thy in. GS.TS.BS. Mats Hammar,
B mn Sn ph khoa v sc khe Ph n,29. Khoa Khoa hc sc khe, i hc
Linkping, Linkping, Thy in. GS.TS BS. Jan Lexell, Khoa Phc hi chc
nng, Bnh vin i hc Lund,30. B mn Phc hi chc nng, Khoa Khoa hc lm
sng, i hc Lund, Lund, Thy in. GS.TS. Chuyn gia vt l tr liu Kerstin
Frndin, B mn Vt l tr liu,31. Khoa sinh hc thn kinh khoa hc iu dng v
x hi, Vin Karolin- ska, Stockholm, Thy in. TS. Chuyn gia vt l tr
liu Jorunn L Helbostad, B mn Khoa hc thn32. kinh, Khoa Y hc, i hc
Khoa hc v cng ngh Na Uy (NTNU), Trond- heim, Na Uy. GS.TS.BS. Egil
W. Martinsen, Bnh vin i hc Aker, Oslo, i hc Oslo,33. Na Uy. BS.
Jill Taube, Trung tm y t Gia nh v Cng ng, Vin Karolinska,34.
Stockholm, Thuy in. PGS.TS. Chuyn gia vt l tr liu, Margareta
Emtner, i hc Uppsala v35. Bnh vin i hc Uppsala, Uppsala, Thy in.
GS.TS.BS. Tommy Hansson, Khoa Chnh hnh, Bnh vin i hc Sahlg-36.
renska, Gothenburg, Thy in. TS. BS. Inger Thune, Bnh vin i hc Oslo,
Ullevl, Na Uy.37. TS. Chuyn gia vt l tr liu sa Cider, Khoa Vt l tr
liu, Bnh vin i38. hc Sahlgrenska, Gothenburg, Thy in. PGS.TS.BS.
Bengt Kjellman, Stockholm, Thu in.39. GS.TS.BS. Egil W. Martinsen,
Bnh vin i hc Aker, i hc Oslo, Oslo,40. Na Uy. TS.BS. Eva Andersson,
Trng Khoa hc Th thao v Sc kho Thu in,41. Stockholm, Thu in .
8. 10 Hotngthlctrongphngviutrbnh GS.TS.BS ClaesGran stenson,
Khoa Ni tit, Chuyn ha v i tho42. ng, Bnh vin i hc Karolinska v Vin
Karolinska, Stockholm, Thy in. GS.TS.BS Kre Birkeland, Khoa Ni tit,
Bnh vin i hc Aker v Trng43. Y, i hc Oslo, Oslo, Na Uy. PGS.TS.
Chuyn gia vt l tr liu Raija TyniLenn, Khoa Vt l tr liu,44. Bnh vin
i hc Karolinska, Stockholm, Thy in. PGS.TS.BS. Maria
Schaufelberger, Bnh vin i hc Sahlgrenska, Goth-45. enburg, Thy in.
GS.TS.BS. Lennart Bergfeldt, Hc vin Sahlgrenska, i hc Gothenburg46.
v Bnh vin i hc Sahlgrenska, Gothenburg, Thy in. GS.TS.BS. Anders
Englund, Trung tm Ri lon nhp tim v Vin Karolin-47. ska, Bnh vin
South, Stockholm, Thy in. GS.TS.BS. Knut Gjesdal, Khoa Tim mch, Bnh
vin i hc Ullevl,48. Oslo, Na Uy. GS.TS.BS. Sverre Kjeldsen, Khoa
Tim Mch, Bnh vin i hc Oslo, Ul-49. levl, Na Uy. PGS.TS.BS. Bjrn
Dahlf, Khoa Y, Bnh vin i hc Sahlgrenska stra,50. Gothenburg, Thy
in. ThS. Y t chnh Lena Bjrck, Labo Nghin cu, Bnh vin i hc Sahlg-51.
renska, Gothenburg, Thy in. GS.TS.BS. Dag S Thelle, i hc Oslo, IMB,
Khoa Thng k Sinh hc, Oslo,52. Na Uy. GS.TS.BS. MaiLis Hellnius,
Khoa Y hc, Vin Karolinska v Bnh vin53. i hc Karolinska, Stockholm,
Thy in. GS.TS.BS. Stephan Rssner, Khoa Bo Ph, Bnh vin i hc
Karolinska,54. Stockholm, Thy in. GS.TS. Chuyn gia vt l tr liu Ewa
Roos, Vin Khoa hc th thao v c55. kh sinh hc, i hc Min nam an Mch,
Odense, an Mch.
9. 11 Hotngthlctrongphngviutrbnh TS. Chuyn gia vt l tr liu Eva
Ljunggren Ribom, Vin Khoa hc Phu56. thut, Khoa Chnh hnh, i hc
Uppsala, Uppsala, Thy in. GS.TS.BS. Karin PiehlAulin, B mn Khoa hc
Sc khe, i hc rebro,57. rebro, Bnh vin i hc Danderyd, Stockholm, Thy
in. Chuyn gia vt l tr liu Kaisa Mannerkorpi, Khoa Vt l tr liu, Bnh
vin58. i hc Sahlgrenska, Gothenburg, Thy in. GS.TS.BS. Stein
Knardahl, Vin Quc gia v i sng ngh nghip v tm59. l, i hc Oslo, Oslo,
Na Uy. GS.TS.BS. Jon Karlsson, Khoa Chnh hnh, Bnh vin i hc
Sahlgren-60. ska/Mlndal, Gothenburg, Thy in. GS.TS.BS. Clas
Mannheimer, Trung tm au, Khoa Y, Bnh vin i hc61. Sahlgrenska /stra,
Gothenburg, Sweden. GS.TS.BS. David Bergqvist, Khoa Phu thut, Bnh
Vin i hc Uppsala,62. Uppsala, Thy in. GS.TS. Chuyn gia vt l tr liu
Christina H. Opava, Khoa Sinh hc thn63. kinh, Khoa hc iu dng v x
hi, Phn mn Vt l tr liu, Vin Karo- linska, Khoa Thp khp, Bnh vin i
hc Karolinska, Stockholm, Thy in. PGS.TS.BS. Ralph Nisell, Khoa Thp
khp, Bnh vin i hc Karolinska,64. Stockholm, Thy in. TS.BS. Nils
Hjeltnes, Khoa phc hi chc nng sau chn thng ty sng,65. Bnh vin
Sunnaas, Nesoddtangen, Na Uy. PGS.TS. Ingibjrg H. Jonsdottir, Vin Y
hc stress Gothenburg, Thy66. in. GS.TS.BS. Holger Ursin, Gio s danh
d, i hc Bergen, Bergen, Na67. Uy. Gio s danh d, TS. BS. Gunnar
Grimby, Khoa khoa hc thn kinh lm68. sng v phc hi chc nng, Vin khoa
hc thn kinh v sinh l, Hc vin Sahlgrenska, i hc Gothenburg,
Gothenburg, Thy in.
10. 12 Hotngthlctrongphngviutrbnh TS., Chuyn gia vt l tr liu
Carin Willn, Khoa Vt l tr liu v liu php69. ngh nghip, Vin khoa hc
thn kinh v sinh l, Hc vin Sahlgrenska, i hc Gothenburg, Gothenburg,
Thy in. TS., Chuyn gia vt l tr liu Margareta Engardt, Stockholm,
Thy in.70. GS.TS.BS. Katharina Stibrant Sunnerhagen, Hc vin
Sahlgrenska, i71. hc Gothenburg, Gothenburg, Thy in, Bnh vin Phc hi
chc nng Sunnaas, Khoa Y, i hc Oslo, Oslo, Na Uy.
11. 13 Hotngthlctrongphngviutrbnh LI NI U X hi hin i gn lin vi
vic thay i cc thi quen sng nh t hot ng th lc, n ung khng hp l. Cc
thi quen ny l mt trong cc yu t lm thay i c cu v gnh nng bnh tt. Rt
nhiu nghin cu trn th gii khng nh hiu qu hot ng th lc trong vic phng
v iu tr mt s bnh, tnh trng bnh. Ti Vit Nam, ngay t xa xa, ng cha ta
khuyn rn con chu cn ch luyn tp c c c th khe mnh. Tuy nhin, vic tp
luyn trong thi gian bao lu? Tp cc ng tc g? Cng luyn tp ra sao li
cha c cp ti mt cch chi tit. Cho ti nay, ti Thy in v mt s quc gia
trn th gii, hot ng th lc c coi nh mt phng thuc v cng c k n nh cc
thuc cha bnh khc. c s gip ca cc chuyn gia Thy in, chng ti trn trng
gii thiu ti c gi cun Hot ng th lc trong phng v iu tr bnh, c dch t
bn ting Anh. Cun sch ny l s tng hp cc bng chng t cc nghin cu v tc
dng ca hot ng th lc cng nh cc ch k n hot ng th lc i vi tng bnh c
th. Hy vng rng cc ni dung ca cun sch ny s gip cho cc bc s, nhn vin
y t trong vic t vn chuyn su v hot ng th lc vi tng bnh nhn c th. Ln
xut bn u tin s khng trnh khi cc sai st. Chng ti mong s nhn c kin gp
ca cc c gi c th iu chnh kp thi cho cc ln xut bn tip theo. Trn trong
cm n. iu phi dch v bin son PGS.TS. Nguyn c Hinh
12. 15 Hotngthlctrongphngviutrbnh LI GII THIU Hot ng th lc c th
coi l mt bin php hu hiu nng cao sc khe v phng chng bnh tt. Mt x hi
tng cng hot ng th lc s c tc dng gim thiu gnh nng bnh tt. Cho ti
nay, rt nhiu nghin cu chng minh c tc dng ca hot ng th lc trn mt s
bnh v tnh trng bnh nh i tho ng, tng huyt p, bnh tim mch, bo ph, ung
th i trng, long xng v trm cm. Cun sch ny l bn dch ln u tin sang
ting Vit t phin bn ting Anh uc xut bn nm 2010 da trn bn gc Physical
Activity in the Prevention and Treatment of disease (FYSS) bng ting
Thy in vo nm 2008. Hin nay, cun sch ny c coi nh cm nang v k n hot
ng th lc, c s dng rng ri ti h thng y t Thy in cng nh ti nhiu quc
gia trn th gii. Mc ch ca cun sch ny nhm nng cao kin thc v gi tr ca
vic thc y hot ng th lc cho bnh nhn ni ring v cho cng ng ni chung. i
tng ca cun sch ny rt a dng, bao gm t cc dch v y t ti cc t chc phi
chnh ph, cc ban ngnh hay cng ng. Mc d vi mc ch nn tng l nng cao nhn
thc nhng ni dung rt d tip cn, d thc hnh cho tt c nhng ai hot ng
trong lnh vc nhm nng cao hot ng th lc. Ngoi ra, cun sch ny cng c cn
nhc nh l nn tng ca sch gio khoa cho cc chng trnh o to khc nhau. S
ra i ca cun sch ny bng ting Thy in v ting Anh l kt qu ca d n c iu
phi bi Hi ngh nghip v Hot ng th lc (vit tt l YFA), mt hi ngh nghip
c lp, phn hi ca Hi y hc th thao Thy in thuc Tng hi Y hc Thy in. y l
mt hi gm rt nhiu chuyn gia n t cc chuyn ngnh khc nhau. YFA c mi hp
tc cht ch vi Vin Y t cng cng Thy in. Cng t cun sch ny, YFA cng xut
bn nhng n phm ngn gn hn c s dng cho tng nhm i tng c th.
13. 16 Hotngthlctrongphngviutrbnh Cun sch ny uc dch v in vi s
gip v h tr rt ln t ban lnh o ca YFA. Chng ti xin gi li cm n chn
thnh nht ti cc thnh vin ca ban bin tp GS. Mats Brjesson, GS. MaiLis
Hellenius, GS. Eva Jansson, GS. Jon Karlsson, BS.Matti Leijon, PGS.
Agneta Sthle, BS. Jill Taube. Ti cng xin gi li cm n ti ng Peter
Lamming vi s h tr cc th tc hnh chnh cho vic ra i cun sch ny. Cui
cng, cho ti gi li bit n ti Hi Y hc th thao Thy in cng vi AnnKristin
Andersson tip tc h tr cho cng vic ny. Chng ti cng mong rng FYSS s
gip vic tng cng th lc cho bnh nhn v ngi dn, qua gp phn nng cao sc
khe ca cng ng. Cun sch dch ny l mt ni dung chnh ca d n Hot ng th lc
trong phng v iu tr bnh khng ly nhim: t bng chng ti chnh sch, d n hp
tc i tc gia Thy in v Vit Nam vi ngun kinh ph h tr t t chc h tr pht
trin quc t SIDA (Thy in). Ngoi ra, d n cn bao gm cc hot ng o to cho
cc ging vin, cc bc s Vit Nam ti Thy in, ti Vit Nam v cc hot ng
truyn thng nhm nng cao nhn thc v thc y hot ng th lc cho cng ng. D n
ny c iu phi bi TS. Trn Th Thanh HngTrng i hc Y H Ni v ti. Ti cng cc
ng nghip Thy in mun gi li cm n chn thnh ti TS. Hng v cc ng nghip
ang cng tc ti H Ni v Ph Th. Cui cng, ti cng xin gi li bit n ti
Th.s. Helena Wallin h tr gn nh tt c cc hot ng ca d n v Gabriella
Beckvid Henriksson trong vic h tr nhng giai on cui ca d n. Thay mt
ban bin tp PGS.TS. Carl Johan Sundberg Vin Karolinska, Thy in Ch
tch YFA
14. 17 Hotngthlctrongphngviutrbnh CC THUT NG, CC CH VIT TT -
RM: mc lp ti a. 1RM tng ng vi trng lng ti a c th c nng ln bng mt ln
thc hin ng tc. - VO2 ti a: Kh nng tiu th oxy ti a - MET: n v chuyn
ha tng ng - HR ti a: tn s tim ti a - Borg RPE: Thang im Borg v kh
nng nhn thc tnh trng gng sc, im s t 6 n 20
15. 18 Hotngthlctrongphngviutrbnh
16. 19 Hotngthlctrongphngviutrbnh Mc lc Chng 1 Xu hng bnh tt ti
Vit Nam v khuyn co v hot ng th lc
......................................39 Trn Th Thanh Hng, Trn Quc
Bo, Phan Trng Ln 1. M hnh bnh
tt.....................................................................................39
2. Bnh khng ly nhim v cc yu t nguy c lin quan ti li
sng.....................................................................................................41
3. Khuyn co v hot ng th lc Vit
Nam......................................42 Chng 2 Hiu qu chung ca
hot ng th lc...................................44 Jan Henriksson,
Carl Johan Sundberg 1. M
u.....................................................................................................44
2. Cc yu t quyt nh s p ng i vi luyn tp th lc...............45 3. Tc
dng ca gng sc nht thi v tp luyn u n.................... 47 4. o liu
lng tp v hiu qu cc bi
tp...........................................48 5. Qu
tim....................................................................................................49
6. H c
xng............................................................................................50
7.
Mu..........................................................................................................54
8.
Xng........................................................................................................61
9. Sn
xng................................................................................................63
10. M lin
kt..............................................................................................64
11. Phi v thng kh
phi...........................................................................64
12. Cu trc c th v m m
...................................................................65
13. H thn
kinh...........................................................................................
67 14.
Da............................................................................................................68
15. ng tiu ha v
gan.........................................................................69
16. H thng
hormon..................................................................................69
17. 20 Hotngthlctrongphngviutrbnh Chng 3 Khuyn co chung v hot
ng th lc................................81 Eva Jansson, Sigmund A
Anderssen 1. Thp vn
ng..........................................................................................81
2. Cc khuyn co nhm tng cng sc
khe......................................83 3. Nhng khuyn co i vi
tp aerobic, tp luyn sc mnh v do
dai............................................................86
4. Nhng im khc v ging nhau gia cc khuyn co hin nay.....86 Chng 4
Thc y hot ng th
lc...................................................93 Matti E.
Leijon, Lena Kallings, Johan Faskunger Geir Lrum , Mats Brjesson,
Agneta Sthle 1. Hoat ng th lc la
gi?..........................................................................93
2. T ly thuyt n thc
hanh.....................................................................94
3. Cac yu t to thanh
cng....................................................................
101 4. T vn vi cu trc
5A..........................................................................
102 5. Nhng ngi c chuyn mn nao co th k n hoat ng th
lc?....................................................................................
103 6. Cac kt lun v t vn
gm:................................................................
106 7. M ta mt m hinh thc hin
FaR.....................................................107 8. FaR
khu vc Bc
u..........................................................................111
Chng 5 Tr nn tch cc hot ng
.................................................115 Anita Wester,
Lina Wahlgren, Ingemar Wedman 1. M
u....................................................................................................
115 2. Hoat ng th lc theo
tui.............................................................
116 3. Suy nghi v thay i li
sng................................................................
116
18. 21 Hotngthlctrongphngviutrbnh 4. Cac m hinh thay i hanh vi
trong linh vc hoat ng th lc........ 117 5. M hinh lin ly
thuyt.............................................................................
117 6. Cac giai oan thay
i..........................................................................
118 7. Cac qua trinh thay
i............................................................................
121 8. Cac qua trinh can
thip........................................................................
123 9. Thit lp thoi quen tp luyn thng
xuyn....................................... 125 10. Trai nghim va
thay i theo thi gian..............................................
126 11. Tac dung va s thay i theo thi
gian.............................................. 126 12. Thay i
ng
lc.................................................................................127
13. Phu n va nam
gii.............................................................................
130 14. Cac hoat ng th lc phai c iu chinh theo iu kin ca
nhn.............................................................................
130 Chng 6 Phng vn to ng lc gip k n hot ng th lc........134 Barbro
Holm Ivarsson, Peter Prescott 1. Gii
thiu.................................................................................................
134 2. Phong vn tao ng
lc.......................................................................
135 3. Bt u cuc phong
vn.......................................................................137
4. Cu hoi phn gi ra noi v thay
i.......................................... 141 5. Sn sang thay
i............................................................................
144 6. Cung cp thng
tin...............................................................................
148 7. i mt s khng c vi s tn
trong................................................. 149 8. Theo
doi..................................................................................................
151 9. Bng
chng............................................................................................
151 Chng 7 nh gi v kim sot hot ng th
lc..............................153 Maria Hagstrmer, Peter Hassmn
Tm
tt........................................................................................................
153
19. 22 Hotngthlctrongphngviutrbnh 1. nh gi hot ng th lc
.................................................................
153 2. nh gi hot ng tnh ti
................................................................
158 3. nh gi sc
bn..................................................................................
159 4. nh gi sc
mnh..............................................................................
162 5. nh gi cu trc c th
.....................................................................
163 6. Lu khi nh gi hot ng th
lc.................................................. 165 7. nh gi v
kim sot cng
........................................................167 Chng 8
Cc hnh thc tp
luyn.......................................................177
Monica Klungland Torstveit, Kari B 1. Cc hnh thc tp
luyn..........................................................................177
2.
Aerobic....................................................................................................177
3. Aerobic di nc
.................................................................................178
4. Chy di
nc......................................................................................178
5. Cc mn th thao vi bng, bng r v qun
vt..............................178 6. Th dc mm do
.................................................................................178
7. Trt tuyt vit
d...................................................................................179
8. p
xe.....................................................................................................179
9. Khiu
v.................................................................................................
180 10. i b vi gy
.......................................................................................
180 11.
Pilates....................................................................................................
180 12. Kh
cng.................................................................................................
181 13. Cho thuyn/bi
xung.......................................................................
181 14.
Chy.......................................................................................................
181 15. My tp nng bc chn
/crosstraining......................................... 181 16.
Luyn tp tng c lc theo
nhm....................................................... 182 17.
Bi
li.....................................................................................................
182 18.
Yoga......................................................................................................
182 19. i b
.....................................................................................................
182
20. 23 Hotngthlctrongphngviutrbnh Chng 9 Luyn tp c lc v sc
khe..............................................184 Eva Jansson,
Ulrik Wislff, Dorthe Stensvold Tm
tt........................................................................................................
184 1. Khuyn
co.............................................................................................
184 2. Liu cc bi tp c lc c tt cho sc
khe?...................................... 186 3. Bi tp tng c lc c
gy nguy him khng?................................... 190 Chng 10
Bnh truyn nhim v cc mn th thao..............................198
Gran Friman, Lars Wessln, Ola Rnsen Tm
tt........................................................................................................
198 1. nh ngha, biu hin v nguyn nhn
.............................................. 198 2. Triu chng,
chn on, iu tr v bin chng ............................... 199 3. Bnh
tng bch cu n nhn (nhim
EBV).......................................202 4. Vim c tim
...........................................................................................203
5. C ch tc ng ca nhim khun i vi hot ng th lc ........206 6. Hot ng
th lc va kch thch va c ch h min dch..............207 7. Nhim khun v
hot ng th lc cc nguy c v sc khe.......208 8. Hng dn kim sot v t vn
nhim khun vn ng vin...... 210 9. T vn hnh thc hot ng th lc sau khi
mc bnh tng bch cu n nhn v cc bnh nhim khun khc khi kh nng hot ng
gim ng k. ................................................ 214 10.
Lc u tp luyn bao nhiu l thch hp v mt bao lu mt ngi c th quay li tp
luyn bnh thng sau khi mc bnh tng bch cu n nhn.
........................................................................
215 Chng 11 Th thao v t
t...............................................................218
Mats Brjesson, Eva Nylander, Erik Ekker Solberg
21. 24 Hotngthlctrongphngviutrbnh Tm
tt........................................................................................................
218 1. nh
ngha..............................................................................................
218 2. Nguyn
nhn.........................................................................................
219 3. T l hin mc/t l mi
mc...............................................................
219 4. Chn
on.............................................................................................220
5. Sng lc ch ng/c mc ch bnh tim vn ng vin.............220 6. Khuyn
ngh ca cng ng Bc
u..................................................222 7. Sng lc c
gip bo tn tnh mng khng?.....................................223 8.
Tm lc khuyn
co............................................................................223
Chng 12 Hot ng th lc vi tr em v thanh thiu nin..................226
Ulrika Berg Tm
tt........................................................................................................226
1. i
cng...............................................................................................226
2. Tr em v thanh thiu nin ngy nay cn tp th dc mc
no?..........................................................................................227
3. Tc ng ca hot ng th
lc..........................................................230 4.
Tc ng trn th hnh (aerobic
fitness)..............................................230 5. Tc ng
trn c
lc.............................................................................
231 6. Tc ng trn chc nng nhn
thc................................................... 231 7. Tc ng
trn tm trng v sc khe tm thn.................................233 8.
Tc ng trn h
xng.......................................................................233
9. Tc ng trn bo ph v cc yu t nguy c ca bnh tim
mch...................................................................................234
10. Luyn tp th lc gng sc trong giai on pht trin v trng thnh c tc ng
bt li no khng?...................................236 11. Tr em v
thanh thiu nin ni
g?.....................................................236 12.
Khuyn
ngh.........................................................................................237
22. 25 Hotngthlctrongphngviutrbnh 13. C th y mnh hot ng th lc
tr em v thanh thiu nin bng cch
no?......................................................238 14. Tr
em/thanh thiu nin v th dc th
thao...................................238 15. Cc i tng c
bit........................................................................239
16. Cc phng php y mnh hot ng th lc c nh gi
cha?..........................................................................242
17. Kt
lun.................................................................................................243
Chng 13 Hot ng th lc vi ph n mang
thai...............................250 Ann Josefsson, Kari B Tm
tt........................................................................................................250
1. Cc thay i sinh l khi mang
thai.......................................................250 2.
au lng v au vng chu
hng...................................................... 251 3.
Chng tiu tin khng kim
sot......................................................... 251 4.
Chng bo
ph.......................................................................................252
5. Hiu qu ca hot ng th
lc..........................................................252 6.
Tin sn git/nhim c thai
nghn...................................................252 7. Bnh i
tho ng thai
k................................................................252
8. Chng bo
ph.......................................................................................253
9. au lng v/hoc au vng chu
hng............................................253 10. Chng tiu tin
khng kim
sot.......................................................254 11. T
vn v hot ng th lc khi mang
thai.......................................254 12. Bi tp
aerobic.....................................................................................255
13. Bi tp sc
mnh.................................................................................255
14. Bi tp tng linh hot cho
khp...................................................256 15. Cc xt
nghim chc nng cn thit kim tra sc khe............256 16. Chng ch
nh.....................................................................................257
17. Cc nguy
c..........................................................................................258
23. 26 Hotngthlctrongphngviutrbnh Chng 14 Hot ng th lc vi ph n
mn kinh................................261 Mats Hammar, Kari B Tm
tt........................................................................................................
261 1. nh
ngha..............................................................................................262
2. Nguyn nhn v triu
chng...............................................................262
3. Chn on cc triu chng ca mn
kinh.........................................265 4. iu tr cc triu
chng mn
kinh........................................................265 5.
Nhc im ca liu php thay th
estrogen...................................266 6. Hiu qu ca hot ng
th lc..........................................................267
7. Tc dng ln cc chc nng khc nhau trong thi k mn kinh......267 8. Ch
nh...................................................................................................271
9. Hng
dn.............................................................................................272
10. Gi v cc bi tp thch
hp............................................................272
11. Cc xt nghim chc nng cn thit kim tra sc khe.............273 12.
Tng tc vi liu php dng
thuc..................................................273 13. Chng
ch
nh.....................................................................................273
14. Nguy
c.................................................................................................273
Chng 15 Hot ng th lc i vi ngi ln
tui...............................281 Jan Lexell, Kerstin Frndin,
Jorunn L Helbostad Tm
tt........................................................................................................
281 1. M
u...................................................................................................282
2. nh hng ca qu trnh lo ha v tc dng ca hot ng th
lc.........................................................282 3.
Chc nng tm l v cht lng cuc
sng.......................................289
24. 27 Hotngthlctrongphngviutrbnh Chng 16 Hot ng th lc v hi
chng ri lon lo u.......................292 Egil W. Martinsen, Jill
Taube Tm
tt........................................................................................................292
1. nh
ngha..............................................................................................292
2. T l mc bnh/t l mc
mi.............................................................295
3. Nguyn nhn v yu t nguy
c..........................................................295 4.
Tin
lng..............................................................................................295
5. iu
tr....................................................................................................295
6. Hiu qu ca hot ng th
lc..........................................................296 7.
Ch
nh..................................................................................................
301 Chng 17 Hot ng th lc v hen ph
qun......................................306 Margareta Emtner
......................................................................................306
Tm
tt........................................................................................................306
1. nh
ngha..............................................................................................307
2. Triu chng v chn
on...................................................................309
3. Tin lng
.............................................................................................309
4. Nguyn tc iu tr: iu tr bng
thuc............................................. 310 5. iu tr bng
thuc i vi tnh trng tc nghn ng th do tp th dc
..........................................................................................
310 6. Cc ch c bit khi tp
luyn.......................................................... 313
Chng 18 Hot ng th lc v cc bnh l mn tnh vng lng...........319 Tommy
Hansson Tm tt
.......................................................................................................
319 1. nh
ngha..............................................................................................
319
25. 28 Hotngthlctrongphngviutrbnh 2. Nguyn nhn ca cc vn v lng
mn tnh c trng.............. 321 3. nh hng ca cc bnh mn tnh
lng........................................326 4. Hiu qu ca hot ng
th lc..........................................................327
5. Ch
nh..................................................................................................328
7. K
n....................................................................................................329
8. Chng ch
nh......................................................................................329
Chng 19 Hot ng th lc v bnh ung
th......................................337 Inger Thune Tm
tt........................................................................................................337
1. T l mi mc, nguyn nhn v cc yu t nguy c
.........................338 2. Cc c ch sinh hc ca hot ng th lc
......................................342 3. o lng hot ng th lc
trong bnh l ung th ..........................346 4. Cc yu t d phng
s cp
...............................................................346
5. Hot ng th lc vi vai tr iu tr v phc hi chc nng trong bnh l ung th
...............................................................................349
6. Cc hnh thc hot ng th lc, tn sut, cng v thi gian
..............................................................................
351 Chng 20 Hot ng th lc v bnh phi tc nghn mn tnh (COPD).356
Margareta Emtner Tm
tt........................................................................................................356
1. nh
ngha..............................................................................................357
2. Nguyn nhn v yu t nguy
c..........................................................357 3. T
l mc bnh/t l mc
mi.............................................................358
4. C ch bnh
sinh..................................................................................358
5. Triu chng v chn
on...................................................................359
6. Tin
lng..............................................................................................359
26. 29 Hotngthlctrongphngviutrbnh 7. Nguyn tc iu
tr................................................................................359
8. C ch tc
dng....................................................................................363
Chng 21 Hot ng th lc v bnh mch
vnh.................................371 Agneta Sthle, sa Cider Tm
tt.........................................................................................................371
1. nh
ngha..............................................................................................372
2. Triu
chng............................................................................................373
3. Nguyn tc iu
tr................................................................................374
4. Hiu qu ca hot ng th
lc..........................................................375 5.
Ch
nh..................................................................................................
381 6. Nguyn tc tp
luyn............................................................................382
7. Tng tc vi liu php iu tr bng
thuc.......................................384 8. Chng ch
nh......................................................................................386
Chng 22 Hot ng th lc v trm
cm............................................392 Bengt Kjellman,
Egil W. Martinsen, Jill Taube, Eva Andersson Tm
tt........................................................................................................392
1. nh
ngha..............................................................................................392
2. Tiu chun chn
on..........................................................................393
3. Quy trnh chn
on.............................................................................394
4. Hiu qu ca hot ng th
lc..........................................................395
Chng 23 Hot ng th lc v bnh i tho ng typ 2...................406
ClaesGran stenson, Kre Birkeland, Jan Henriksson Tm
tt........................................................................................................406
27. 30 Hotngthlctrongphngviutrbnh 1. nh
ngha..............................................................................................407
2. T l hin mc /t l mi
mc..............................................................407
3. Nguyn
nhn.........................................................................................407
4. Cc yu t nguy c
...............................................................................408
5. C ch bnh sinh
.................................................................................408
6. Triu chng v tin
lng.....................................................................408
7. Chn
on.............................................................................................409
8. iu
tr....................................................................................................409
9. Hiu qu ca hot ng th
lc.......................................................... 410
10. Ch
nh..................................................................................................
411 Chng 24 Hot ng th lc v bnh suy
tim.......................................419 sa Cider, Raija
TyniLenn, Maria Schaufelberger Tm
tt........................................................................................................
419 1. nh
ngha..............................................................................................420
2. Nguyn
nhn.........................................................................................
421 3. T l mc bnh/t l mi mc
............................................................ 421 4.
Bnh
sinh...............................................................................................
421 5. Triu chng v chn
on...................................................................422
6. Tin
lng..............................................................................................423
7. Nguyn tc iu
tr................................................................................423
8. Tc dng ca hot ng th
lc..........................................................423 9.
Tc dng tc thi ca bi tp
c.........................................................424 10.
Tc dng lu
di..................................................................................425
11. K
n...................................................................................................427
12. C ch tc
dng...................................................................................428
13. Tng tc vi
thuc.............................................................................
431
28. 31 Hotngthlctrongphngviutrbnh Chng 25 Hot ng th lc v ri loi
nhp tim...................................440 Agneta Sthle, Lennart
Bergfeldt, Anders Englund, Knut Gjesdal Tm
tt........................................................................................................440
1. nh
ngha..............................................................................................
441 2. Nguyn
nhn.........................................................................................442
3. Cc yu t nguy
c................................................................................442
4. C ch bnh
sinh..................................................................................443
5. Cc triu chng
chnh...........................................................................443
6. Chn
on.............................................................................................444
7. iu
tr....................................................................................................444
8. Tc dng ca hot ng th
lc..........................................................445 9.
Tp luyn th lc ngi c cc ri lon nhp tim khc nhau ........446 10. Ch
nh.................................................................................................448
11. K
n...................................................................................................448
12. C ch tc
dng...................................................................................
451 13. Thm d chc
nng............................................................................
451 14. Tng tc vi thuc iu
tr.................................................................452
15. Chng ch
nh.....................................................................................452
16. Nguy
c.................................................................................................452
Chng 26 Hot ng th lc v bnh tng huyt
p.............................456 Mats Brjesson, Sverre Kjeldsen,
Bjrn Dahlf Tm
tt........................................................................................................456
1. Gii
thiu.................................................................................................457
2. Tp th dc nhp iu duy tr vc
dng.........................................460 3. Luyn tp tng cng
sc mnh/nng vt nng trng thi tnh
........................................................................................460
4. Luyn tp theo vng trn (circuit
training)........................................... 461
29. 32 Hotngthlctrongphngviutrbnh 5. Tp kh
cng..........................................................................................
461 6. Ch
nh..................................................................................................462
7. K
n....................................................................................................464
Chng 27 Hot ng th lc v ri lon chuyn ha Lipid....................478
Lena Bjrck, Dag S Thelle Tm
tt........................................................................................................478
1. C s khoa
hc......................................................................................478
2. C ch tc ng
...................................................................................479
Chng 28 Hot ng th lc v hi chng chuyn ha.........................487
MaiLis Hellnius Tm
tt........................................................................................................487
1. nh
ngha..............................................................................................488
2. Yu t nguy c ca hi chng chuyn
ha........................................488 3. Sinh bnh hc ca hi
chng chuyn ha.........................................489 4. Cc
triu chng thng gp hu qu ca hi chng chuyn ha
?.............................................................................................490
5. Chn
on.............................................................................................490
6. iu
tr....................................................................................................492
7. Tc dng ca hot ng th
lc..........................................................492 8.
Ch
nh..................................................................................................495
9. K
n....................................................................................................495
10. Li khuyn v hot ng th lc phng v iu tr hi chng chuyn
ha............................................................495
11. Li khuyn v tp th dc
...................................................................496
12. Theo di tun th luyn tp v cho kin phn
hi........................497 13. Nguy c ca hot ng th lc v tm quan
trng ca khm sc
khe...................................................................................498
30. 33 Hotngthlctrongphngviutrbnh 14. Tng tc vi phc iu tr bng
thuc.......................................499 15. Chng ch
nh.....................................................................................499
Chng 29 Hot ng th lc v bo
ph...............................................511 Stephan Rssner
Tm
tt.........................................................................................................
511 1. nh
ngha...............................................................................................
511 2. Nguyn
nhn.........................................................................................
516 3. Chn
on.............................................................................................
518 4. Cc vn v phng php
lun...................................................... 518 5.
Hot ng th lc v bo
ph..............................................................
519 6. Nguyn tc iu
tr................................................................................520
7. Cc nguyn tc iu tr
khc................................................................520
8. Trin vng thc
t..................................................................................522
9. Tc ng ca hot ng th lc vi bo
ph......................................522 10. Hot ng th lc hng
ngy............................................................523
11. Li khuyn hu ch v hot
ng........................................................524 12.
Theo di khch
quan..........................................................................525
13. Hot ng th lc v cm gic ngon
ming....................................525 14. Chin lc trong cng
ng...............................................................528
15. Kim tra chc
nng.............................................................................528
16. Tng tc
thuc...................................................................................529
17. Chng ch
nh.....................................................................................529
18. Nguy
c.................................................................................................530
Chng 30 Hot ng th lc v vim xng
khp................................533 Ewa Roos Tm
tt........................................................................................................533
31. 34 Hotngthlctrongphngviutrbnh 1. nh
ngha..............................................................................................534
2. Chn
on.............................................................................................534
3. C ch bnh
sinh..................................................................................534
4. Din bin ca vim xng
khp..........................................................535 5.
T l mc bnh/t l mc
mi.............................................................536
6. Yu t nguy
c.......................................................................................536
7. Cc triu chng thng gp
...............................................................536
8. Nguyn tc iu tr
...............................................................................536
9. Hiu qu ca hot ng th
lc..........................................................537 10.
Tp th dc trong iu tr vim xng khp iu l tt nht!.537 11. Hiu qu tch cc
ca hot ng th lc...........................................538 12.
Ch
nh.................................................................................................539
13. Cc hnh thc tp aerobic fitness
...................................................... 541 14. C ch
tc
dng...................................................................................544
15. Lng
gi..............................................................................................544
Chng 31 Hot ng th lc v bnh long
xng...............................549 Eva Ljunggren Ribom, Karin
PiehlAulin Tm
tt........................................................................................................549
1. nh ngha long
xng.......................................................................550
2. T l hin mc/t l mi
mc...............................................................550
3. Nguyn
nhn.........................................................................................550
4. Cc yu t nguy c
...............................................................................550
5. Sinh bnh
hc........................................................................................550
6. Ch
nh..................................................................................................555
7. K n hot ng th
lc.....................................................................557
8. C ch tc dng ca hot ng th lc ln b xng......................558 9.
Cc xt nghim chc nng cn thit khi kim tra sc khe.............559
32. 35 Hotngthlctrongphngviutrbnh Chng 32 Hot ng th lc v
au.....................................................565 Mats
Brjesson, Kaisa Mannerkorpi Stein Knardahl, Jon Karlsson, Clas
Mannheimer Tm
tt........................................................................................................565
1. Gii
thiu.................................................................................................566
2. nh
ngha.............................................................................................566
3. Sinh l
au.............................................................................................567
4. Hiu qu ca hot ng th
lc..........................................................568 5.
C ch tc
dng....................................................................................570
6. Tc dng gin
tip................................................................................573
7. K
n....................................................................................................573
8. Tm tt k
n.......................................................................................574
9. Ch nh trn lm
sng.........................................................................575
10. Tng tc vi thuc iu
tr.................................................................579
11. Chng ch
nh.....................................................................................580
Chng 33 Hot ng th lc v bnh l mch mu ngoi bin..............589 David
Bergqvist, Agneta Sthle Tm
tt........................................................................................................589
1. nh
ngha..............................................................................................589
2. Hiu qu ca hot ng th lc
.........................................................590 3. C
ch tc dng ca hot ng th lc i vi triu chng i lc cch
hi:...........................................................................................
591 4. K
n....................................................................................................592
Chng 34 Hot ng th lc v vim khp dng thp..........................597
Christina H. Opava, Ralph Nisell Tm
tt........................................................................................................597
33. 36 Hotngthlctrongphngviutrbnh 1. nh
ngha..............................................................................................598
2. Sinh l
bnh...........................................................................................598
3. Triu
chng............................................................................................599
4. Chn
on.............................................................................................600
5. Tin
lng..............................................................................................600
6. Nguyn tc iu
tr................................................................................600
7. Hiu qu ca hot ng th
lc..........................................................602 8.
Li cm
n.............................................................................................607
Chng 35 Hot ng th lc v tn thng ty
sng............................611 Nils Hjeltnes Tm
tt.........................................................................................................
611 1. Gii
thiu.................................................................................................
612 2. Mc v rng ca tn
thng.................................................... 612 3. Dch
t
hc.............................................................................................
614 4. iu tr tn thng ty sng do chn
thng.................................... 614 5. nh hng ca chn thng
ty sng ln mc hot ng th
lc..................................................................
615 6. Chc nng thn kinh c/s co
cng................................................... 616 7. Chc
nng
phi.....................................................................................
616 8. S suy gim kh nng iu khin t
ng......................................... 616 9. Lon phn x t
ng...........................................................................617
10. Chc nng chuyn ha
......................................................................
618 11. Nhng tnh trng
khc.........................................................................
618 12. Tp th dc, hiu qu v nhng iu kin c
bit........................ 619 13.
Da..........................................................................................................620
14. ng dn niu v s tiu
tin..........................................................620
15. H tiu ha ng tiu ha
...........................................................620 16.
D phng co
cng...............................................................................
621
34. 37 Hotngthlctrongphngviutrbnh 17. Gim mt khong ca xng (long
xng).............................. 621 18. Khu phn n v dinh
dng............................................................622
19. Chng
au...........................................................................................622
20. Hi chng rng
ty.............................................................................623
21. Phu thut bn
tay..............................................................................623
22. Nhng dng c h tr chnh
hnh.....................................................623 23. Kt
lun................................................................................................624
Chng 36 Hot ng th lc v
stress.................................................629 Ingibjrg
H. Jonsdottir, Holger Ursin Tm
tt........................................................................................................629
1. nh
ngha..............................................................................................629
2. T l hin mc/t l mi
mc...............................................................630
3. Nguyn
nhn.........................................................................................
631 4. Chn
on.............................................................................................
631 5. nh hng ca hot ng th lc
.....................................................632 6. nh hng
ca hot ng th lc ln sc khe tm thn ..............632 7. nh hng cp ca
hot ng th lc ln nhng h thng stress sinh
l..................................................................633
8. nh hng lu di ca hot ng th lc ln h thng stress sinh
l..........................................................................................................634
9. nh hng ca hot ng th lc ln kh nng thch ng..............634 10. nh
hng ca hot ng th lc ln no ......................................635
11. K
n...................................................................................................636
Chng 37 Hot ng th lc v bnh t
qu......................................641 Gunnar Grimby, Carin
Willn Margareta Engardt, Katharina Stibrant Sunnerhagen Tm
tt........................................................................................................
641
35. 38 Hotngthlctrongphngviutrbnh 1. nh
ngha..............................................................................................
641 2. Dch t
hc.............................................................................................642
3. Triu
chng............................................................................................642
4. Nguyn tc iu
tr................................................................................642
5. Hiu qu ca hot ng th
lc..........................................................643 6.
Ch
nh..................................................................................................647
7. K
n....................................................................................................647
8. C ch tc
dng....................................................................................650
9. Bi tp th dc thm
m......................................................................650
10. Nghim php nh gi chc nng v kim sot sc khe............ 651 11.
Tng tc vi liu php dng thuc
..................................................652 12. Chng ch
nh v nguy
c.................................................................652
36. 1. Xu hng bnh tt v khuyn co v hot ng th lc ti Vit Nam 39
Chng 1 Xu hng bnh tt ti Vit Nam v khuyn co v hot ng th lc Trn Th
Thanh Hng, Trn Quc Bo, Phan Trng Ln 1. M hnh bnh tt Cng vi s thay i
cu trc dn s, ton cu ha, th ha v di dn, thay i mi trng, bin i kh hu
v thi quen sng, m hnh bnh tt ca Vit Nam cng c nhiu s thay i. Trong
khi t l mc cc bnh do nguyn nhn ly nhim ang gim th t l mc bnh khng
ly nhim li gia tng n mc bo ng. Gnh nng bnh tt do bnh khng ly nhim
vt qu gnh nng do bnh ly nhim. S liu nghin cu nm 2008 cho thy gnh
nng ca bnh khng ly nhim chim 71% tng ganh nng bnh tt, cao gp nhiu
ln so vi ganh nng bnh ly nhim, suy dinh dng va cac tinh trang bnh
ly ba me - tre em (13%) [11]. Ti bnh vin, trong khi t l mc bnh
truyn nhim gim t 55,5% (nm 1976) xung cn 19,8% (nm 2010) th t l mc
bnh khng ly nhim ang tng nhanh t 42,6% trong nm 1976 ln ti 71,6%
trong nm 2010 [1]. Bng 1.1: Tnh hnh bnh tt v t vong ti bnh vin
19762010. n v: % Nm Nhm bnh 1976 1986 1996 2006 2010 Dch ly Mc Cht
55,50 53,06 59,20 52,10 37,63 33,13 24,94 13,23 19,82 30,08
37. 40 Hotngthlctrongphngviutrbnh Nm Nhm bnh 1976 1986 1996
2006 2010 Khng ly Mc Cht 42,65 44,71 39,00 41,80 50,02 43,68 62,40
62,62 71,56 45,50 (Ngun: Thng k Y t 20062010, B Y t, 2011) Xu hng
mc bnh v t vong ti bnh vin c trnh by trong biu di y: XU HNG MAC
BENH80 60 40 20 0 Dch lay 1976 1996 2006 2010 Khong lay Tai nan,
ngo oc, chan thng 1986 (Ngun: Thng k y t 20062010, B Y t, 2011) Hnh
1.1: Xu hng mc bnh XU HNG T VONG 70 60 50 40 30 20 10 0 1976 1986
1996 2006 2010 Dch lay Khong lay Tai nan, ngo oc, chan thng Hnh
1.2: Xu hng t vong
38. 1. Xu hng bnh tt v khuyn co v hot ng th lc ti Vit Nam 41 2.
Bnh khng ly nhim v cc yu t nguy c lin quan ti li sng 2.1. Tnh hnh
mt s bnh khng ly nhim Chng trnh phng chng bnh khng ly nhim ca Vit
Nam c Chnh ph ph duyt v bt u trin khai t nm 2002. Cc bnh khng ly
nhim c tp trung u tin bao gm tng huyt p, i tho ng type 2, mt s bnh
ung th ph bin, tm thn v bnh phi tc nghn mn tnh. T l mc cc bnh khng
ly nhim ni trn u c xu hng tng theo thi gian. Theo nghin cu ca gio s
ng Vn Chung th t l mc tng huyt p ngi dn cc tnh pha Bc Vit Nam nm
1976 l 1,9% th cho ti nm 2002, t l ny ln ti 16,3%. Trn 50% ngi dn
trn 65 tui mc tng huyt p [2]. Theo iu tra quc gia v i tho ng typ 2
th t l ny l 2,7% nm 2002 v tng ln ti 5,7% vo nm 2008 [3]. i vi bnh
ung th th hng nm c tnh ti Vit Nam c 150 000 trng hp mc mi v 75 000
ngi t vong do ung th [4]. Theo nghin cu ca Bnh vin tm thn Trung ng
1 thc hin nm 2002 cho thy t l trm cm ca ngi Vit Nam chim 2,8% v t l
ng kinh l 0,33% [5]. Nu c tnh t l bnh phi tc nghn mn tnh da trn t l
ht thuc l th t l mc bnh phi tc nghn mn tnh ca ngi Vit Nam chim 6,7%
[6]. 2.2. Cc yu t nguy c lin quan ti li sng Ht thuc l Ht thuc l c
chng minh l nguy c hng u ca mt s loi ung th. Ht thuc l ch ng v th
ng u l nguyn nhn gy ra mt s bnh him ngho. Nu nh t l ht thuc l nam
gii nm 1998 l 50% th t l ny ln ti 56% trong nm 2002 [7]. Tuy nhin,
theo iu tra quc gia nm 2010 th t l ht thuc l nam gii t 15 tui tr ln
l 47%. n gii, t l ht thuc ch chim 1,8% [8].
39. 42 Hotngthlctrongphngviutrbnh Ung ru Cha c nghin cu quc gia
v s dng ru/bia ngi Vit Nam nhng theo nghin cu ca Vin chin lc v chnh
sch y t nm 2009 cho thy ri lon tm thn do ru l mt trong 10 bnh gy ra
gnh nng bnh tt ln nht cho nam gii Vit Nam. Theo iu tra Bnh khng ly
nhim v yu t nguy c ti 8 tnh/ thnh ph ca Vit Nam nm 2009-2010 trong
nhm tui 25-64, t l nam gii c ung t nht 5 n v ru/bia trong 1 ngy
trong tun va qua chim 25,2% trong khi t l n gii c ung t nht 4 n v
ru/bia trong 1 ngy trong tun va qua l 0,6% [9]. Dinh dng khng hp l
Theo iu tra bnh khng ly nhim v yu t nguy c ti 8 tnh /thnh ph ca Vit
Nam nm 2009-2010 cho thy c ti 80% nam cng nh n gii trong nhm tui
25-64 tiu th di 400 gam rau/qu trong 1 ngy. Kt qu nghin cu ny cng
cho thy t l tha cn bo ph (BMI 23) l 26,8%. Mc d bo ph Vit Nam cha
phi tnh trng bo ng nh i vi cc nc pht trin nhng t l ny cng ang gia
tng c bit cc thnh ph ln [9]. Hot ng th lc TTheo iu tra Y t quc gia
nm 2002 cho thy t l khng hot ng th lc ca nhm t 15 tui tr ln l 65%,
i vi nhng ngi lm ngh tnh ti l 57% [10] Theo iu tra bnh khng ly nhim
v yu t nguy c ti 8 Tnh /thnh ph ca Vit Nam nm 2009 -2010, t l ngi t
vn ng chim 27,9% nam gii v 31,9% n gii [9]. 3. Khuyn co v hot ng th
lc Vit Nam Mt ni dung khng th thiu c trong Chng trnh phng v kim sot
bnh khng ly nhim Vit Nam l thc y hot ng th lc. Tuy nhin, do hn ch v
ngun lc cng nh cha c cc chuyn gia chuyn su v ni dung ny nn cc hng
dn v hot ng th lc mi ch tun theo cc hng dn ca T chc Y t Th gii. Cha
c cc nghin cu ton din v cc khuyn co c th p dng cho ngi Vit Nam. Hot
ng th lc mi dng s khuyn khch hot ng thng qua cc chng trnh truyn
thng, gio dc sc khe. Hin cha c
40. 1. Xu hng bnh tt v khuyn co v hot ng th lc ti Vit Nam 43 cc
hng dn c th hot ng th lc vi thi gian bao nhiu? Tn sut nh th no? Cng
ra sao? Vi tng bnh c th. Ti liu tham kho B Y t (2011). Thng k y t
2006-2010. B Y t.1. Vin tim mch quc gia (2010). Bo co Chng trnh quc
gia phng2. chng bnh tng huyt p. Bnh vin Ni tit (2008). iu tra quc
gia v bnh i tho ng3. typ 2. Nh xut bn Y hc (2009). Dch t hc bnh ung
th.4. Bnh vin tm thn Trung ng I (2009). Bo co kt qu thc hin5. Chng
trnh mc tiu quc gia phng bnh tm thn. B Y t (2009). Hi tho quc gia v
Bnh phi tc nghn mn tnh,6. thng 11/2009 ti H Ni. B Y t (2002). iu
tra quc gia v thuc l.7. B Y t (2010). iu tra quc gia v s dng thuc
l.8. B Y t (2011). Bo co s b kt qu iu tra Bnh khng ly nhim9. v yu t
nguy c ti 8 Tnh/thnh ph ca Vit Nam (http://ncd.org.
vn/index.php?option=com_content&view=article&id=47&Itemid=60
&lang=vi). B Y t (2002). iu tra y t quc gia11. Trng ai hoc Y t
Cng10. cng (2011). Nghin cu ganh nng bnh tt va chn thng Vit Nam nm
2008.
41. 44 Hotngthlctrongphngviutrbnh Chng 2 Hiu qu chung ca hot ng
th lc Jan Henriksson, Carl Johan Sundberg 1. M u Thnh phn to nn cc
m v b gen trong c th chng ta nhn chung ging ht nh ca t tin chng ta
10.000 nm v trc. C th con ngi c cu to thch hp vi vic di chuyn. Hot
ng th lc mang li li ch cho c th cht v tr c ca con ngi. Hu ht cc m,
c quan u chu tc ng ca hot ng th lc v thch nghi vi luyn tp u n. Hot
ng th lc u n gip lm gim ng k nguy c t vong sm. Chng ny tp trung vo
nhng hiu qu tc th ca hot ng gng sc v hiu qu lu di ca hot ng th lc u
n hoc nhng bi tp duy tr vc dng (nh cc bi tp aerobic cc bi tp lm tng
nhp tim v nhp h hp). Hot ng th lc c nh ngha l tt c cc chuyn ng ca c
th c c do s co c v lm tng nng lng tiu th [1]. Cc thng tin chi tit v
ti liu tham kho xin xem ti cc sch gio khoa v tng quan cc bo co
nghin cu trong h thng d liu v sinh l luyn tp [26] hoc nhng ti liu
tham kho chuyn su hn ti tng chng. Nhng kha cnh ca vic luyn tp sc
mnh s c tho lun mt chng khc. Hot ng th lc bao gm cc hot ng vi mc
nng nh khc nhau. Cng hot ng cng ln th cng c nh hng tc th n nhiu chc
nng ca c th. Mc tiu th oxy c lin quan trc tip n tiu hao nng lng, t
0,25 lt/pht ti thi im ngh ngi tng n 1 lt/pht khi i b thong th. Khi
gng
42. 2. Hiu qu chung ca hot ng th lc 45 sc mnh, mc tiu th oxy
tng n 27 lt/pht, cao gp 1025 ln so vi lc ngh ngi. Gng sc lm tng nhp
tim v cung lng tim, tng trao i cht, tng huyt p, tng thn nhit, tng
ti mu c tim v cc c khc, to ra nhiu acid lactic v tng tit cc hormon
nh adrenalin, hormon tng trng v cortisol. Kh nng tiu th oxy ti a ph
thuc vo tm vc ca c th, gii tnh, tui, mc tp luyn, di truyn v nhiu yu
t khc. Nhng yu t gii hn kh nng gng sc ti a ca c th khc nhau ty thuc
vo thi gian ca qu trnh gng sc. Thi gian c cp trong cun sch ny c xem
l thi gian trung bnh dnh cho nhng ngi trung nin. Khi thi gian gng
sc ti a ko di 515 pht, tun hon trung tm (tim) c vai tr quan trng
nht trong vic gii hn kh nng tiu th oxy ti a. Nu qu trnh gng sc cng
di, kh nng gng sc cng b gii hn bi nhng thnh phn ca h c xng tham gia
vo qu trnh ny (ty th, mng mao mch, mt s phn t vn chuyn, kh nng
m...) v tc ng n ngng chuyn ha ym kh (xem phn nh ngha di y). Nu thi
gian gng sc ko di hn (trn 3060 pht), glycogen d tr trong c b cn
kit, s lm gim kh nng gng sc. 2. Cc yu t quyt nh s p ng i vi luyn tp
th lc C nhiu yu t xc nh mc ci thin ca mt ngi khi tng mc hot ng th
lc. Mt yu t quan trng l tnh trng sc khe v vc dng trc khi luyn tp. V
d, s ci thin s r rng hn mt ngi t vn ng v c th lc km so vi mt ngi
thng xuyn luyn tp v c th hnh tt. Luyn tp c tc dng c hiu i vi nhng c
quan v m tham gia vo qu trnh luyn tp. iu ny c ngha l nhng bi tp nht
nh ch tc ng v tng sc mnh ln nhng c v xng tng ng nht nh. Thi gian
luyn tp cng ng mt vai tr quan trng. Mc d c th nhn thy mt s hiu qu
sau thi gian ngn luyn tp (mt vi tun) nhng nhn chung hiu qu s r rng
hn khi tp luyn lin tc t vi thng ti vi nm. D nhin, hiu qu ca bi tp s
dn khng cn t l vi mc vn ng v thm ch, trong nhiu trng hp cn tp luyn
nhiu hn ch nhm mc ch duy tr vc dng c th.
43. 46 Hotngthlctrongphngviutrbnh Ba yu t quan trng khc l tn
sut (mc thng xuyn luyn tp), thi gian (thi gian ca mi bui tp) v cng
(mc nng ca bi tp). Ba yu t ny to thnh liu lng luyn tp. Ni mt cch
khc, liu tp cng cao th hiu qu cng ln. Tuy nhin, cng cn nhn mnh rng
liu tp thp cng c tc dng nhng vi kt qu hn ch hn. 2.1. Tn sut i vi tp
luyn th lc, t hiu qu gi gn vc dng v sc khe tt nht, cn phi duy tr
luyn tp thng xuyn v u n. Hiu qu mang li t mt bui tp c th tc ng n c
th trong nhiu ngy v mt i sau . V vy, nn duy tr vic luyn tp vi cng
thp hng ngy. 2.2. Thi gian Nh mt quy lut, hot ng th lc cng ko di th
hiu qu cng ln. Trong nhiu trng hp, tp luyn th lc trong ngy c th
chia lm nhiu bui tp ko di khong 1015 pht, min l m bo tng thi gian
tp mt ngy. Li khuyn chung nht l mi ngi nn dnh t nht 30 pht/ngy luyn
tp. 2.3. Cng Bi tp cng cng cao th hiu qu ln sc khe v vc dng cng
nhiu, mc d nhng bi tp vi cng nng c th dn n nhng tc ng khng mong
mun. Nhng bi tp vi cng thp c tc dng nhng luyn tp vi cng cao hn s l
yu t quan trng gip ci thin v duy tr th lc. Ngoi ra, cn c mt s yu t
nh hng n kt qu ca qu trnh luyn tp. V d, tc dng ca bi tp c lin quan
ti s thay i cng v s lng cc c tham gia. Yu t di truyn ng vai tr tng
i ln trong mc p ng i vi luyn tp, chim t 1/3 n 1/2 ty mi c th. Kt qu
t mt s nghin cu cho rng nhng ngi c kh nng tp luyn vi mc cao hn nhng
ngi khc thng l do h c gen c hot ha mnh hn [7, 8]. C ch di truyn c
ng vai tr duy nht trong s khc bit v p ng vi luyn tp hay khng hin vn
cha c xc nh r. Tui c th cng l yu t quan trng, mc d nhng ngi ln tui
khng h gim kh nng ci thin th lc tng i ca h. Thnh phn trong khu phn
n cng ng vai tr nht nh. Ch n thiu cht lm
44. 2. Hiu qu chung ca hot ng th lc 47 gim p ng vi cc bi tp.
Tuy nhin, vic b sung thm khu phn n cng cha c chng minh l mang li
hiu qu. 3. Tc dng ca gng sc nht thi v tp luyn u n Khi tho lun v hiu
qu ca hot ng th lc ln cc c quan v h c quan trong c th, cn phi phn
bit hai im quan trng: Th nht l nhng s thay i ca c th trong (v sau)
khi tp luyn so-- vi trng thi lc ngh ngi. Th hai l nhng chuyn bin t
c (ti thi im ngh ngi hoc khi-- gng sc) sau mt thi gian luyn tp nht
nh so vi trng thi c th khng c tp luyn. Trong phn ny, ni dung u tin
nhm cp ti hiu qu tc th ca-- gng sc v ni dung th hai cp ti hiu qu ca
tp luyn thng xuyn. Hiu qu tc th ca gng sc ph thuc vo mt s yu t,
trong c yu t l s khc bit ca cc m c quan. Thi gian nhn thy s ci thin
cc chc nng khc nhau do luyn tp l khc nhau (v d, chc nng gi thng
bng, chc nng phi hp). Theo sinh l hc, hot ng th lc va c gi l ym kh
va l a kh, ph thuc vo loi hnh chuyn ha no chim u th. Theo nguyn tc,
hot ng th lc l a kh (ph thuc vo oxy) nu thi gian t c tiu th oxy ti
a l di 2 pht [3]. Sau , cc c ly nng lng t qu trnh phn hy
carbohydrat hoc cht bo ph thuc oxy. Nu mt ngi c nng lng tin hnh hot
ng th lc ti a trong hai pht, th qu trnh chuyn ha ny c th l 50% a kh
v 50% ym kh (khng ph thuc oxy). Trong mt khong thi gian ngn, hot ng
th lc vi cng cao th cc c s phi lm vic trong mi trng thiu oxy (chuyn
ha ym kh). Trong tnh trng ny, ngun cung cp nng lng chnh l acid
lactic do thoi ha glycogen v gluco. Kt qu l, nhng bi tp a kh v ym
kh to ra nhng hiu qu luyn tp khc nhau. Bi tp a kh c thc hin trong
mt thi gian nht nh s kch thch s thch nghi ca tim v h c xng. iu ny
gii thch ti sao tp luyn thng xuyn s lm tng chc nng tim v tng th tch
ty th ca nhng t bo c tham gia luyn tp. Thi gian tp luyn trong nhng
bi tp ym kh n thun (nh chy nc rt) qu ngn c th
45. 48 Hotngthlctrongphngviutrbnh tc ng ln tim v c. Thay vo ,
nhng bi tp nh vy lm tng sn xut v dung np acid lactic. Hot ng th lc
hng ngy thng bao gm c cc hot ng a kh v hot ng ym kh, v d nh i b leo
dc. Nhng bi tp nng cao sc bn, c bit tp vi ti trng ln, l dng in hnh
ca hot ng ym kh. Trong tp luyn ngt qung (v d gng sc nng ko di 1015
giy, xen k nhng khong ngh di tng ng), nhng bi tp a kh v ym kh thng
thng c kt hp sao cho tng thi gian tp vi cng nng c th di mang li
nhng li ch c trn tim v c [81]. 4. o liu lng tp v hiu qu cc bi tp
Phng php thng dng nh gi v iu chnh liu tp ca tng ngi l o nhp tim v
mc gng sc. Ni dung ny s c bn lun chi tit trong Chng 7. Dng c o bc
chn hoc my m bc chn c s dng tnh cc chuyn ng dc. y l nhng cng c tt o
tng s bc chn khi i b v chy nhng li khng o c cc dng vn ng khc. thu c
cc s o khch quan v hot ng th lc ca mt ngi trong mt thi gian nht nh,
ngi ta s dng gia tc k ba trc. Dng c ny c th o c tn sut, cng v thi
gian ca chuyn ng trn cc mt phng nm ngang, i xng dc v thng ng [11].
Hiu qu luyn tp trong nhng bi tp ym kh thng c o bng s thay i kh nng
tiu th oxy ti a. Kh nng tiu th oxy ti a l mc tiu th oxy cao nht m
mt ngi c th t c, c o khi ngi c nhp tim cao nht (nh ang chy) v c vai
tr quan trng trong nhng bi tp ngn (515 pht) [12]. Kh nng tiu th oxy
ti a s ci thin khong 2050% trong thi gian t 26 thng tp luyn vi cng
mnh. Tuy nhin, s p ng vi luyn tp khc nhau ty thuc vo mi c th. T kh
nng tiu th oxy ti a c th tnh c mc tiu th nng lng cao nht ca mt ngi
do mi lt oxy c s dng tng ng vi mt nng lng khong 20kJ (5kCal). V vic
o trc tip lng oxy tiu th ti a tng i kh khn, i hi nhng k thut c bit
v s gng sc ti a nn gn y, ngi ta thng s dng phng php gin tip, trong
lng oxy tiu th ti a c tnh da vo nhp tim vi mc gng sc thp hn [3].
Tuy nhin mc tin cy ca phng php gin tip ny cn hn ch.
46. 2. Hiu qu chung ca hot ng th lc 49 Ngng chuyn ha ym kh
(test ngng acid lactic) c th c xc nh bng cch o nng acid lactic
trong mu mu c ly trong khi gng sc khng ti a [13]. Ngng chuyn ha ym
kh c xc nh bng cng gng sc c duy tr cao nht m ti thi im s xut hin ca
acid lactic trong mu s cn bng vi s mt i ca n. Nu tnh theo phn trm,
gi tr ny s cao hn nhiu so vi kh nng tiu th oxy ti a sau mt thi gian
tp luyn. Qu trnh tp luyn c th gip ci thin nng lng tiu hao trong qu
trnh luyn tp, th hin bng s gim nng lng tiu th cho cng mt hot ng
(gim lng oxy tiu th) v tng hiu qu. C th thy rt r iu ny trong nhiu
hot ng nh chy b trong khi i vi nhng hot ng khc (nh p xe), hiu qu ni
chung li ging nhau tt c mi ngi. Ngoi cc ch s trn, cn c th o lng tc
dng ca hot ng th lc qua s thay i mt s ch s chuyn ha. V d: c th o cc
ch s hemoglobin glycosyl ha (HbA1c, nh gi nng gluco mu trong mt thi
gian di), gluco mu sau n hai gi, nhy cm vi insulin, cc ch s nh gi
lng cht bo trong c th nh: cn trng lng di nc, np vo da, DXA (hp ph
tia X nng lng kp), BOD POD [15]. Hoc c th o ch s IgA trong nc bt
[16] nh gi mi lin quan gia min dch v hot ng th lc. 5. Qu tim 5.1.
Gng sc nht thi Vi qu trnh luyn tp cn phi huy ng nhng nhm c ln th tc
ng ca hot ng th lc ln tim v h tun hon rt cao. Nhu cu cung cp oxy v
cht dinh dng ca h c xng rt cao, tuy nhin, nhu cu thi carbonic v cc
sn phm khc cn cao hn. Cng trong qu trnh ny, nhu cu cn bng gia nhit
v tnh trng toan kim cng ht sc cn thit v do vy, i hi s lu chuyn mu
mnh m hn. Nhu cu ny c p ng thng qua h thn kinh thc vt, lm tng nhp
tim v tng lc co c tim. Tn s tim tng n khong 120 nhp/pht (so vi bnh
thng 6080 nhp/pht) km theo tng th tch nht bp ng ngha vi tng lng mu
c bm ra khi tim trong mi nht bp. Khi gng sc, tn s tim c th tng ti a
ti 150230 nhp/pht, lng mu c bm ra c th tng ti a n 2040 lt/pht (so
vi 45 lt/pht lc ngh ngi), ph thuc ch yu vo tui v mt s yu t khc. Lc
co c tim tng lm tng p lc trong cc bung tim. Nhp tim v sc co c tim
tng t l thun vi cng vn ng. Qu tim cng
