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ARC Journal of Research in Sports Medicine Volume 3, Issue 1, 2018, PP 29-32 www.arcjournals.org

Aerobic Exercise and Hemorheology

Bin Liu1, Yan Song2*, Junlong Sheng3 1Sports college, Jilin University, Changchun, China. 2Associate professor, Research direction: Sports and Health, Hainan Medical University, China. 3College of Sports Human Sciences, Beijing Sport University, Beijing, China.

*Corresponding Author: Yan Song, Associate professor, Research direction: Sports and Health, Hainan Medical University, China. Email: [email protected]

Abstract: Hemorheology is an important factor of normal flow. Decreased physical function or diseases will cause abnormal hemorheology. Aerobic exercise can optimize the indicators of hemorheology, prevent complications, improve quality of life. This article reviewed the effects of aerobic exercise on the hemorheology in ill population and middle-aged and older population, aimed to analyze the relationship between aerobic exercise and hemorheology, and provided reference for investigation in this field. Keywords: Aerobic exercise, Hemorheology, Middle-aged and older population.

1. INTRODUCTION investigators consider hemorheology as a indicator of sub-health. Aerobic exercise is referred to the exercise of more than 40 min with sufficient , with Hemorheology includes whole blood the rate accounting for 60-80 % of the (BVH, BVL), erythrocyte aggregation (EA), maximum heart rate. Aerobic exercise can plasma specific viscosity (PV), red increase cardiopulmonary endurance and (RBC) and platelet electrophoresis time (s), oxygen uptake, and promote the generation of whole blood reduced viscosity (BVH, BVL), collateral circulation to recover damaged erythrocyte sedimentation rate (ESR), organs. (HCT), deformability Usually, Tai Chi, swimming, gymnastics and (TK), fibrinogen (FIB) and red blood cell rehabilitation training are aerobic exercise. hardness (IK), BVH, BVL, PV, EA and TK are Anaerobic exercise is referred to the situation main indicators. BVH is predominantly that oxygen uptake cannot meet the demand of attributed to TK, higher BVH, weak TK and exercise, and the body is in hypoxia. RBC elasticity, abnormal vascular wall. BVL is In 1950s, Copley first presented dependent on EA, BVH and BVL. Plasma “hemorheology” as “the study in the viscosity is closely associated with plasma components in blood and the flow characteristic , especially FIB. EA can reflect of blood”. Currently, hemorheology is referred erythrocyte aggregation objectively. to the study in blood circulation, component Abnormal hemorheology will cause impairment of flow and deformability. Blood circulation is blood circulation. Blood viscosity can influence indispensable for life. Blood transports nutrient blood circulation or blood volume to tissues and organs. Under fixed blood pressure and vascular volume, blood flow is directly. Increased blood viscosity and mainly regulated by hemorheology. Increased circulatory impairment as well as slow blood blood viscosity is associated with blood flow will decrease the blood flow in organs and circulation disorder, increased circulatory tissues, especially microcirculation perfusion, resistance and slow blood flow, and finally, cause insufficient blood and oxygen, leading to decreased blood input in tissues and organs, decreased tissue function and finally diseases, leading to metabolic disorder caused by such as , coronary heart disease, ischemia and hypoxia in tissues and organs. , peripheral vascular disease and Abnormal hemorheology is the basis of anxiety, although there are many predisposing thrombus, edema and inflammation, and usually factors, these disease are closely related to occurs in sub-health status. Therefore, most abnormal blood viscosity.

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2. EXERCISE AND HEMORHEOLOGY parameters and decrease the possibility of relapse of cerebral infarction. 2.1. The Effect of Aerobic Exercise on the Hemorheology of Patients 2.1.2. The Effect of Aerobic Exercise on the 2.1.1. The Effect of Aerobic Exercise on the Hemorheology of Patients with Diabetes Hemorheology of Patients with Cerebral Diabetes is a common disease and induced by Infarction deficiency of insulin due to islet B cell damage. The blood supply in patients with cerebral Generally, hemorheology will change, such as increased blood viscosity, increased ESR, HCT, infarction is obstructed, causing insufficient FIB and EA. These measurements will increase supply of blood and oxygen, which will result in regardless of body shape. Aerobic exercise can necrosis and damage to relevant neurological increase oxygen consumption, promote function. The morbidity accounts 3/4 of metabolism and affect the hemorheology of cerebrovascular diseases with a high mortality. diabetes patients. More than half recovered patients will have disability to some degree, particularly Lin Hua, et al measured the hemorheology of 74 hemiplegia. Clinical and experimental studies patients with type 2 diabetes, and found the showed abnormal hemorheology was a BVL and FIB was significantly decreased, and the TK was significantly increased in the predisposing cause of cerebral infarction. exercise group after 1.5 months of exercise . Zhen Jun, et al performed intervention of Zheng Xiajing measured the hemorheology of aerobic exercise (5 times/week, for 4 weeks) in 40 diabetes patients, and found that the BV and 80 patients with cerebral infarction, HCT in the exercise group after 6 weeks of measurement of hemorheology showed treadmill exercise were significantly lower than significantly improvement of BVH, BVL and those before therapy [1]. TK was significantly PV in each group . Li Dan, et al performed increased, and this was basically consistent with intervention of aerobic exercise (3 months) in 60 Lin Hua’s study. patients with cerebral infarction and found Aerobic exercise can accelerate the generation decreased BV and TK in all patients, of RBC, decrease the aging of RBC, increase meanwhile, they suggested that exercise could new RBC and TK. Simmonds, et al performed improve blood flow, decrease the risk of the intervention of medium-load treadmill recurrent cerebral infarction and improve quality exercise for 18 weeks in 18 patients with type 2 of life. diabetes, and the hemorheology showed that Zhou Huae, et al investigated the hemorheology aerobic exercise improved the concentration of of 80 patients with cerebral infarction and found FIB and plasma [2]. They also demonstrated that the peak velocity and mean blood flow that the hemorheology and health of elderly velocity were significantly improved in the 14- women with type 2 diabetes had been improved day exercise group. Rehabilitation exercise can after routine walking for 12 weeks [3]; EA was increase the blood circulation in patients with significantly decreased, indicating that exercise cerebral infarction and prevent lower limb had changed the intrinsic properties of RBC and decreased EA. thrombosis. Exercise can increase blood flow, accelerate blood flow velocity, increase vascular These studies provided scientific evidences for shear force, promote the production of NO and the development of exercise for elderly patients optimize vascular function. Long-time exercise with type 2 diabetes. With increasing risk of can effectively prevent arteriosclerosis. cardiovascular diseases, aerobic exercise can enhance anti-inflammation and prevent Aerobic exercise is important for the recovery of arteriosclerosis, this will affect the blood flow activities of patients with cerebral infarction and and hemorheology significantly. can significantly increase the hemorheology. 2.1.3. The Effect of Aerobic Exercise on the Aerobic exercise can decrease blood viscosity, Hemorheology of Patients with increase blood supply to the brain, promote Hypertension cerebral metabolism, prevent the risk of recurrent cerebral infarction and improve the The pathogenesis of hypertension is complex. prognosis. Rehabilitation training can not only Hypertension patients usually have dizziness, increase limb movement abilities to the most vomiting, fatigue and headache, and the blood extent, but also optimize hemorheology of hypertension patients will have some

ARC Journal of Research in Sports Medicine Page | 30 Aerobic Exercise and Hemorheology concentration, viscosity, aggregation and finding could explain higher plasma viscosity coagulation, this will affect systemic blood and RBC aggregation in elderly subjects [8]. circulation, especially microcirculatory High blood viscosity will impact the disturbance. Therefore, the diagnosis and microcirculation and normal physiological treatment of hypertension is not only dependent functions, or even cause cardio-cerebrovascular on blood pressure control, but also protecting diseases, such as hypertension and cerebral the vascular endothelial function and decreasing thrombosis. Decreased blood viscosity is the incidence of complications in hypertension beneficial to the health of the elderly, can patients. increase blood flow, enhance metabolism, From the view of hemorheology, the change of decrease the aging of tissue cells, thus whole viscous shear stress and flow rate is the blood viscosity is an important indicator of fundamental cause of hypertension. The change blood viscosity. of BV can affect peripheral resistance and Dan Sun observe the hemorheology further blood pressure, while EA affects BVL measurements of 60 middle-aged and older and deformability affects BVH. persons with winter swimming, and found that Kilic-Erkek performed the intervention of the HCT, FIB, whole blood viscosity and ESR medium-intensity swimming in hypertension were significantly decreased in the exercise rats (SHR) and found that swimming could group. Stratton J R, et al demonstrated that 6- decrease the EA of SHR [4]. Liu Tao, et al month aerobic exercise could improve aerobic measured the hemorheology in 90 hypertension exercise ability and decrease the concentration patients and found that Tai Chi for 6 months of plasma FIB in elderly male by 13%, and could significantly decrease BVH, BVL, PV, frequent exercise could improve PV, BVH and ESR, HCT and EA [5]. Wang Lei, et al divided BVL. Yao Binbin observed the hemorheology 60 hypertension patients into 3 groups and measurements of 60 elderly persons after 18- performed intervention of walking, the week Tai Chi, and found that Tai Chi could hemorheology was changed, the BVH, BVL, PV decrease the BVH, BVL, PV and HCT in and HCT were significantly improved in the middle-aged and older persons [9]. exercise group [6]. The intermittent exercise group had more significant improvement. Aerobic exercise can activate the antioxidase, Coppola L obtained similar conclusion in his remove excessive free radicals generated during study . SZU-LING CHOU, et al suggested that exercise, increase RBC fluidity and cyclic intermittent aerobic exercise could deformability, and accelerate the remove of effectively relieve the trend of increasing EA aging RBC. Newly generated RBC can replace and decreasing deformability [7]. Feng Hong aging RBC, decrease RBC rigidity and increase found the BVH, BVL, PV, ESR and HCT were RBC elasticity. Increased TK and decreased not significantly changed in middle-aged and blood volume will decrease HCT, both will older hypertension patients after one-time decrease BVH and BVL and improve intermittent aerobic exercise. As the exercise hemorheology. Zhang Xinyu measured the intensity was low, there was less sweat and no hemorheology of 74 middle-aged and older dehydration. parsons after 24 weeks of aerobic dancing, and found that aerobic dancing could improve 2.2. The Effect of Aerobic Exercise on the Hemorheology of Middle-Aged and Older aerobic exercise ability, increase blood volume, Patients enhance TK and decrease BVH and BVL. Keeping exercise could increase PV and RBC China has entered aging society. Increased volume, promote microcirculation, improve in food, the lack of exercise and hemorheology and maintain the blood supply in abnormal lifestyle result in increasing incidence tissues and organs. Ren Chaoxue, et al obtained of hypertension and coronary heart disease, pose similar conclusion [10]. In his study, the 30 a threat to national health. The damage of middle-aged and older persons in the exercise hemorheology in the elderly has definite clinical group took dancing exercise for 6 months. The manifestations, including increased BVH, BVL observation of hemorheology showed 6-month and PV, injured TK and increased EA. Because Fitness Qigong and dancing could decrease the of the pro-inflammatory state in the elderly, the blood viscosity and improve hemorheology in concentration of BIF is usually increased, this middle-aged and older persons.

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3. CONCLUSION [3] Michael J. Simmonds; Clare L. Minahan; Kevin R. Serre; Gregory C. Gass; Sonya M. Marshall Aerobic exercise can effectively prevent and Gradisnik; Luke J. Haseler; Surendran relieve vascular diseases and metabolic diseases Sabapathy. Preliminary findings in the heart rate through regulating the indicators of variability and haemorheology response to hemorheology. Decreased blood viscosity is varied frequency and duration of walking in beneficial to blood perfusion into tissues and women 65–74 yr. with type 2 diabetes [J]. muscles, and can optimize microcirculation, Clinical Hemorheology and Microcirculation. enhance the capacity of carrying oxygen and 2012, Vol.51 (No.2): 87-99. nutrient delivery in blood. It can also promote [4] Kilic-Erkek O;Kilic-Toprak E;Kucukatay the excretion of metabolic waste and promote V;Bor-Kucukatay M..Exercise training and detraining modify hemorheological parameters body health. Long-time aerobic exercise, such as of spontaneously hypertensive rats. jogging, swimming, brisk walking and Tai Chi [J].Biorheology.2014， Vol.51 (No.6)355-367. can make people comfortable. With decreased [5] Liu Tao, Huang Qidong, Liu Weizhong. The metabolism in organs, the elderly usually have effect of Tai Chi on the blood pressure, fatigue and loss of appetite. Keep aerobic hemorheology and long-term quality of life in exercise can enhance the activities of tissues and elderly patients with hypertension [J]. Chinese cells, and improve physical conditions. Journal of Gerontology, 2018 (6). ”In Chinese”. [6] Wang Lei; Zhao Zhigang; Gao Zhenzhen. Equal- ACKNOWLEDGEMENTS volume interval and continuous physical The study was supported by “Hainan Natural exercise on dynamic blood pressure and Science Foudation Project (Grant No. 817135) hemorheology in mild and moderate Project Name: Study on Aerobic Exercise hypertension [J]. Chinese Journal of Intervention of Cognitive Dysfunction in Aged Rehabilitation Medicine.2016 ， Vol.31 (No.1): Rats, Hippocampal Mitochondria DNA and its 45-49，76. Related Expression Mechanism.” [7] Szu-Ling Chou1;Yu -Chieh Huang2; Tieh-Cheng Fu1;Chih-Chin Hsu1;Jong- Shyan Wang1，2 ( REFERENCES s5492@ mail. cgu. edu. tw). Cycling Exercise [1] Zheng Xiajing, Guo Genping, Liu Zhimei. The Training Alleviates Hypoxia- Impaired effect of treadmill exercise on the glucose Erythrocyte . [J]. Med Sci Sports metabolism and hemorheology in patients with Exerc.2016， Vol.48 (No.1): 57-65. type 2 diabetes mellitus [J]. Clinical Education [8] Michael J. Simmonds; Herbert J. Meiselman; of General Practice. 2014 (5).”In Chinese”. Oguz K. Baskurt. Blood rheology and aging [J].J [2] Simmonds ， Michael J. a;b;*; Sabapathy Geriatr Cardiol.2013， Vol.10 (No.3)291-301. Surendran a;b; Serre， Kevin R. c; Haseler， [9] Yao Binbin. The effect of Tai Chi of different Luke J. a;b; Gass ， Gregory C. c; Marshall- intensity on the hemorheology measurements in Gradisnik， Sonya M. a; Minahan， Clare L. middle-aged and older patients [J]. Journal of a;b. Regular walking improves plasma protein Zunyi Normal College. 2014 (2). ”In Chinese”. concentrations that promote blood [10] Ren Chaoxue, Gao Xinyou, Han Yueqi. The hyperviscosity in women65-74 yr. with type2 effect of Fitness Qigong on the hemorheology of diabetes.[ J]. Clin Hemorheol Microcirc..2016， male middle-aged and older patients [J]. Sports Vol. 64 (No.2): 189-198. World (Academic). 2017 (8). ”In Chinese”.

Citation: Bin Liu, Yan Song, Junlong Sheng, Aerobic Exercise and Hemorheology. ARC Journal of Research in Sports Medicine 2018; 3(1):29-32. Copyright: © 2018 Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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