{"id":1859,"date":"2023-05-28T12:00:39","date_gmt":"2023-05-28T05:00:39","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=1859"},"modified":"2023-07-31T17:34:39","modified_gmt":"2023-07-31T10:34:39","slug":"sinh-ly-co-co-va-bien-doi-cua-co-sau-tap-luyen-chan-thuong","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/sinh-ly-co-co-va-bien-doi-cua-co-sau-tap-luyen-chan-thuong\/","title":{"rendered":"Physiology of muscle contraction and muscle changes after exercise and injury"},"content":{"rendered":"

1. T\u1ed4NG QUAN M\u00d4 C\u01a0 V\u00c0 C\u01a0 X\u01af\u01a0NG<\/strong><\/h3>\n

M\u00f4 c\u01a1 l\u00e0 m\u1ed9t trong b\u1ed1n lo\u1ea1i m\u00f4 trong c\u01a1 th\u1ec3 ng\u01b0\u1eddi, b\u00ean c\u1ea1nh bi\u1ec3u m\u00f4, m\u00f4 th\u1ea7n kinh, m\u00f4 li\u00ean k\u1ebft. M\u00f4 c\u01a1 g\u00f3p ph\u1ea7n v\u00e0o ch\u1ee9c n\u0103ng di chuy\u1ec3n c\u1ee7a c\u01a1 th\u1ec3 c\u0169ng nh\u01b0 s\u1ef1 v\u1eadn \u0111\u1ed9ng c\u1ee7a c\u00e1c c\u01a1 quan (s\u1ef1 co b\u00f3p c\u1ee7a tim, nhu \u0111\u1ed9ng ru\u1ed9t, s\u1ef1 co gi\u00e3n m\u1ea1ch,\u2026).<\/p>\n

V\u1ec1 m\u00f4 h\u1ecdc, m\u00f4 c\u01a1 \u0111\u01b0\u1ee3c chia l\u00e0m hai lo\u1ea1i, l\u00e0 c\u01a1 v\u00e2n (striated muscle<\/em>) v\u00e0 c\u01a1 tr\u01a1n (smooth muscle<\/em>). D\u01b0\u1edbi k\u00ednh hi\u1ec3n vi, ng\u01b0\u1ee3c l\u1ea1i v\u1edbi c\u01a1 tr\u01a1n cho h\u00ecnh \u1ea3nh tr\u01a1n l\u00e1n, c\u01a1 v\u00e2n cho th\u1ea5y h\u00ecnh \u1ea3nh c\u1ee7a c\u00e1c \u0111\u01b0\u1eddng v\u00e2n l\u00e0 nh\u1eefng d\u1ea3i s\u00e1ng t\u1ed1i c\u1ea5u t\u1ea1o t\u1eeb nh\u1eefng protein actin-myosin \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp ch\u1ed3ng l\u1eafp, xen k\u1ebd nhau trong c\u00e1c s\u1ee3i t\u01a1 c\u01a1 (myofibrils<\/em>). V\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu, m\u00f4 c\u01a1 \u0111\u01b0\u1ee3c chia th\u00e0nh c\u01a1 x\u01b0\u01a1ng, c\u01a1 tim v\u00e0 c\u01a1 tr\u01a1n (H\u00ecnh 2.1)<\/strong>. C\u01a1 tim \u0111\u1ea3m nhi\u1ec7m ch\u1ee9c n\u0103ng co b\u00f3p c\u1ee7a tim. C\u01a1 tr\u01a1n t\u1ea1o th\u00e0nh l\u1edbp gi\u1eefa c\u1ee7a nh\u1eefng c\u01a1 quan h\u00ecnh \u1ed1ng (\u1ed1ng ti\u00eau h\u00f3a, m\u1ea1ch m\u00e1u, t\u1eed cung,\u2026) c\u0169ng nh\u01b0 c\u01a1 tr\u00f2n v\u00e0 c\u01a1 tia c\u1ee7a \u0111\u1ed3ng t\u1eed, \u0111\u1ea3m nhi\u1ec7m nhu \u0111\u1ed9ng ru\u1ed9t, s\u1ef1 co gi\u00e3n m\u1ea1ch m\u00e1u v\u00e0 ph\u1ea3n x\u1ea1 \u0111\u1ed3ng t\u1eed. Nh\u1eefng ho\u1ea1t \u0111\u1ed9ng n\u00e0y di\u1ec5n ra t\u1ef1 \u0111\u1ed9ng d\u01b0\u1edbi s\u1ef1 ki\u1ec3m so\u00e1t c\u1ee7a h\u1ec7 th\u1ea7n kinh giao c\u1ea3m v\u00e0 ph\u00f3 giao c\u1ea3m. C\u01a1 x\u01b0\u01a1ng (skeletal muscle<\/em>) l\u00e0 m\u1ed9t lo\u1ea1i c\u01a1 v\u00e2n (H\u00ecnh 2.1)<\/strong>, c\u00f3 nguy\u00ean \u1ee7y v\u00e0 b\u00e1m t\u1eadn t\u1ea1i x\u01b0\u01a1ng, qua \u0111\u00f3 t\u1ea1o n\u00ean nh\u1eefng c\u1eed \u0111\u1ed9ng c\u01a1 kh\u1edbp c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 gi\u00fap gi\u1eef th\u0103ng b\u1eb1ng t\u01b0 th\u1ebf. S\u1ef1 co c\u01a1 x\u01b0\u01a1ng c\u00f3 t\u00ednh t\u1ef1 ch\u1ee7 v\u00e0 \u0111\u01b0\u1ee3c chi ph\u1ed1i b\u1edfi h\u1ec7 th\u1ea7n kinh b\u1ea3n th\u1ec3.<\/p>\n

\"Picture1\"<\/p>\n

H\u00ecnh 2.1.<\/strong> Ph\u00e2n lo\u1ea1i m\u00f4 c\u01a1 theo gi\u1ea3i ph\u1eabu bao g\u1ed3m (a) <\/strong>C\u01a1 x\u01b0\u01a1ng v\u1edbi nh\u1eefng s\u1ee3i c\u01a1 (ho\u1eb7c t\u1ebf b\u00e0o c\u01a1) d\u00e0i, kh\u00f4ng ph\u00e2n nh\u00e1nh, v\u1edbi nh\u00e2n ngo\u1ea1i bi\u00ean v\u00e0 nh\u1eefng s\u1ee3i v\u00e2n c\u01a1 vu\u00f4ng g\u00f3c v\u1edbi ch\u1ec1u d\u00e0i s\u1ee3i c\u01a1. C\u00e1c d\u1ea3i v\u00e2n t\u1ed1i th\u1ef1c ch\u1ea5t l\u00e0 nh\u1eefng v\u1ecb tr\u00ed m\u00e0 nhi\u1ec1u protein actin v\u00e0 myosin ch\u1ed3ng l\u1eafp xen k\u1ebd l\u1eabn nhau v\u00e0 ng\u01b0\u1ee3c l\u1ea1i, c\u00e1c d\u1ea3i v\u00e2n s\u00e1ng l\u00e0 n\u01a1i c\u00f3 s\u1ef1 ch\u1ed3ng l\u1eafp \u00edt h\u01a1n. (b)<\/strong> C\u01a1 tim \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o b\u1edfi nh\u1eefng s\u1ee3i c\u01a1 ph\u00e2n nh\u00e1nh nh\u01b0ng n\u1ed5i b\u1eadt b\u1edfi nh\u1eefng \u0111\u0129a \u0111\u1ec7m xen k\u1ebd gi\u1eefa nh\u1eefng t\u1ebf b\u00e0o c\u01a1 tim h\u1ed7 tr\u1ee3 vi\u1ec7c d\u1eabn truy\u1ec1n \u0111i\u1ec7n th\u1ebf kh\u1eed. C\u01a1 tim c\u0169ng c\u00f3 nh\u1eefng s\u1ee3i t\u01a1 c\u01a1 ch\u1ee9a actin v\u00e0 myosin ch\u1ed3ng l\u1eafp l\u1eabn nhau v\u00e0 t\u1ea1o th\u00e0nh nh\u1eefng s\u1ee3i v\u00e2n c\u01a1 nh\u01b0 c\u01a1 x\u01b0\u01a1ng. (c)<\/strong> C\u01a1 tr\u01a1n kh\u00e1c bi\u1ec7t v\u00ec kh\u00f4ng c\u00f3 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c v\u00e2n c\u01a1 v\u00e0 t\u1ebf b\u00e0o c\u01a1 tr\u01a1n l\u00e0 nh\u1eefng t\u1ebf b\u00e0o h\u00ecnh thoi, thu\u00f4n d\u1eb9t hai \u0111\u1ea7u v\u1edbi nh\u00e2n trung t\u00e2m, s\u1eafp x\u1ebfp li\u1ec1n k\u1ec1 nhau t\u1ea1o n\u00ean h\u00ecnh \u1ea3nh tr\u01a1n l\u00e1ng so v\u1edbi c\u01a1 v\u00e2n [1]<\/p>\n

V\u1ec1 c\u1ea5u tr\u00fac, m\u1ed9t \u0111\u01a1n v\u1ecb c\u01a1 x\u01b0\u01a1ng (v\u00ed d\u1ee5 c\u01a1 nh\u1ecb \u0111\u1ea7u) \u0111\u01b0\u1ee3c c\u1ea5u th\u00e0nh b\u1edfi nhi\u1ec1u b\u00f3 c\u01a1 n\u1eb1m chung trong m\u1ed9t bao c\u01a1 (H\u00ecnh 2.2)<\/strong>. M\u1ed7i b\u00f3 c\u01a1 bao g\u1ed3m nhi\u1ec1u s\u1ee3i c\u01a1 (t\u1ebf b\u00e0o c\u01a1) trong m\u1ed9t bao b\u00f3 c\u01a1. M\u1ed7i t\u1ebf b\u00e0o c\u01a1 \u0111\u01b0\u1ee3c bao quanh b\u1edfi bao s\u1ee3i c\u01a1 v\u00e0 ch\u1ee9a t\u1eeb v\u00e0i tr\u0103m \u0111\u1ebfn v\u00e0i ng\u00e0n s\u1ee3i t\u01a1 c\u01a1 c\u1ea5u t\u1ea1o t\u1eeb nh\u1eefng protein actin v\u00e0 myosin. Nh\u1eefng protein n\u00e0y \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp xen k\u1ebd nhau th\u00e0nh nh\u1eefng \u0111\u01a1n v\u1ecb co c\u01a1 (sarcomere<\/em>). Nh\u1eefng bao li\u00ean k\u1ebft k\u1ec3 tr\u00ean n\u1ed1i li\u00ean t\u1ee5c v\u1edbi nhau t\u1ea1i g\u00e2n c\u01a1 c\u00f9ng v\u1edbi l\u1edbp m\u1ea1c s\u00e2u, gi\u00fap b\u00e1m kh\u1ed1i c\u01a1 v\u00e0o x\u01b0\u01a1ng. Nh\u01b0 v\u1eady, vi\u1ec7c co (ho\u1eb7c gi\u00e3n) m\u1ed9t c\u01a1 x\u01b0\u01a1ng b\u1eaft \u0111\u1ea7u t\u1eeb vi\u1ec7c r\u00fat ng\u1eafn (ho\u1eb7c k\u00e9o d\u00e0i) t\u1eebng \u0111\u01a1n v\u1ecb co c\u01a1. Qu\u00e1 tr\u00ecnh n\u00e0y kh\u1edfi \u0111\u1ea7u nh\u1edd m\u1ed9t \u0111i\u1ec7n th\u1ebf \u0111\u1ed9ng tr\u00ean m\u00e0ng t\u1ebf b\u00e0o c\u01a1 khi m\u1ed9t t\u00edn hi\u1ec7u th\u1ea7n kinh \u0111\u01b0\u1ee3c d\u1eabn truy\u1ec1n t\u1ea1i synapse th\u1ea7n kinh c\u01a1 (neuromuscular junction<\/em>).<\/p>\n

\"Picture2\"
H\u00ecnh 2.2. <\/strong>C\u1ea5u t\u1ea1o c\u1ee7a m\u1ed9t c\u01a1 x\u01b0\u01a1ng (c\u01a1 nh\u1ecb \u0111\u1ea7u) [1]<\/figcaption><\/figure>\n

2. C\u1ea4U T\u1ea0O C\u1ee6A M\u1ed8T T\u1ebe B\u00c0O C\u01a0<\/strong><\/h3>\n

L\u1edbp m\u00e0ng t\u1ebf b\u00e0o c\u1ee7a s\u1ee3i c\u01a1 c\u0169ng l\u00e0 m\u1ed9t l\u1edbp \u0111\u00f4i phospholipid, tuy nhi\u00ean c\u00f3 chia th\u00e0nh nh\u1eefng r\u00e3nh \u2013 \u1ed1ng T hay \u1ed1ng ngang (transverse tubule<\/em>) \u2013 ch\u1ea1y s\u00e2u v\u00e0o b\u00ean trong t\u1ebf b\u00e0o c\u01a1 v\u00e0 vu\u00f4ng g\u00f3c v\u1edbi c\u00e1c s\u1ee3i t\u01a1 c\u01a1 (H\u00ecnh 2.3)<\/strong>. Ch\u00ednh nh\u1eefng r\u00e3nh n\u00e0y h\u00ecnh th\u00e0nh s\u1ef1 t\u01b0\u01a1ng t\u00e1c gi\u1eefa d\u1ecbch ngo\u1ea1i b\u00e0o v\u00e0 l\u01b0\u1edbi n\u1ed9i b\u00e0o c\u1ee7a t\u1ebf b\u00e0o c\u01a1. Khi c\u00f3 m\u1ed9t \u0111i\u1ec7n th\u1ebf \u0111\u1ed9ng \u0111\u01b0\u1ee3c kh\u1edfi \u0111\u1ea7u t\u1ea1i \u0111\u1ea7u m\u00fat th\u1ea7n kinh c\u01a1, n\u00f3 s\u1ebd \u0111\u01b0\u1ee3c lan t\u1ecfa \u0111\u1ebfn c\u00e1c \u1ed1ng T v\u00e0 k\u00edch th\u00edch ho\u1ea1t \u0111\u1ed9ng c\u1ee7a l\u01b0\u1edbi n\u1ed9i ch\u1ea5t cho s\u1ef1 co c\u01a1.<\/p>\n

Ngo\u00e0i nh\u1eefng s\u1ee3i t\u01a1 c\u01a1, l\u01b0\u1edbi n\u1ed9i ch\u1ea5t c\u1ee7a t\u1ebf b\u00e0o c\u01a1 l\u00e0 n\u01a1i ch\u1ee9a calcium n\u1ed9i b\u00e0o v\u00e0 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh co c\u01a1. L\u01b0\u1ee3ng calcium c\u1ea7n thi\u1ebft \u0111\u1ec3 th\u00fac \u0111\u1ea9y ho\u1ea1t \u0111\u1ed9ng c\u1ee7a hai protein actin v\u00e0 myosin \u0111\u01b0\u1ee3c cung c\u1ea5p t\u1eeb l\u01b0\u1edbi n\u1ed9i ch\u1ea5t v\u00e0 sau \u0111\u00f3, c\u00e1c ion Ca2+<\/sup> \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p th\u1ee5 v\u00e0o l\u01b0\u1edbi n\u1ed9i ch\u1ea5t, c\u1ee5 th\u1ec3 l\u00e0 v\u00f9ng cisternae t\u1eadn c\u00f9ng k\u1ebf c\u1ea1nh c\u00e1c \u1ed1ng ngang, nh\u1eb1m d\u1ef1 tr\u1eef cho l\u1ea7n co c\u01a1 ti\u1ebfp theo.<\/p>\n

\"Picture3\"<\/p>\n

H\u00ecnh 2.3.<\/strong> C\u1ea5u tr\u00fac c\u1ee7a t\u1ebf b\u00e0o c\u01a1 b\u00ean ngo\u00e0i, bao g\u1ed3m m\u00e0ng t\u1ebf b\u00e0o v\u1edbi nh\u1eefng l\u1ed7 m\u1edf v\u00e0o trong c\u00e1c \u1ed1ng ngang. C\u00e1c \u1ed1ng n\u00e0y ch\u1ea1y vu\u00f4ng g\u00f3c v\u1edbi chi\u1ec1u d\u00e0i s\u1ee3i c\u01a1 v\u00e0 k\u1ebf c\u1ea1nh v\u00f9ng cisternae t\u1eadn c\u00f9ng c\u1ee7a c\u00e1c l\u01b0\u1edbi n\u1ed9i ch\u1ea5t v\u00e0 \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c d\u1eabn truy\u1ec1n tin hi\u1ec7u kh\u1eed c\u1ef1c l\u00e0m t\u0103ng calcium n\u1ed9i b\u00e0o [2]<\/p>\n

M\u1ed9t \u0111\u01a1n v\u1ecb co c\u01a1 \u0111\u01b0\u1ee3c t\u00ednh t\u1eeb hai v\u1ea1ch \u201cZ\u201d li\u00ean ti\u1ebfp ch\u1ee9a c\u00e1c s\u1ee3i m\u1ea3nh actin v\u00e0 c\u00e1c s\u1ee3i d\u00e0y myosin. C\u00e1c s\u1ee3i protein n\u00e0y \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp xen k\u1ebd v\u00e0 tr\u01b0\u1ee3t l\u00ean nhau \u0111\u1ec3 t\u1ea1o ra s\u1ef1 co c\u01a1, c\u00f3 s\u1eed d\u1ee5ng n\u0103ng l\u01b0\u1ee3ng ATP t\u1eeb qu\u00e1 tr\u00ecnh h\u00f4 h\u1ea5p hi\u1ebfu kh\u00ed ch\u1eadm ho\u1eb7c \u0111\u01b0\u1eddng ph\u00e2n k\u1ef5 kh\u00ed nhanh. C\u00e1c s\u1ee3i m\u1ea3nh g\u1eafn k\u1ebft \u0111\u1ea7u ngo\u00e0i v\u1edbi \u0111\u0129a Z, trong khi \u0111\u1ea7u ph\u00eda trong \u0111\u01b0\u1ee3c t\u1ef1 do \u1edf tr\u1ea1ng th\u00e1i ngh\u1ec9 (gi\u00e3n c\u01a1). C\u00e1c s\u1ee3i d\u00e0y ph\u00e2n b\u1ed1 \u1edf trung t\u00e2m \u0111\u01a1n v\u1ecb co c\u01a1, xen k\u1ebd v\u1edbi c\u00e1c s\u1ee3i m\u1ea3nh v\u00e0 \u0111\u01b0\u1ee3c n\u1ed1i v\u1edbi \u0111\u0129a Z nh\u1edd titin, m\u1ed9t protein kh\u00e1c trong h\u1ec7 th\u1ed1ng s\u1ee3i t\u01a1 c\u01a1. Khi c\u01a1 co, c\u00e1c s\u1ee3i d\u00e0y g\u1eafn \u0111\u01b0\u1ee3c v\u00e0o c\u00e1c s\u1ee3i m\u1ea3nh v\u00e0 k\u00e9o c\u00e1c s\u1ee3i m\u1ea3nh v\u00e0o trong, l\u00e0m cho c\u00e1c \u0111\u0129a Z g\u1ea7n l\u1ea1i (m\u1ed7i \u0111\u01a1n v\u1ecb co c\u01a1 ng\u1eafn l\u1ea1i). Khi c\u01a1 gi\u00e3n, \u0111\u1ea7u trong c\u1ee7a s\u1ee3i m\u1ea3nh l\u1ea1i \u0111\u01b0\u1ee3c th\u1ea3 t\u1ef1 do v\u00e0 \u0111\u0129a Z hai b\u00ean tr\u1edf l\u1ea1i v\u1ec1 v\u1ecb tr\u00ed c\u0169 (H\u00ecnh 2.4)<\/strong>.<\/p>\n

\"Picture4\"<\/p>\n

H\u00ecnh 2.4. (a)<\/strong> M\u1ed9t t\u1ebf b\u00e0o c\u01a1 ch\u1ee9a nhi\u1ec1u s\u1ee3i t\u01a1 c\u01a1. M\u1ed7i s\u1ee3i t\u01a1 c\u01a1 ch\u1ee9a nhi\u1ec1u protein actin v\u00e0 myosin (hay c\u00f2n g\u1ecdi l\u00e0 s\u1ee3i m\u1ea3nh v\u00e0 s\u1ee3i d\u00e0y). D\u1ea3i A l\u00e0 v\u00f9ng bao g\u1ed3m s\u1ee3i d\u00e0y v\u00e0 s\u1ee3i m\u1ea3nh ch\u1ed1ng l\u1ea5p xen k\u1ebd nhau t\u1ea1o ra nh\u1eefng s\u1ee3i v\u00e2n t\u1ed1i m\u00e0u tr\u00ean phi\u00ean b\u1ea3n m\u00f4 h\u1ecdc. D\u1ea3i I l\u00e0 nh\u1eefng v\u00f9ng \u00edt ch\u1ed3ng l\u1ea5p h\u01a1n, ch\u1ec9 bao g\u1ed3m nh\u1eefng s\u1ee3i m\u1ea3nh v\u00e0 s\u1ee3i titin xen k\u1ebd nhau. (b)<\/strong> M\u1eb7t c\u1eaft ngang t\u1ea1i t\u1eebng v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng v\u1edbi c\u00e1c v\u00f9ng v\u00e0 c\u00e1c d\u1ea3i tr\u00ean s\u1ee3i t\u01a1 c\u01a1. (c)<\/strong> M\u1ed9t \u0111\u01a1n v\u1ecb co c\u01a1 \u0111\u01b0\u1ee3c gi\u1edbi h\u1ea1n b\u1edfi hai \u0111\u01b0\u1eddng Z hai b\u00ean [1]. (d) <\/strong>Vi\u1ec7c m\u1ed9t c\u01a1 co ho\u1eb7c gi\u00e3n th\u1ef1c ch\u1ea5t l\u00e0 s\u1ef1 r\u00fat ng\u1eafn ho\u1eb7c v\u1ec1 v\u1ecb tr\u00ed ban \u0111\u1ea7u (hay c\u00f3 th\u1ec3 k\u00e9o gi\u00e3n) c\u1ee7a m\u1ed9t \u0111\u01a1n v\u1ecb co c\u01a1 [3]<\/p>\n

3. SINH L\u00dd CO C\u01a0<\/strong><\/h3>\n

Nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp,<\/a> s\u1ef1 co c\u01a1 x\u01b0\u01a1ng l\u00e0 qu\u00e1 tr\u00ecnh c\u00f3 ch\u1ee7 \u00fd d\u01b0\u1edbi s\u1ef1 chi ph\u1ed1i c\u1ee7a h\u1ec7 th\u1ea7n kinh b\u1ea3n th\u1ec3. T\u00edn hi\u1ec7u th\u1ea7n kinh \u0111\u01b0\u1ee3c d\u1eabn truy\u1ec1n t\u1eeb h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng theo d\u00e2y th\u1ea7n kinh h\u01b0\u1edbng t\u00e2m t\u1eeb s\u1eebng tr\u01b0\u1edbc t\u1ee7y s\u1ed1ng \u0111\u1ebfn kh\u1edbp th\u1ea7n kinh c\u01a1. M\u1ed9t c\u01a1 x\u01b0\u01a1ng (v\u00ed d\u1ee5 c\u01a1 nh\u1ecb \u0111\u1ea7u) \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp th\u00e0nh nh\u1eefng \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng, v\u1edbi m\u1ed7i \u0111\u01a1n v\u1ecb bao g\u1ed3m m\u1ed9t s\u1ee3i th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng v\u00e0 t\u1ea5t c\u1ea3 c\u00e1c s\u1ee3i c\u01a1 m\u00e0 th\u1ea7n kinh \u0111\u00f3 chi ph\u1ed1i (H\u00ecnh 2.5)<\/strong>. Nh\u01b0 v\u1eady, m\u1ed9t s\u1ee3i th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng c\u00f3 th\u1ec3 d\u1eabn truy\u1ec1n \u0111\u1ebfn nhi\u1ec1u t\u1ebf b\u00e0o c\u01a1, nh\u01b0ng m\u1ed9t t\u1ebf b\u00e0o c\u01a1 ch\u1ec9 \u0111\u01b0\u1ee3c \u0111i\u1ec1u khi\u1ec3n b\u1edfi m\u1ed9t s\u1ee3i th\u1ea7n kinh v\u1eadn \u0111\u1ed9ng. S\u1ed1 l\u01b0\u1ee3ng \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng, c\u0169ng nh\u01b0 s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o c\u01a1, \u0111\u01b0\u1ee3c k\u00edch th\u00edch c\u00e0ng nhi\u1ec1u th\u00ec l\u1ef1c co c\u01a1 c\u00e0ng m\u1ea1nh. T\u00edn hi\u1ec7u th\u1ea7n kinh t\u1eeb h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng c\u00e0ng m\u1ea1nh, c\u00e0ng nhi\u1ec1u \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng \u0111\u01b0\u1ee3c k\u00edch th\u00edch. \u0110\u1ed1i v\u1edbi nh\u1eefng c\u01a1 x\u01b0\u01a1ng th\u1ef1c hi\u1ec7n v\u1eadn \u0111\u1ed9ng tinh, m\u1ed9t \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng ch\u1ee9a \u00edt t\u1ebf b\u00e0o c\u01a1, trong khi \u1edf nh\u1eefng c\u01a1 x\u01b0\u01a1ng th\u1ef1c hi\u1ec7n v\u1eadn \u0111\u1ed9ng th\u00f4 ho\u1eb7c nh\u1eefng v\u1eadn \u0111\u1ed9ng m\u1ea1nh (c\u01a1 nh\u1ecb \u0111\u1ea7u, tam \u0111\u1ea7u, t\u1ee9 \u0111\u1ea7u \u0111\u00f9i,\u2026), m\u1ed9t \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng c\u00f3 th\u1ec3 bao g\u1ed3m c\u1ea3 tr\u0103m c\u1ea3 ng\u00e0n t\u1ebf b\u00e0o c\u01a1. Nh\u01b0 v\u1eady, s\u1ef1 s\u1eafp x\u1ebfp c\u00e1c \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng v\u00e0 m\u1ee9c \u0111\u1ed9 t\u00edn hi\u1ec7u th\u1ea7n kinh \u0111i\u1ec1u h\u00f2a l\u1ef1c c\u1ea7n thi\u1ebft kh\u00e1c nhau trong nh\u1eefng ho\u1ea1t \u0111\u1ed9ng kh\u00e1c nhau.<\/p>\n

\"Picture5\"<\/p>\n

H\u00ecnh 2.5.<\/strong> S\u01a1 \u0111\u1ed3 th\u1ec3 hi\u1ec7n s\u1ef1 chi ph\u1ed1i c\u1ee7a th\u1ea7n kinh b\u1ea3n th\u1ec3 b\u1eaft \u0111\u1ea7u t\u1eeb s\u1eebng tr\u01b0\u1edbc t\u1ee7y s\u1ed1ng v\u00e0 k\u1ebft th\u00fac t\u1ea1i synapse th\u1ea7n kinh c\u01a1 tr\u00ean c\u00e1c t\u1ebf b\u00e0o c\u01a1. M\u1ed7i neuron v\u1eadn \u0111\u1ed9ng v\u00e0 c\u00e1c s\u1ee3i c\u01a1 \u0111\u01b0\u1ee3c n\u00f3 chi ph\u1ed1i t\u1ea1o th\u00e0nh m\u1ed9t \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng (trong h\u00ecnh bao g\u1ed3m 2 \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng) [3]<\/p>\n

D\u1eabn truy\u1ec1n h\u00f3a h\u1ecdc t\u1ea1i synapse th\u1ea7n kinh c\u01a1, qua ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh acetylcholin, m\u1edf k\u00eanh Na l\u00e0m Na ngo\u1ea1i b\u00e0o tr\u00e0n v\u00e0o trong v\u00e0 g\u00e2y kh\u1eed c\u1ef1c t\u1ebf b\u00e0o c\u01a1, t\u1ea1o m\u1ed9t \u0111i\u1ec7n th\u1ebf \u0111\u1ed9ng gi\u00fap k\u00edch th\u00edch c\u01a1 co (H\u00ecnh 2.6a)<\/strong>. \u0110i\u1ec7n th\u1ebf \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o c\u01a1 \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh khi s\u1ef1 kh\u1eed c\u1ef1c \u0111\u1ea1t ng\u01b0\u1ee1ng \u201340 mV v\u00e0 \u0111i\u1ec1u n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o n\u1ed3ng \u0111\u1ed9 c\u1ee7a acetylcholin trong khe sau synapse. Ngo\u00e0i ra, \u0111i\u1ec7n th\u1ebf \u0111\u1ed9ng c\u00f2n \u0111\u01b0\u1ee3c lan t\u1ecfa v\u00e0o s\u00e2u b\u00ean trong t\u1ebf b\u00e0o c\u01a1, \u0111\u1ebfn nh\u1eefng v\u00f9ng k\u1ebf c\u1ea1nh l\u01b0\u1edbi n\u1ed9i ch\u1ea5t v\u00e0 s\u1ee3i t\u01a1 c\u01a1, qua nh\u1eefng \u1ed1ng T. T\u1ea1i \u0111\u00e2y, s\u1ef1 kh\u1eed c\u1ef1c m\u00e0ng c\u1ee7a \u1ed1ng T ho\u1ea1t h\u00f3a th\u1ee5 th\u1ec3 dihydropyridine (DHP receptor<\/em>), m\u1ed9t protein c\u00f3 li\u00ean k\u1ebft v\u1edbi m\u1ed9t k\u00eanh th\u1ea3 calcium tr\u00ean m\u00e0ng c\u1ee7a l\u01b0\u1edbi n\u1ed9i ch\u1ea5t (hay c\u00f2n c\u00f3 t\u00ean kh\u00e1c l\u00e0 th\u1ee5 th\u1ec3 Ryanodine), qua \u0111\u00f3 m\u1edf k\u00eanh n\u00e0y v\u00e0 l\u00e0m t\u0103ng calcium n\u1ed9i b\u00e0o (H\u00ecnh 2.6b)<\/strong>.\u00a0<\/p>\n

\"Picture1\"<\/p>\n

H\u00ecnh 2.6. (a)<\/strong> Kh\u1edbp n\u1ed1i th\u1ea7n kinh c\u01a1 v\u00e0 ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh acetylcholine sau khi \u0111\u01b0\u1ee3c ph\u00f3ng th\u00edch v\u00e0o khe synapse t\u1eeb c\u00e1c b\u00f3ng synapse t\u1ea1i \u0111\u1ea7u m\u00fat th\u1ea7n kinh [4]. (b)<\/strong> S\u1ef1 kh\u1eed c\u1ef1c m\u00e0ng t\u1ea1i c\u00e1c \u1ed1ng T k\u00edch ho\u1ea1t th\u1ee5 th\u1ec3 Ryanodyin gi\u1ea3i ph\u00f3ng ion calcium t\u1eeb l\u01b0\u1edbi n\u1ed9i ch\u1ea5t l\u00e0m t\u0103ng calcium n\u1ed9i b\u00e0o gi\u00fap co c\u01a1 [3]<\/p>\n

S\u1ef1 li\u00ean k\u1ebft c\u1ee7a ion calcium v\u1edbi protein troponin tr\u00ean s\u1ee3i m\u1ea3nh l\u00e0m d\u1ecbch chuy\u1ec3n protein tropomyosin, b\u1ed9c l\u1ed9 v\u00f9ng g\u1eafn k\u1ebft v\u1edbi myosin tr\u00ean protein actin (H\u00ecnh 2.7a)<\/strong>. Nh\u1edd \u0111\u00f3, m\u1ed9t c\u1ea7u n\u1ed1i \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp gi\u1eefa s\u1ee3i d\u00e0y v\u00e0 s\u1ee3i m\u1ea3nh, t\u1ea1o ti\u1ec1n \u0111\u1ec1 cho qu\u00e1 tr\u00ecnh co c\u01a1. N\u1ed3ng \u0111\u1ed9 c\u1ee7a calcium n\u1ed9i b\u00e0o c\u00e0ng cao, l\u1ef1c co c\u01a1 c\u00e0ng m\u1ea1nh. Tuy nhi\u00ean, khi n\u1ed3ng \u0111\u1ed9 n\u00e0y \u0111\u1ea1t t\u1edbi ng\u01b0\u1ee1ng b\u00e3o h\u00f2a (~10\u20135<\/sup>M), l\u1ef1c co c\u01a1 \u0111\u1ea1t t\u1ed1i \u0111a. V\u1edbi m\u1ed7i m\u1ed9t \u0111i\u1ec7n th\u1ebf \u0111\u1ed9ng ch\u1ec9 c\u00f3 m\u1ed9t \u0111\u1ee3t gi\u1ea3i ph\u00f3ng calcium t\u1eeb l\u01b0\u1edbi n\u1ed9i ch\u1ea5t. Di\u1ec5n ra song song v\u1edbi qu\u00e1 tr\u00ecnh n\u00e0y l\u00e0 s\u1ef1 t\u00e1i h\u1ea5p th\u1ee5 calcium n\u1ed9i b\u00e0o v\u00e0o trong l\u01b0\u1edbi n\u1ed9i ch\u1ea5t qua b\u01a1m calsequestrin s\u1eed d\u1ee5ng ATP.<\/p>\n

\"Picture2\"
H\u00ecnh 2.7. (a) <\/strong>T\u01b0\u01a1ng t\u00e1c gi\u1eefa s\u1ee3i actin v\u00e0 myosin khi c\u00f3 v\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 g\u1eafn k\u1ebft c\u1ee7a Ca2+<\/sup>. (b) <\/strong>Chu tr\u00ecnh co c\u01a1 v\u00e0 vai tr\u00f2 c\u1ee7a ion Ca2+<\/sup> v\u00e0 ATP [4]<\/figcaption><\/figure>\n

Ban \u0111\u1ea7u khi c\u01a1 \u0111ang ngh\u1ec9, \u0111\u1ea7u myosin c\u00f2n \u0111\u01b0\u1ee3c g\u1eafn k\u1ebft v\u1edbi ADP v\u00e0 m\u1ed9t nh\u00f3m phosphate (Pi) (H\u00ecnh 2.7b)<\/strong>. Khi myosin n\u1ed1i \u0111\u01b0\u1ee3c v\u1edbi actin (trong m\u00f4i tr\u01b0\u1eddng gi\u00e0u calcium), \u00e1i l\u1ef1c v\u1edbi c\u1ee7a myosin v\u1edbi ADP v\u00e0 Pi gi\u1ea3m, d\u1eabn \u0111\u1ebfn s\u1ef1 thay \u0111\u1ed5i c\u1ea5u tr\u00fac c\u1ee7a myosin v\u00e0 gi\u00fap k\u00e9o actin tr\u01b0\u1ee3t v\u00e0o trong. L\u00fac n\u00e0y, c\u1ea7u n\u1ed1i v\u1eabn c\u00f2n \u0111\u01b0\u1ee3c gi\u1eef v\u1eefng v\u00e0 t\u00ecnh tr\u1ea1ng co c\u01a1 v\u1eabn di\u1ec5n ra. Khi ATP b\u00e1m v\u00e0o \u0111\u1ea7u myosin, actin \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng, trong khi ph\u00e2n t\u1eed ATP b\u1ecb th\u1ee7y ph\u00e2n t\u1ea1o th\u00e0nh ADP v\u00e0 Pi (tr\u1ea1ng th\u00e1i ban \u0111\u1ea7u c\u1ee7a \u0111\u1ea7u myosin). Khi t\u00edn hi\u1ec7u th\u1ea7n kinh ti\u1ebfp t\u1ee5c, l\u01b0\u1ee3ng calcium n\u1ed9i b\u00e0o v\u1eabn cao v\u00e0 gi\u1edbi h\u1ea1n co ng\u1eafn c\u1ee7a c\u01a1 v\u1eabn ch\u01b0a \u0111\u1ea1t \u0111\u01b0\u1ee3c, th\u00ec m\u1ed9t chu k\u1ef3 m\u1edbi ti\u1ebfp t\u1ee5c, myosin l\u1ea1i b\u00e1m v\u00e0o actin, ly gi\u1ea3i ADP v\u00e0 Pi v\u00e0 k\u00e9o s\u1ee3i actin tr\u01b0\u1ee3t v\u00e0o trong, r\u1ed3i gi\u1ea3i ph\u00f3ng actin nh\u1edd ATP. Nh\u01b0 v\u1eady, ATP \u0111\u00f3ng vai tr\u00f2 trong qu\u00e1 tr\u00ecnh gi\u00e3n c\u01a1 b\u1eb1ng c\u00e1ch (1) gi\u1ea3i ph\u00f3ng actin kh\u1ecfi \u0111\u1ea7u myosin, (2) ho\u1ea1t h\u00f3a b\u01a1m calsequestrin gi\u00fap t\u00e1i h\u1ea5p thu calcium n\u1ed9i b\u00e0o v\u00e0o l\u01b0\u1edbi n\u1ed9i ch\u1ea5t v\u00e0 (3) ho\u1ea1t \u0111\u1ed9ng c\u1ee7a b\u01a1m Na\/K ATPase tr\u00ean m\u00e0ng t\u1ebf b\u00e0o c\u01a1 \u0111\u1ec3 gi\u00fap thi\u1ebft l\u1eadp \u0111i\u1ec7n th\u1ebf ngh\u1ec9.<\/p>\n

4. BI\u1ebeN \u0110\u1ed4I C\u1ee6A C\u01a0 SAU T\u1eacP LUY\u1ec6N<\/strong><\/h3>\n

Nh\u1eefng s\u1ee3i c\u01a1 trong c\u00e1c c\u01a1 x\u01b0\u01a1ng \u0111\u01b0\u1ee3c chia th\u00e0nh hai lo\u1ea1i, bao g\u1ed3m c\u01a1 co r\u00fat ch\u1eadm v\u00e0 c\u01a1 co r\u00fat nhanh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a hai nh\u00f3m n\u00e0y \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y trong (B\u1ea3ng 2.1)<\/strong>. B\u1ea5t k\u1ef3 c\u01a1 x\u01b0\u01a1ng n\u00e0o c\u0169ng c\u00f3 \u0111\u1ee7 c\u1ea3 hai nh\u00f3m s\u1ee3i c\u01a1 n\u00e0y, v\u1edbi t\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n kh\u00e1c nhau t\u00f9y v\u00e0o nh\u00f3m c\u01a1 (B\u1ea3ng 2.2)<\/strong>, ch\u1ee9c n\u0103ng ch\u00fang th\u1ef1c hi\u1ec7n, c\u0169ng nh\u01b0 qu\u00e1 tr\u00ecnh t\u1eadp luy\u1ec7n (B\u1ea3ng 2.3)<\/strong>.<\/p>\n

B\u1ea3ng 2.1. <\/strong>Ph\u00e2n bi\u1ec7t c\u01a1 co r\u00fat ch\u1eadm v\u00e0 c\u01a1 co r\u00fat nhanh [3]<\/p>\n\n\n\n\n
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C\u01a1 co r\u00fat ch\u1eadm (Slow-twitch)<\/strong><\/p>\n<\/td>\n

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C\u01a1 co r\u00fat nhanh, mau ki\u1ec7t s\u1ee9c (Fast-twitch, fatigable)<\/strong><\/p>\n<\/td>\n<\/tr>\n

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\u2022\u00a0\u00a0 K\u00edch th\u01b0\u1edbc nh\u1ecf<\/p>\n

\u2022\u00a0\u00a0 S\u1eed d\u1ee5ng cho ho\u1ea1t \u0111\u1ed9ng s\u1ee9c b\u1ec1n, \u0111\u1ed9 l\u1eb7p l\u1ea1i cao (ch\u1ea1y marathon)<\/p>\n

\u2022\u00a0\u00a0 H\u1ec7 m\u00e1u nu\u00f4i d\u00e0y \u0111\u1eb7c h\u01a1n<\/p>\n

\u2022\u00a0\u00a0 Nhi\u1ec1u ti th\u1ec3 h\u01a1n, h\u00f4 h\u1ea5p hi\u1ebfu kh\u00ed nhi\u1ec1u h\u01a1n d\u1eabn \u0111\u1ebfn nhi\u1ec1u ATP v\u00e0 th\u1eddi gian s\u1eed d\u1ee5ng c\u01a1 d\u00e0i h\u01a1n<\/p>\n

\u2022\u00a0\u00a0 C\u00f3 nhi\u1ec1u myoglobin d\u1eabn \u0111\u1ebfn m\u00e0u \u0111\u1ecf c\u1ee7a c\u01a1 n\u1ed5i b\u1eadt h\u01a1n<\/p>\n<\/td>\n

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\u2022\u00a0\u00a0 K\u00edch th\u01b0\u1edbc to g\u1ea5p \u0111\u00f4i<\/p>\n

\u2022\u00a0\u00a0 Ph\u00f9 h\u1ee3p khi c\u1ea7n m\u1ed9t l\u1ef1c m\u1ea1nh trong th\u1eddi gian ng\u1eafn (xu\u1ea5t ph\u00e1t khi ch\u1ea1y \u0111ua, t\u1eadp t\u1ea1)<\/p>\n

\u2022\u00a0\u00a0 H\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u \u00edt h\u01a1n v\u00e0 h\u00f4 h\u1ea5p hi\u1ebfu kh\u00ed kh\u00f4ng ch\u1ee7 y\u1ebfu<\/p>\n

\u2022\u00a0\u00a0 \u00cdt ti th\u1ec3 h\u01a1n nh\u01b0ng nhi\u1ec1u men \u0111\u01b0\u1eddng ph\u00e2n \u0111\u1ec3 t\u1ea1o ATP nhanh h\u01a1n v\u00e0 ch\u1ec9 \u0111\u1ee7 s\u1eed d\u1ee5ng trong th\u1eddi gian ng\u1eafn<\/p>\n

\u2022\u00a0\u00a0 \u00cdt myoglobin v\u00e0 c\u00f3 h\u1ec7 th\u1ed1ng l\u01b0\u1edbi n\u1ed9i ch\u1ea5t nhi\u1ec1u h\u01a1n \u2192 t\u0103ng calcium n\u1ed9i b\u00e0o nhanh h\u01a1n<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

B\u1ea3ng 2.2. <\/strong>T\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n c\u01a1 co r\u00fat ch\u1eadm \u1edf m\u1ed9t s\u1ed1 c\u01a1 x\u01b0\u01a1ng [5]<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

C\u01a1<\/strong><\/p>\n<\/td>\n

\n

T\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n c\u01a1 co r\u00fat ch\u1eadm<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Nh\u00f3m c\u01a1 t\u1ea1i kh\u1edbp \u1ed5 ch\u1ea3o<\/a> (c\u01a1 tr\u00ean gai, c\u01a1 d\u01b0\u1edbi gai, c\u01a1 tr\u00f2n b\u00e9, c\u01a1 d\u01b0\u1edbi vai)<\/p>\n<\/td>\n

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Trung b\u00ecnh 44%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 delta<\/p>\n<\/td>\n

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47% \u2013 74%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 m\u00f4ng l\u1edbn<\/p>\n<\/td>\n

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52% \u2013 60%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 th\u1eb3ng \u0111\u00f9i<\/p>\n<\/td>\n

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t\u1eeb 30% \u0111\u1ebfn nh\u1ecf h\u01a1n 50%<\/p>\n<\/td>\n<\/tr>\n

\n

Nh\u00f3m c\u01a1 g\u1ed3m c\u01a1 r\u1ed9ng ngo\u00e0i, c\u01a1 r\u1ed9ng gi\u1eefa, c\u01a1 r\u1ed9ng trong<\/p>\n<\/td>\n

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44% \u2013 64%<\/p>\n<\/td>\n<\/tr>\n

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Nh\u00f3m c\u01a1 g\u1ed3m c\u01a1 b\u00e1n g\u00e2n, c\u01a1 b\u00e1n m\u00e0ng, c\u01a1 nh\u1ecb \u0111\u1ea7u \u0111\u00f9i<\/p>\n<\/td>\n

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44% \u2013 67%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 b\u1ee5ng ch\u00e2n<\/p>\n<\/td>\n

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44% \u2013 65%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 d\u00e9p<\/p>\n<\/td>\n

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~ 70%<\/p>\n<\/td>\n<\/tr>\n

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C\u01a1 multifidus<\/p>\n<\/td>\n

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~ 65%<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

B\u1ea3ng 2.3. <\/strong>T\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n nh\u00f3m s\u1ee3i c\u01a1 theo lo\u1ea1i h\u00ecnh th\u1ec3 thao [3]<\/p>\n\n\n\n\n\n\n\n\n
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Lo\u1ea1i h\u00ecnh<\/strong><\/p>\n<\/td>\n

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T\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n c\u01a1 co r\u00fat nhanh (%)<\/strong><\/p>\n<\/td>\n

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T\u1ec9 l\u1ec7 bi\u1ec3u hi\u1ec7n c\u01a1 co r\u00fat ch\u1eadm (%)<\/strong><\/p>\n<\/td>\n<\/tr>\n

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Ch\u1ea1y marathon<\/p>\n<\/td>\n

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18<\/p>\n<\/td>\n

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82<\/p>\n<\/td>\n<\/tr>\n

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B\u01a1i l\u1ed9i<\/p>\n<\/td>\n

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26<\/p>\n<\/td>\n

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74<\/p>\n<\/td>\n<\/tr>\n

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C\u1eed t\u1ea1<\/p>\n<\/td>\n

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55<\/p>\n<\/td>\n

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45<\/p>\n<\/td>\n<\/tr>\n

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Ch\u1ea1y n\u01b0\u1edbc r\u00fat<\/p>\n<\/td>\n

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63<\/p>\n<\/td>\n

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37<\/p>\n<\/td>\n<\/tr>\n

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Nh\u1ea3y<\/p>\n<\/td>\n

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63<\/p>\n<\/td>\n

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37<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Trong luy\u1ec7n t\u1eadp s\u1ee9c b\u1ec1n (endurance training<\/em>), b\u00e0i t\u1eadp v\u1edbi kh\u00e1ng l\u1ef1c nh\u1eb9 trong kho\u1ea3ng th\u1eddi gian d\u00e0i, c\u01a1 x\u01b0\u01a1ng th\u00edch \u1ee9ng b\u1eb1ng c\u00e1ch t\u0103ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ti th\u1ec3 (v\u00e0 c\u00f3 th\u1ec3 s\u1ed1 l\u01b0\u1ee3ng ti th\u1ec3) v\u00e0 t\u0103ng m\u1eadt \u0111\u1ed9 t\u01b0\u1edbi m\u00e1u \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u0111\u1ee7 ngu\u1ed3n oxy cho chuy\u1ec3n h\u00f3a hi\u1ebfu kh\u00ed, t\u1ea1o \u0111\u1ee7 ATP \u0111\u1ec3 duy tr\u00ec s\u1ee9c b\u1ec1n trong m\u1ed9t th\u1eddi gian d\u00e0i. Nh\u1eefng b\u00e0i t\u1eadp s\u1ee9c b\u1ec1n s\u1eed d\u1ee5ng nh\u1eefng nh\u00f3m c\u01a1 l\u1edbn v\u1edbi nh\u1ecbp \u0111i\u1ec7u nh\u1ecbp nh\u00e0ng, \u0111\u1ec1u \u0111\u1eb7n \u00edt nh\u1ea5t 30 ph\u00fat (\u0111i b\u1ed9 nhanh, ch\u1ea1y b\u1ed9, \u0111\u1ea1p xe \u0111\u1ea1p, b\u01a1i l\u1ed9i,\u2026).<\/p>\n

T\u1eadp luy\u1ec7n v\u1edbi kh\u00e1ng l\u1ef1c (strength training<\/em> ho\u1eb7c high \u2013 resistance training<\/em>) gi\u00fap t\u0103ng s\u1ee9c c\u01a1 b\u1eb1ng vi\u1ec7c thay \u0111\u1ed5i \u0111\u00e1p \u1ee9ng th\u1ea7n kinh c\u01a1 v\u00e0 ph\u00ec \u0111\u1ea1i c\u01a1. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y x\u1ea3y ra trong kho\u1ea3ng 2 \u2013 3 th\u00e1ng luy\u1ec7n t\u1eadp. Khi \u0111\u00f3, t\u00edn hi\u1ec7u th\u1ea7n kinh s\u1ebd huy \u0111\u1ed9ng nhi\u1ec1u \u0111\u01a1n v\u1ecb v\u1eadn \u0111\u1ed9ng h\u01a1n gi\u00fap l\u00e0m t\u0103ng s\u1ee9c c\u01a1. C\u00e1c b\u00e0i t\u1eadp chuy\u1ec3n h\u00f3a y\u1ebfm kh\u00ed l\u00e0 nh\u1eefng b\u00e0i c\u00f3 c\u01b0\u1eddng \u0111\u1ed9 cao di\u1ec5n ra trong kho\u1ea3ng th\u1eddi gian ng\u1eafn, v\u00ed d\u1ee5 nh\u01b0 ch\u1ea1y n\u01b0\u1edbc r\u00fat, c\u1eed t\u1ea1,\u2026 Nh\u01b0 v\u1eady, ki\u1ec3u h\u00ecnh c\u01a1 c\u0169ng s\u1ebd b\u1ecb thay \u0111\u1ed5i sao cho ph\u00f9 h\u1ee3p v\u1edbi lo\u1ea1i v\u1eadn \u0111\u1ed9ng, trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, c\u01a1 co r\u00fat nhanh s\u1ebd \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n nhi\u1ec1u h\u01a1n [6].<\/p>\n

Ph\u00ec \u0111\u1ea1i c\u01a1 (muscle hypertrophy<\/em>) l\u00e0 s\u1ef1 t\u0103ng kh\u1ed1i l\u01b0\u1ee3ng c\u01a1, t\u1ee9c l\u00e0 t\u0103ng s\u1ed1 l\u01b0\u1ee3ng protein actin v\u00e0 myosin trong t\u1ebf b\u00e0o c\u01a1 \u0111\u00e1p \u1ee9ng v\u1edbi m\u1ee9c \u0111\u1ed9 s\u1eed d\u1ee5ng cao ho\u1eb7c co c\u01a1 v\u1edbi t\u1ea3i tr\u1ecdng n\u1eb7ng (v\u00ed d\u1ee5 nh\u01b0 n\u00e2ng t\u1ea1). C\u01a1 ph\u00ec \u0111\u1ea1i c\u00f2n t\u0103ng t\u1ed5ng h\u1ee3p s\u1ed1 l\u01b0\u1ee3ng men chuy\u1ec3n h\u00f3a cho qu\u00e1 tr\u00ecnh \u0111\u01b0\u1eddng ph\u00e2n, gi\u00fap t\u1ea1o n\u0103ng l\u01b0\u1ee3ng nhanh trong qu\u00e1 tr\u00ecnh co c\u01a1 ng\u1eafn h\u1ea1n.<\/p>\n

C\u01a1 c\u0169ng c\u00f3 th\u1ec3 thay \u0111\u1ed5i chi\u1ec1u d\u00e0i \u0111\u1ec3 \u0111\u00e1p \u1ee9ng v\u1edbi s\u1ef1 k\u00e9o gi\u00e3n ho\u1eb7c co r\u00fat. \u0110\u00e2y c\u0169ng \u0111\u01b0\u1ee3c coi l\u00e0 ph\u00ec \u0111\u1ea1i c\u01a1, v\u00ec khi c\u01a1 b\u1ecb k\u00e9o gi\u00e3n h\u01a1n m\u1ee9c gi\u1edbi h\u1ea1n, \u0111\u01a1n v\u1ecb co c\u01a1 m\u1edbi s\u1ebd \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh v\u00e0 th\u00eam v\u00e0o hai b\u00ean c\u1ee7a s\u1ee3i t\u01a1 c\u01a1. Ng\u01b0\u1ee3c l\u1ea1i, khi c\u01a1 b\u1ecb co r\u00fat, c\u00e1c \u0111\u01a1n v\u1ecb ho\u1ea1t \u0111\u1ed9ng \u1edf hai \u0111\u1ea7u c\u1ee7a s\u1ee3i t\u01a1 c\u01a1 s\u1ebd b\u1ecb ti\u00eau bi\u1ebfn m\u1ea5t. Nh\u1eefng qu\u00e1 tr\u00ecnh n\u00e0y x\u1ea3y ra \u0111\u1ec3 t\u00e1i c\u1ea5u tr\u00fac c\u01a1 m\u1ed9t c\u00e1ch ph\u00f9 h\u1ee3p cho ho\u1ea1t \u0111\u1ed9ng m\u00e0 c\u01a1 \u0111\u00e1p \u1ee9ng.<\/p>\n

S\u1ef1 t\u0103ng s\u1ed1 l\u01b0\u1ee3ng s\u1ee3i c\u01a1 (fibers hyperplasia<\/em>) c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p v\u1eadn \u0111\u1ed9ng kh\u1eafc nghi\u1ec7t. B\u1ea3n ch\u1ea5t c\u1ee7a qu\u00e1 tr\u00ecnh n\u00e0y l\u00e0 s\u1ef1 t\u00e1ch \u0111\u00f4i c\u1ee7a nh\u1eefng s\u1ee3i c\u01a1 \u0111\u00e3 ph\u00ec \u0111\u1ea1i. Tuy nhi\u00ean, hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y hi\u1ebfm x\u1ea3y ra v\u00e0 d\u00f9 c\u00f3, s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o c\u01a1 c\u0169ng ch\u1ec9 t\u0103ng th\u00eam v\u00e0i ph\u1ea7n tr\u0103m [3].<\/p>\n

5. BI\u1ebeN \u0110\u1ed4I C\u1ee6A C\u01a0 SAU CH\u1ea4N TH\u01af\u01a0NG<\/strong><\/h3>\n

S\u1ef1 \u0111\u00e1p \u1ee9ng c\u1ee7a c\u01a1 sau t\u1ed5n th\u01b0\u01a1ng bao g\u1ed3m ba giai \u0111o\u1ea1n [7]. Trong v\u00f2ng v\u00e0i ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng, giai \u0111o\u1ea1n 1 l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a th\u01b0\u01a1ng t\u1ed5n l\u00ean m\u00f4 c\u01a1, l\u00e0m ho\u1ea1i t\u1eed<\/a> v\u00e0 tho\u00e1i bi\u1ebfn c\u01a1\u00a0<\/p>\n

Song song v\u1edbi \u0111\u00f3 l\u00e0 ph\u1ea3n \u1ee9ng vi\u00eam v\u00e0 s\u1ef1 th\u00e2m nh\u1eadp c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o mi\u1ec5n d\u1ecbch. \u0110\u00e1p \u1ee9ng vi\u00eam sau kho\u1ea3ng 2 \u2013 4 ng\u00e0y s\u1ebd \u0111\u01b0\u1ee3c thuy\u00ean gi\u1ea3m nh\u1edd nh\u1eefng \u0111\u1ea1i th\u1ef1c b\u00e0o lo\u1ea1i II, h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh l\u00e0nh c\u01a1 v\u00e0 t\u1ea1o s\u1eb9o sau n\u00e0y. Trong l\u00fac n\u00e0y, m\u1ee5c ti\u00eau c\u1ee7a v\u1eadt l\u00fd tr\u1ecb li\u1ec7u l\u00e0 h\u1ed7 tr\u1ee3 s\u1ef1 kh\u00e1ng vi\u00eam v\u00e0 qu\u00e1 tr\u00ecnh l\u00e0nh cho v\u1ebft th\u01b0\u01a1ng. Vi\u1ec7c ngh\u1ec9 ng\u01a1i v\u00e0 tr\u00e1nh v\u1eadn \u0111\u1ed9ng n\u1eb7ng nh\u1eb1m kh\u00f4ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng th\u00eam m\u00f4 c\u01a1 v\u00e0 c\u00e1c m\u00f4 m\u1ec1m xung quanh [5]. M\u1ed9t t\u00e1c \u0111\u1ed9ng c\u01a1 h\u1ecdc \u0111\u01b0\u1ee3c nh\u1eafc \u0111\u1ebfn c\u00f3 l\u1ee3i trong giai \u0111o\u1ea1n n\u00e0y l\u00e0 li\u1ec7u ph\u00e1p massage, cho th\u1ea5y kh\u1ea3 n\u0103ng kh\u00e1ng vi\u00eam v\u00e0 t\u1ea1o ti th\u1ec3 gi\u00fap t\u1ebf b\u00e0o t\u1ed5n th\u01b0\u01a1ng l\u00e0nh nhanh h\u01a1n [8].<\/p>\n

Trong v\u00f2ng 5 ng\u00e0y \u0111\u1ebfn 2 tu\u1ea7n sau ch\u1ea5n th\u01b0\u01a1ng, giai \u0111o\u1ea1n 2 l\u00e0 qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i v\u00e0 t\u00e1i c\u1ea5u tr\u00fac m\u00f4 c\u01a1 m\u1edbi. Nh\u1eefng t\u1ebf b\u00e0o v\u1ec7 tinh<\/a> (satellite cells<\/em>) l\u00e0 nh\u1eefng t\u1ebf b\u00e0o g\u1ed1c \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, t\u0103ng sinh v\u00e0 bi\u1ec7t h\u00f3a th\u00e0nh nh\u1eefng s\u1ee3i c\u01a1 m\u1edbi. Ngo\u00e0i ra, nh\u1eefng c\u1ea5u tr\u00fac m\u00f4 s\u1ee3i c\u0169ng \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh nh\u1eb1m thay th\u1ebf nh\u1eefng m\u00f4 t\u1ed5n th\u01b0\u01a1ng, tuy nhi\u00ean v\u1eabn c\u00f2n m\u1ecfng manh v\u00e0 y\u1ebfu. \u0110\u00e2y l\u00e0 l\u00fac v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng \u0111\u1ec3 s\u1edbm gi\u00fap b\u1ec7nh nh\u00e2n ph\u1ee5c h\u1ed3i nh\u1eefng ch\u1ee9c n\u0103ng v\u1eadn \u0111\u1ed9ng; nh\u01b0ng c\u00e1c b\u00e0i t\u1eadp c\u1ea7n \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u1edf m\u1ee9c \u0111\u1ed9 ch\u1ecbu \u0111\u1ef1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, kh\u00f4ng g\u00e2y \u0111au v\u00e0 \u0111\u01b0\u1ee3c gi\u00e1m s\u00e1t nh\u1eb1m tr\u00e1nh t\u1ed5n h\u1ea1i l\u00ean nh\u1eefng c\u1ea5u tr\u00fac m\u00f4 m\u1edbi c\u00f2n y\u1ebfu [5]. Ngo\u00e0i ra, th\u00ed nghi\u1ec7m in vitro c\u0169ng cho th\u1ea5y vai tr\u00f2 c\u1ee7a vi\u1ec7c k\u00e9o gi\u00e3n c\u01a1 h\u1ecdc l\u00ean s\u1ef1 ho\u1ea1t h\u00f3a c\u1ee7a c\u00e1c t\u1ebf b\u00e0o v\u1ec7 tinh [9].<\/p>\n

Giai \u0111o\u1ea1n cu\u1ed1i c\u00f9ng l\u00e0 s\u1ef1 t\u00e1i c\u1ea5u tr\u00fac m\u00f4 c\u01a1, c\u1ee5 th\u1ec3 l\u00e0 s\u1ef1 tr\u01b0\u1edfng th\u00e0nh c\u1ee7a nh\u1eefng t\u1ebf b\u00e0o c\u01a1 m\u1edbi bi\u1ec7t h\u00f3a, s\u1ef1 ph\u1ee5c h\u1ed3i c\u1ee7a h\u1ec7 th\u1ea7n kinh v\u00e0 m\u1ea1ng l\u01b0\u1edbi m\u1ea1ch m\u00e1u. S\u1ef1 x\u01a1 h\u00f3a c\u0169ng di\u1ec5n ra nhi\u1ec1u h\u01a1n v\u00e0 m\u00f4 s\u1ee3i t\u1ea1o th\u00e0nh c\u00f3 s\u1ee9c c\u0103ng c\u0169ng nh\u01b0 kh\u1ea3 n\u0103ng ch\u1ecbu l\u1ef1c t\u1ed1t h\u01a1n trong th\u1eddi gian n\u00e0y. Nh\u1eefng y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng (growth factor<\/em>), v\u00ed d\u1ee5 nh\u01b0 IGF-1, HGF, VEGF, FGF, TGF-\u03b21, PDGF, \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong kho\u1ea3ng th\u1eddi gian n\u00e0y. Vi\u1ec7c gia t\u0103ng \u0111\u1ed9 n\u1eb7ng c\u1ee7a c\u00e1c b\u00e0i t\u1eadp \u1edf giai \u0111o\u1ea1n n\u00e0y l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n t\u1ed1i \u01b0u s\u1ef1 ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng<\/a>.<\/p>\n

Teo c\u01a1 (muscle atrophy<\/em>) l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng gi\u1ea3m kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 ho\u1eb7c gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng protein actin v\u00e0 myosin khi c\u01a1 kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong kho\u1ea3ng th\u1eddi gian d\u00e0i (v\u00e0i tu\u1ea7n), v\u00ed d\u1ee5: khi c\u01a1 b\u1ecb m\u1ea5t chi ph\u1ed1i th\u1ea7n kinh ho\u1eb7c khi ng\u01b0\u1eddi b\u1ec7nh b\u1ecb b\u1ea5t \u0111\u1ed9ng<\/a> v\u00ec b\u1ea5t k\u1ef3 l\u00fd do n\u00e0o. Ngo\u00e0i ra, hi\u1ec7n t\u01b0\u1ee3ng teo c\u01a1 c\u00f2n \u0111\u01b0\u1ee3c th\u1ea5y \u1edf ng\u01b0\u1eddi cao tu\u1ed5i (sarcopenia<\/em>). Tuy nhi\u00ean, qu\u00e1 tr\u00ecnh n\u00e0y v\u1eabn c\u00f2n t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng c\u1ee7a t\u1eebng c\u00e1 th\u1ec3 v\u00e0 kh\u00f4ng x\u1ea3y ra \u0111\u1ed3ng \u0111\u1ec1u cho t\u1ea5t c\u1ea3 c\u00e1c nh\u00f3m c\u01a1 [10]. Nhi\u1ec1u nghi\u00ean c\u1ee9u cho th\u1ea5y s\u1ef1 teo c\u01a1 do b\u1ea5t \u0111\u1ed9ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn lo\u1ea1i c\u01a1 co r\u00fat ch\u1eadm nhi\u1ec1u h\u01a1n c\u01a1 co r\u00fat nhanh, c\u0169ng nh\u01b0 nh\u00f3m c\u01a1 du\u1ed7i nhi\u1ec1u h\u01a1n nh\u00f3m c\u01a1 kh\u00e9p [11]. C\u00e1c protein n\u00e0y b\u1ecb ph\u00e2n h\u1ee7y b\u1edfi con \u0111\u01b0\u1eddng ubiquitin-proteosome v\u00e0 c\u00e1c t\u1ebf b\u00e0o c\u01a1 tho\u00e1i h\u00f3a \u0111\u01b0\u1ee3c thay th\u1ebf b\u1edfi m\u00f4 s\u1ee3i ho\u1eb7c m\u00f4 m\u1ee1 \u1edf giai \u0111o\u1ea1n mu\u1ed9n. Nh\u01b0 v\u1eady, ch\u1ee9c n\u0103ng co gi\u00e3n c\u1ee7a c\u01a1 x\u01b0\u01a1ng tr\u01b0\u1edbc \u0111\u00e2y kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c. H\u01a1n n\u1eefa, m\u00f4 x\u01a1 trong nh\u1eefng \u201ckh\u1ed1i c\u01a1 teo\u201d c\u00f3 xu h\u01b0\u1edbng r\u00fat ng\u1eafn v\u00e0 ph\u01b0\u01a1ng ph\u00e1p k\u00e9o gi\u00e3n c\u01a1 trong v\u1eadt l\u00fd tr\u1ecb li\u1ec7u c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 tr\u00e1nh t\u00ecnh tr\u1ea1ng co r\u00fat c\u01a1 (contracture<\/em>) [3].<\/p>\n

6. NGUY\u00caN T\u1eaeC T\u1eacP LUY\u1ec6N AN TO\u00c0N V\u00c0 HI\u1ec6U QU\u1ea2<\/strong><\/h3>\n

Vi\u1ec7c thi\u1ebft k\u1ebf c\u00e1c b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u v\u00e0 ho\u1ea1t \u0111\u1ed9ng r\u00e8n luy\u1ec7n n\u00f3i chung c\u1ea7n \u0111\u1ea3m b\u1ea3o ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng c\u00e1 nh\u00e2n v\u00ec m\u1ed7i ng\u01b0\u1eddi c\u00f3 s\u1ee9c ch\u1ecbu \u0111\u1ef1ng v\u00e0 m\u1ee9c \u0111\u00e1p \u1ee9ng kh\u00e1c nhau. C\u00e1c y\u1ebfu t\u1ed1 v\u1ec1 tu\u1ed5i t\u00e1c, gi\u1edbi t\u00ednh, h\u00ecnh th\u1ec3 c\u0169ng nh\u01b0 nh\u1eefng ti\u1ec1n c\u0103n ch\u1ea5n th\u01b0\u01a1ng c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t nh\u1eb1m thi\u1ebft k\u1ebf c\u00e1c b\u00e0i t\u1eadp v\u1edbi \u0111\u1ed9 kh\u00f3 v\u00e0 t\u00ednh ch\u1ea5t ph\u00f9 h\u1ee3p cho t\u1eebng b\u1ec7nh nh\u00e2n.<\/p>\n

\u0110\u1ed9 kh\u00f3 c\u1ee7a c\u00e1c b\u00e0i t\u1eadp c\u1ea7n cao h\u01a1n ng\u01b0\u1ee1ng quen thu\u1ed9c c\u1ee7a ng\u01b0\u1eddi t\u1eadp \u0111\u1ec3 th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh \u0111\u00e1p \u1ee9ng c\u1ee7a c\u01a1 v\u00e0 c\u00e1c m\u00f4 m\u1ec1m v\u1edbi v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u. Tuy nhi\u00ean, s\u1ef1 v\u01b0\u1ee3t ng\u01b0\u1ee1ng n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00e0o \u0111\u00fang giai \u0111o\u1ea1n khi t\u1ed5n th\u01b0\u01a1ng \u0111\u1ee7 l\u00e0nh v\u00e0 \u0111\u1ee7 kh\u1ea3 n\u0103ng ch\u1ecbu \u0111\u1ef1ng s\u1ee9c t\u1ea3i c\u1ee7a b\u00e0i t\u1eadp v\u00e0 c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c qua vi\u1ec7c gia t\u0103ng c\u01b0\u1eddng \u0111\u1ed9, th\u1eddi gian hay t\u1ea7n su\u1ea5t luy\u1ec7n t\u1eadp m\u1ed9t c\u00e1ch d\u1ea7n d\u1ea7n. M\u1ed9t s\u1ed1 c\u00e1ch ti\u1ebfp c\u1eadn kh\u00e1c c\u00f3 th\u1ec3 bao g\u1ed3m t\u0103ng \u0111\u1ed9 kh\u00f3, gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng ngh\u1ec9 gi\u1eefa gi\u1edd, t\u0103ng s\u1ef1 l\u1eb7p l\u1ea1i, t\u0103ng s\u1ee9c c\u1ea3n.<\/p>\n

C\u1ee5 th\u1ec3, giai \u0111o\u1ea1n ngay sau ch\u1ea5n th\u01b0\u01a1ng, khi c\u00e1c m\u00f4 b\u1ecb t\u1ed5n th\u01b0\u01a1ng v\u00e0 qu\u00e1 tr\u00ecnh vi\u00eam di\u1ec5n ra t\u1ed1i \u0111a, th\u00ec vi\u1ec7c ngh\u1ec9 ng\u01a1i c\u0169ng nh\u01b0 \u1ee9ng d\u1ee5ng c\u00e1c t\u00e1c nh\u00e2n v\u1eadt l\u00fd tr\u1ecb li\u1ec7u (xem ch\u01b0\u01a1ng C\u00e1c t\u00e1c nh\u00e2n v\u1eadt l\u00fd d\u00f9ng trong tr\u1ecb li\u1ec7u<\/em>) \u0111\u1ec3 gi\u1ea3m \u0111au, kh\u00e1ng vi\u00eam, t\u0103ng gi\u00e3n m\u1ea1ch, h\u1ed7 tr\u1ee3 chuy\u1ec3n h\u00f3a v\u00e0 th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh l\u00e0nh c\u1ea7n \u0111\u01b0\u1ee3c ch\u00fa tr\u1ecdng. Sau \u0111\u00f3, khi v\u00f9ng t\u1ed5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng nh\u1eefng m\u00f4 c\u01a1 v\u00e0 m\u00f4 s\u1ee3i m\u1edbi bi\u1ec7t h\u00f3a, nh\u1eefng b\u00e0i t\u1eadp v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng nh\u1eb1m s\u1edbm ph\u1ee5c h\u1ed3i v\u1eadn \u0111\u1ed9ng v\u00e0 tr\u00e1nh t\u00ecnh tr\u1ea1ng co r\u00fat ho\u1eb7c c\u1ee9ng kh\u1edbp, nh\u01b0ng c\u1ea7n \u0111\u1ea3m b\u1ea3o m\u1ee9c \u0111\u1ed9 v\u1eeba ph\u1ea3i, kh\u00f4ng g\u00e2y \u0111au v\u00e0 \u0111\u00fang ng\u01b0\u1ee1ng ch\u1ecbu \u0111\u1ef1ng c\u1ee7a b\u1ec7nh nh\u00e2n, nh\u1eb1m tr\u00e1nh t\u00e1c \u0111\u1ed9ng l\u00ean nh\u1eefng m\u00f4 m\u1edbi c\u00f2n y\u1ebfu. Vi\u1ec7c t\u0103ng ti\u1ebfn d\u1ea7n d\u1ea7n c\u01b0\u1eddng \u0111\u1ed9, s\u1ed1 l\u01b0\u1ee3ng ho\u1eb7c m\u1ee9c \u0111\u1ed9 b\u00e0i t\u1eadp c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong giai \u0111o\u1ea1n ti\u1ebfp theo khi c\u00e1c m\u00f4 c\u01a1 tr\u01b0\u1edfng th\u00e0nh d\u1ea7n v\u00e0 m\u00f4 s\u1ee3i c\u00f3 kh\u1ea3 n\u0103ng ch\u1ecbu l\u1ef1c cao h\u01a1n. L\u00e0m n\u00f3ng v\u00e0 gi\u1eef c\u01b0\u1eddng \u0111\u1ed9 ph\u00f9 h\u1ee3p \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c ph\u00f2ng ng\u1eeba t\u1ed5n th\u01b0\u01a1ng th\u1ee9 ph\u00e1t ho\u1eb7c \u0111au c\u01a1 do luy\u1ec7n t\u1eadp.<\/p>\n

D\u1ef1a v\u00e0o \u0111\u00e1p \u1ee9ng sinh l\u00fd c\u1ee7a c\u01a1 v\u1edbi c\u00e1c lo\u1ea1i h\u00ecnh b\u00e0i t\u1eadp, c\u00f3 th\u1ec3 th\u1ea5y ph\u1ea7n tr\u0103m bi\u1ec3u hi\u1ec7n c\u1ee7a c\u01a1 co r\u00fat ch\u1eadm s\u1ebd cao h\u01a1n sau c\u00e1c b\u00e0i t\u1eadp r\u00e8n luy\u1ec7n s\u1ee9c b\u1ec1n (s\u1ee9c c\u1ea3n th\u1ea5p, \u0111\u1ed9 l\u1eb7p l\u1ea1i cao, th\u1eddi gian d\u00e0i v\u00e0 nh\u1eafm v\u00e0o h\u00f4 h\u1ea5p hi\u1ebfu kh\u00ed). Ng\u01b0\u1ee3c l\u1ea1i, c\u00e1c b\u00e0i t\u1eadp r\u00e8n luy\u1ec7n s\u1ee9c c\u01a1 (t\u1eadp v\u1edbi l\u1ef1c c\u1ea3n l\u1edbn, th\u1eddi gian ng\u1eafn) s\u1ebd th\u00fac \u0111\u1ea9y bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c s\u1ee3i c\u01a1 co r\u00fat nhanh.<\/p>\n

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