PANDANGAN ISLAM DAN PERAN

SISTIM SARAF OTONOM DALAM

BEROLAHRAGA
• Dr.dr. Zaenal Muttaqien Sofro, AIFM, Sport & Circ.Med.
• Depatemen Fisiologi FKKMK UGM
 Learning Objective
SISTIM SARA OTONOM
• Menjelaskan peran Sistim saraf otonom,
sebelum, selama dan sesudah berolahraga
• Menjelaskan pusat vagus di batang otak
• Menjelaskan peran olahraga terhadap
coping stress
• Menjelaskan FITT principle kaitannya
terhadap overtraining dan vasovagal
reaction
• Menjelaskan gangguan fungsi sistim saraf
otonom terhadap kesehatan
PERSPEKTIF ISLAM
• Menjelaskan peran individu dalam memahami diri dan
pemeliharaan kesehatan sebagai rasa syukur kepada
Allah
• Menjelaskan bahwa Allah menciptakan manusia dalam
keadaan seimbang ( s.al infithar)
• Menjelaskan bagaimana Rasulullah menganjurkan
berolahraga
• Menjelaskan peran segumpal daging yang menentukan
kesehatan secara kaffah (mudghah)
• Menjelaskan keterkaitan olahraga dan akhlaq
• Menjelaskan olahraga dalam koridor bermain (la’ibun)
• Menjelaskan orientasi Lillah dalam berolahraga
• Menjelaskan kematian mendadak karena olahraga
Central
The Human Nervous System
Nervous Cardiovascular Autonomic
System system Nervous
System

Urogenital Immune
tract system

Homeostasis

Gastrointestinal tract
 Chants and Prayer
Insights into a physiology of compassion
 Neuroception:
Promotes mental and physical health

Environment Visceral state

Safe Social Engagement

SNS

Dorsal Vagus

Physiological State
 %

General Level of Physiologic Function

120

100

80

50

40

20

0 10 20 30 40 50 60 70 80 90

Active Person
Age, year
Sedentary Person
Hypertension

Coronary heart diesease

Type 2 Diabetes

Osteoarthritis

Cancers

Stroke

Rp. million healthy cost of companies (WHO Survey, 2000)

ERGOMETRY TEST
Physiologic Requirements to
Perform Exercise
The Oxygen Deficit
Oxygen Deficit and Debt During Light-
Moderate and Heavy Exercise
USE OF ENERGY SOURCES WITH
INCREASING INTENSITY
ATLET PERSIBA U-20
Cardiac Physiology Electrocardiography Diagnosis
 No. Induk : (02635)
Instansi : Atlet Sepak Bola Kombinasi Tekanan Darah dan
Periksa Ke : SATU Denyut Jantung
Tgl. Periksa : 13 Desember 2003 195
220 185 220
Nama : Atlet 1 210 175 210
200 200
Keluhan :- 190 190
165
Pakai obat :- 180 165 180
170 155 170
Umur : 22 Tahun 160 158 160
150 145 152 150
Berat Badan : 57 Kg 140 140

DJ
TD
PWC Pred 194 watt Tinggi Badan : 165,5 Cm 130 135 140 130
120 125 127 120
PWC Real 103,09 % L.P.B. : 1,63 m² 110 110
100 115 100
DJ Latiuhan 150 – 170 /menit DJ. Max pred. : 198 x per menit 110
90 90
103
% DJP : 76,77 80 96 80
70 70
Kondisi DJ Sistolik Diastolik VO2 Max 49.1 cc/kg/menit 60 70 60
50 80 80 80 80 8080 8080 80 50
Istirahat 70 110 80 MET 14.0 MET 40 40
Beban Akhir 152 175 80
30 30
IMT 20,81
0 1 2 3 4 5 6 7 8 9 10 11
Pemulihan 107 145 80 KET. Ideal 1 3 5 7 9 11 13
0 1 2 3 4 5 6 7 8 9 10
E.K.G. Sinus Normal 0Kg Kenaikan Beban 25 watt

Intensitas Latihan
untuk Meningkatkan STAMINA

52 200
52 200,0
51 198
Aerobik

150 20 15 Dianjurkan 50 196

Anaerobik
49 194
49,1 194
48 192

100 110 120 130 140 150 160 170 180 190 200 47 190
Denyut Jantung VO2 Max REAL PRED REAL
94,47% 103,09%
FIT Formula for Lifestyle Physical Activity

Most days of the

week

• Equal to brisk
walking
• About 150 kcal
• 3-5 METS

Accumulate 30
minutes
 % Carbohydrate

20 40 60 80 100

80 60 40 20 0
% Fat

Carbohydrate and fat utilization during exercise

Autonomic Nervous System :
A paired antagonism perspective
vagus
 Pusat vagus bermielin dan yang tidak bermielin
di medulla oblongata. Sumber: Porges (2011)
Gambar 17
 The Polyvagal Theory
By Stephen Porges

The Vagus Nerve in three parts, all

working simultaneously:

Ventral Vagal System:

Is part of the Parasympathetic Nervous
System
(Social Engagement/frontal cortex)

Sympathetic Nervous System:

(Fight/Flight, Freeze - Limbic Brain)

Dorsal Vagal System:

Is part of the Parasympathetic Nervous
System
(Freeze/Immobility/Brainstem)

30
 Hierarchical Model
Polyvagal State

Myelinated (supra-diaphragmatic) Vagus

Sympathetic Nervous System

Unmyelinated (sub-diaprhragmatic) Vagus

Supra-diaphragmatic
vagus

SNS, HPA (stress) Axis

Sympathetic Parasympathetic
Sub-diaphragmatic
vagus
Social Engagement Safe

Ventral
Vagal

Fight, Flight, Freeze Sympathetic Danger

Nervous
System

Dorsal
Vagal Life Threatening
Immobility System

33
 Neuroception

Environment Behaviors
Safe Social Engagement

Play

Loving Behaviors

Physiological State
 - John Hughlings Jackson
(1835-1911)
Father of English
Neurology
Quoted by Stephen
Porges 11/01

Social
Sympathetic
Parasympathetic

Freeze
SCHELLONG TEST
SCHELLONG TEST
 Tekanan Darah & Denyut
Jantung
220 220
210 210
200 200
190 190
180 180

DJ (kali / menit)
170 170
160 160

TD (mmHg)
150 150
140 140
130 130
120 120
110 110
100 100
90 90
80 80
70 70
60 60
50 50
40 40
30 30
0 1 2 3 4 5 6 7
1 2 3 4 5 6 7 8
Waktu (Menit)

Sist. Diast D.J

 Tn. C
Usia : 52 Tahun *
30
28
Tekanan Darah & Denyut
25 Jantung
23
20
220 220
210 210
18 200 200
15 190 190
180 180

DJ (kali / menit)
13
170 170
10 160 160

TD (mmHg)
8 150 150
5
140 140
130 130
3 120 120
0 110 110
-30 -28 -25 -23 -20 -18 -15 -13 -10 -8 -5 -3 0 3 5 8 10 13 15 18 20 23 25 28 30 100 100
-3 90 90
-5 80 80
-8
70 70
60 60
-10 50 50
-13 40 40
-15
30 30
0 1 2 3 4 5 6 7
-18 1 2 3 4 5 6 7 8
-20 Waktu (Menit)
-23
-25
-28 Sist. Diast D.J
-30

Keterangan : 1. Reaksi Hypertonie 2a. Hypotonie Asympatothone

2. Hypotonie Sympatothone 3. Reaksi Vasovagale
Parameter Real Standart IMT 36,59
QT Interval 0,40 0,40 Keterangan Obesitas Lebih 24,7 Kg
MAP 104,99 100 E.C.G. Sinus Normal
Pulse Pressure 45 40 ZONA 2
Gravity: role of baroreceptor reflex in orthostatic adjustment

Cardiovascular ctr in
medulla oblongata

Parasymp. -
Baroreceprots
in aorta & carotid bodies

Vaso- Heart rate

constriction

pressure
DIAGNOSE SCHEMA NACH THULESIUS Big Five Personality

SYMPATHOTONE HYPERTONE
HYPOTONIE REACTION

ASYMPATHONE
HYPOTONIE

VASOVAGALE
REACTION
 New Model
Clinical Polyvagal State Behavior
Optimal regulation
Social communication
Myelinated Vagus State regulation
Learning
Fight/flight
Hyperacusis Hyperarousal
Hypertension Hypervigilance
SNS Avoidant
Gut problems Oppositional behaviors
Anxiety disorders Social withdrawal
Drug abuse Affect limitations
Self-medication

Hypotension Immobilization
Vasovagal syncope Unmyelinated Vagus Behavioral shutdown
Dissociative states
Fibromyalgia
Risk of suicide
JAZAA KUMULLAH KHAIRAN
KATSIRAN