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Hanson BE, Lee JF, Garten RS, O'Keefe ZB, Layec G, Ruple BA, Wray DW, Richardson RS, Trinity JD. Acute sympathetic activation blunts the hyperemic and vasodilatory response to passive leg movement. RESEARCH SQUARE 2024:rs.3.rs-4356062. [PMID: 38765959 PMCID: PMC11100891 DOI: 10.21203/rs.3.rs-4356062/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Heightened muscle sympathetic nerve activity (MSNA) contributes to impaired vasodilatory capacity and vascular dysfunction associated with aging and cardiovascular disease. The contribution of elevated MSNA to the vasodilatory response during passive leg movement (PLM) has not been adequately addressed. This study sought to test the hypothesis that elevated MSNA diminishes the vasodilatory response to PLM in healthy young males (n = 11, 25 ± 2 year). Post exercise circulatory occlusion (PECO) following 2 min of isometric handgrip (HG) exercise performed at 25% (ExPECO 25%) and 40% (ExPECO 40%) of maximum voluntary contraction was used to incrementally engage the metaboreceptors and augment MSNA. Control trials were performed without PECO (ExCON 25% and ExCON 40%) to account for changes due to HG exercise. PLM was performed 2 min after the cessation of exercise and central and peripheral hemodynamics were assessed. MSNA was directly recorded by microneurography in the peroneal nerve (n = 8). Measures of MSNA (i.e., burst incidences) increased during ExPECO 25% (+ 15 ± 5 burst/100 bpm) and ExPECO 40% (+ 22 ± 4 burst/100 bpm) and returned to pre-HG levels during ExCON trials. Vasodilation, assessed by the change in leg vascular conductance during PLM, was reduced by 16% and 44% during ExPECO 25% and ExPECO 40%, respectively. These findings indicate that elevated MSNA attenuates the vasodilatory response to PLM and that the magnitude of reduction in vasodilation during PLM is graded in relation to the degree of sympathoexcitation.
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Yu J, Yang Z, Sun S, Sun K, Chen W, Zhang L, Xu J, Xu Q, Liu Z, Ke J, Zhang L, Zhu Y. The effect of weighted blankets on sleep and related disorders: a brief review. Front Psychiatry 2024; 15:1333015. [PMID: 38686123 PMCID: PMC11056563 DOI: 10.3389/fpsyt.2024.1333015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/27/2024] [Indexed: 05/02/2024] Open
Abstract
Background Sleep disorders such as insomnia can lead to a range of health problems. The high risk of side effects and drug abuse of traditional pharmacotherapy calls for a safer non-pharmacotherapy. Aims To examine the use and efficacy of weighted blankets in improving sleep and related disorders in different populations and explore the possible mechanisms. Methods A literature search was conducted using PubMed, Embase, Web of Science, MEDLINE, Cochrane Library and CNKI databases. Eligible studies included an intervention with weighted blankets and outcomes covering sleep and/or related disorders (behavioral disturbance, negative emotions and daytime symptoms). Studies using other deep pressure, compression, or exercise-related interventions were excluded. Conclusions Most of the included studies showed that weighted blankets could effectively improve sleep quality and alleviate negative emotions and daytime symptoms in patients with sleep disorders, attention deficit hyperactivity disorder, autism spectrum disorder, and other related disorders, with a possible mechanism of deep pressure touch. Recommendations Weighted blankets might be a promising tool for sleep interventions among individuals with sleep disorders in clinical settings. More high-quality and large-scale randomized controlled trials are needed to further validate the safety and efficacy of weighted blankets and explore precise mechanisms.
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Affiliation(s)
- Jie Yu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenqing Yang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Sudan Sun
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaili Sun
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiran Chen
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Liming Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiahui Xu
- Department of Neurology/Center for Sleep Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qinglin Xu
- Department of Neurology/Center for Sleep Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Juan Ke
- Department of Internal Medicine of Traditional Chinese Medicine, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, China
| | - Lisan Zhang
- Department of Neurology/Center for Sleep Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yubo Zhu
- Department of Neurology, Affiliated Hospital of Shaoxing University, Shaoxing, China
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Vasquez-Bonilla AA, Brazo-Sayavera J, Timón R, Olcina G. Monitoring Muscle Oxygen Asymmetry as a Strategy to Prevent Injuries in Footballers. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:609-617. [PMID: 35442862 DOI: 10.1080/02701367.2022.2026865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 12/30/2021] [Indexed: 06/14/2023]
Abstract
Purpose: It has been hypothesized that sports injury risk is explained by muscle metabolism. The objective was to evaluate the muscle oxygen saturation slopes (ΔSmO2 slopes) and muscle oxygenation asymmetry (MO2Asy) at rest and to study their associations with injuries during the pre-season. Methods: A total of 16 male and 10 female footballers participated in this study. Injuries were diagnosed and classified by level of severity during the pre-season. The workload was also evaluated using the rate of perceived exertion × training time, from which the accumulated loads. The SmO2 was measured at rest in the gastrocnemius muscle using the arterial occlusion method in the dominant and non-dominant legs. The repeated measures ANOVA, relative risk, and binary logistic regression were applied to assess the probability of injury with SmO2 and workload. Results: Higher MO2Asy and ΔSmO2 Slope 2 were found among footballer who suffered high-severity injuries and those who presented no injuries. In addition, an MO2Asy greater than 15% and an increase in accumulated load were variables that explained a greater probability of injury. Conclusion: This study presents the new concept of muscle oxygenation asymmetry in sports science and its possible application in injury prevention through the measurement of SmO2 at rest.
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Ermini L, Seddone S, Policastro P, Mesin L, Pasquero P, Roatta S. The Cardiac Caval Index: Improving Noninvasive Assessment of Cardiac Preload. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2247-2258. [PMID: 34877689 DOI: 10.1002/jum.15909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/04/2021] [Accepted: 11/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Inferior vena cava (IVC) pulsatility quantified by the Caval Index (CI) is characterized by poor reliability, also due to the irregular magnitude of spontaneous respiratory activity generating the major pulsatile component. The aim of this study was to test whether the IVC cardiac oscillatory component could provide a more stable index (Cardiac CI-CCI) compared to CI or respiratory CI (RCI). METHODS Nine healthy volunteers underwent long-term monitoring in supine position of IVC, followed by 3 minutes passive leg raising (PLR). CI, RCI, and CCI were extracted from video recordings by automated edge-tracking and CCI was averaged over each respiratory cycle (aCCI). Cardiac output (CO), mean arterial pressure (MAP) and heart rate (HR) were also recorded during baseline (1 minutes prior to PLR) and PLR (first minute). RESULTS In response to PLR, all IVC indices decreased (P < .01), CO increased by 4 ± 4% (P = .055) while HR and MAP did not vary. The Coefficient of Variation (CoV) of aCCI (13 ± 5%) was lower than that of CI (17 ± 5%, P < .01), RCI (26 ± 7%, P < .001) and CCI (25 ± 7%, P < .001). The mutual correlations in time of the indices were 0.81 (CI-RCI), 0.49 (CI-aCCI) and 0.2 (RCI-aCCI). CONCLUSIONS Long-term IVC monitoring by automated edge-tracking allowed us to evidence that 1) respiratory and averaged cardiac pulsatility components are uncorrelated and thus carry different information and 2) the new index aCCI, exhibiting the lowest CoV while maintaining good sensitivity to blood volume changes, may overcome the poor reliability of CI and RCI.
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Affiliation(s)
- Leonardo Ermini
- Laboratory of Integrative Physiology, Department of Neuroscience, Università di Torino, Torino, Italy
| | - Stefano Seddone
- Laboratory of Integrative Physiology, Department of Neuroscience, Università di Torino, Torino, Italy
| | - Piero Policastro
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Luca Mesin
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| | - Paolo Pasquero
- Department of Medical Sciences, Università di Torino, Torino, Italy
| | - Silvestro Roatta
- Laboratory of Integrative Physiology, Department of Neuroscience, Università di Torino, Torino, Italy
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Rashid A, Roatta S. Differential control of blood flow in masseter and biceps brachii muscles during stress. Arch Oral Biol 2022; 141:105490. [PMID: 35759826 DOI: 10.1016/j.archoralbio.2022.105490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The present study aimed to compare sympathetic hemodynamic effects in masticatory and limb muscles in response to different stressors. DESIGN Twelve healthy participants were subjected to a randomized series of stressors, including cold pressor test (CPT), mental arithmetic test, apnea, isometric handgrip (IHG) and post-handgrip muscle ischemia (PHGMI), while in the supine position. Spatially-resolved near-infrared spectroscopy was used to measure relative changes in blood volume and oxygenation (TOI) of the resting masseter and biceps muscles. Cardiac output, heart rate, and arterial blood pressure (ABP) were also monitored. RESULTS Except apnea, all tests increased ABP. Different response patterns were observed in the 2 muscles: TOI significantly increased during contralateral IHG (1.24 ± 1.17%) but markedly decreased during CPT (-4.84 ± 4.09%) and PHGMI (-6.65 ± 5.31%) in the biceps muscle, while exhibiting consistent increases in the masseter (1.88 ± 1.85%; 1.60 ± 1.75%; 1.06 ± 3.29%, respectively) (p < 0.05). CONCLUSIONS The results allow us to infer differential control of blood flow in head and limb muscles. In general, the masseter appears more prone to dilatation than the biceps, exhibiting opposite changes in response to painful stimuli (CPT and PHGMI). Several mechanisms may mediate this effect, including reduced sympathetic outflow to the extracranial vasculature of the head, generally exposed to lower hydrostatic loads than the rest of the body.
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Affiliation(s)
- Anas Rashid
- Lab of Integrative Physiology, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Silvestro Roatta
- Lab of Integrative Physiology, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy.
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Baumgartner JN, Quintana D, Leija L, Schuster NM, Bruno KA, Castellanos JP, Case LK. Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2021; 23:156-174. [PMID: 34425251 DOI: 10.1016/j.jpain.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
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Affiliation(s)
- Jennifer N Baumgartner
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Desiree Quintana
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Linda Leija
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Nathaniel M Schuster
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Kelly A Bruno
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Joel P Castellanos
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Laura K Case
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California.
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Thorn CE, Adio AO, Fox RH, Gardner AM, Winlove CP, Shore AC. Intermittent compression induces transitory hypoxic stimuli, upstream vasodilation and enhanced perfusion of skin capillaries, independent of age and diabetes. J Appl Physiol (1985) 2021; 130:1072-1084. [PMID: 33571053 DOI: 10.1152/japplphysiol.00657.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The benefit of enhanced shear stress to the vascular endothelium has been well-documented in conduit arteries but is less understood in skin microcirculation. The aim of this study was to provide physiological evidence of the vascular changes in skin microcirculation induced by intermittent pneumatic compression (IPC) of 1 s cuff inflation (130 mmHg) every 20 s to the palm of the hand for 30 min. The oxygenation and hemodynamics of dorsal mid-phalangeal finger skin microcirculation were assessed by laser Doppler fluximetry and reflectance spectroscopy before, during, and after IPC in 15 young (18-39 years old) and 39 older (40-80 years old) controls and 32 older subjects with type 2 diabetes mellitus. Each individual cuff inflation induced: 1) brief surge in flux immediately after cuff deflation followed by 2) transitory reduction in blood oxygen for ∼4 s, and 3) a second increase in perfusion and oxygenation of the microcirculation peaking ∼11 s after cuff deflation in all subject groups. With no significant change in blood volume observed by reflectance spectroscopy, despite the increased shear stress at the observed site, this second peak in flux and blood oxygen suggests a delayed vasoactive response upstream inducing increased arterial influx in the microcirculation that was higher in older controls and subjects with diabetes compared to young controls (P < 0.001, P < 0.001, respectively) and achieving maximum capillary recruitment in all subject groups. Transitory hypoxic stimuli with conducted vasodilation may be a mechanism through which IPC enhances capillary perfusion in skin microcirculation independent of age and type 2 diabetes mellitus.NEW & NOTEWORTHY This study demonstrates that hand intermittent pneumatic compression evokes transitory hypoxic stimuli in distal finger skin microcirculation inducing vasodilation of arterial inflow vessels, enhanced perfusion, and maximum capillary recruitment in young and older subjects and older subjects with type 2 diabetes mellitus. Enhanced shear stress in the microcirculation did not appear to induce local skin vasodilation.
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Affiliation(s)
- Clare E Thorn
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
| | - Aminat O Adio
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
| | - Roger H Fox
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
| | - A Michael Gardner
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
| | - C Peter Winlove
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
| | - Angela C Shore
- Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, College of Medicine and Health and NIHR Exeter Clinical Research Facility, and School of Physics and Astronomy, University of Exeter, Exeter, United Kingdom
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Venous Pulse Wave Velocity variation in response to a simulated fluid challenge in healthy subjects. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Kermavnar T, O'Sullivan KJ, de Eyto A, O'Sullivan LW. Discomfort/Pain and Tissue Oxygenation at the Lower Limb During Circumferential Compression: Application to Soft Exoskeleton Design. HUMAN FACTORS 2020; 62:475-488. [PMID: 31928412 DOI: 10.1177/0018720819892098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To establish the relationship between circumferential compression on the lower limb during simulated ramp and staircase profile loading, and the resultant relationship with discomfort/pain and tissue oxygenation. BACKGROUND Excessive mechanical loading by exoskeletons on the body can lead to pressure-related soft tissue injury. Potential tissue damage is associated with objective oxygen deprivation and accompanied by subjective perception of pain and discomfort. METHOD Three widths of pneumatic cuffs were inflated at the dominant thigh and calf of healthy participants using two inflation patterns (ramp and staircase), using a computer-controlled pneumatic rig. Participants rated discomfort on an electronic visual analog scale and deep tissue oxygenation was monitored using near infrared spectroscopy. RESULTS Circumferential compression with pneumatic cuffs triggered discomfort and pain at lower pressures at the thigh, with wider cuffs, and with a ramp inflation pattern. Staircase profile compression caused an increase in deep tissue oxygenation, whereas the ramp profile compression decreased it. CONCLUSION Discomfort and pain during circumferential compression at the lower limb is related to the width of pneumatic cuffs, the inflation pattern, and the volume of soft tissue at the assessment site. The occurrence of pain is also possibly related to the decrease in deep tissue oxygenation during compression. APPLICATION Our findings can be used to inform safe and comfortable design of soft exoskeletons to avoid discomfort and possible soft tissue injury.
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Seddone S, Messere A, Roatta S. Vascular reactivity of cutaneous circulation to brief compressive stimuli, in the human forearm. Eur J Appl Physiol 2020; 120:1041-1050. [PMID: 32212024 DOI: 10.1007/s00421-020-04343-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 03/10/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE A brief compressive stimulus is known to induce a rapid hyperemia in skeletal muscles, considered to contribute to the initial phase of functional hyperemia. Whether the same mechano-sensitivity characterizes the cutaneous circulation is debated. This study aims to investigate whether a rapid hyperemic response to compressive stimuli is also expressed by skin blood flow in humans. METHODS In 12 subjects, brief compressive stimuli were delivered to the forearm at varying pressures/durations (50/2, 100/2, 200/2, 200/1, 200/5 mmHg/s); the sequence was randomized and repeated with the arm above and below heart level. Laser Doppler flowmetry technique was used to monitor skin blood flow. The response was described in terms of peak skin blood flow normalized to baseline (nSBFpeak), time-to-peak from the release of compression, and excess blood volume (EBV, expressed in terms of seconds of basal flow, s-bf) received during the response. RESULTS The results consistently evidenced the occurrence of a compression-induced hyperemic response, with nSBFpeak = 2.9 ± 1.1, EBV = 17.0 ± 6.6 s-bf, time-to-peak = 7.0 ± 0.7 s (200 mmHg, 2 s, below heart level). Both nSBFpeak and EBV were significantly reduced (by about 50%) above compared to below heart level (p < 0.01). In addition, EBV slightly increased with increasing pressure (p < 0.05) and duration (p < 0.01) of the stimulus. CONCLUSIONS For the first time, the rapid dilatator response to compressive stimuli was demonstrated in human cutaneous circulation. The functional meaning of this response remains to be elucidated.
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Affiliation(s)
- Stefano Seddone
- Department of Neuroscience, University of Torino, C.so Raffaello 30, 10125, Torino, Italy
| | - Alessandro Messere
- Department of Neuroscience, University of Torino, C.so Raffaello 30, 10125, Torino, Italy
| | - Silvestro Roatta
- Department of Neuroscience, University of Torino, C.so Raffaello 30, 10125, Torino, Italy.
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Ermini L, Ferraresi C, De Benedictis C, Roatta S. Objective Assessment of Venous Pulse Wave Velocity in Healthy Humans. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:849-854. [PMID: 31810802 DOI: 10.1016/j.ultrasmedbio.2019.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/01/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
Central venous pressure and volume status are relevant parameters for characterization of a patient's hemodynamic condition; however, their invasive assessment is affected by various risks while non-invasive approaches provide limited and subjective indications. Here we explore the possibility of assessing venous pulse wave velocity (vPWV), a potential indicator of venous pressure changes. In eight healthy patients, pressure pulses were generated artificially in the leg veins by rapid compression of the foot, and their propagation was detected at the level of the superficial femoral vein with Doppler ultrasound. Changes in leg venous pressure were obtained by raising the trunk from the initial supine position by 30° and 60°. vPWV increased from 1.78 ± 0.06 m/s (supine) to 2.26 ± 0.19 m/s (60°) (p < 0.01) and exhibited an overall linear relationship with venous pressure. These results indicate that vPWV can be easily assessed, and is a non-invasive indicator of venous pressure changes.
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Affiliation(s)
- Leonardo Ermini
- Laboratory of Integrative Physiology, Department of Neuroscience, University of Torino, Torino, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico of Torino, Torino, Italy
| | - Carlo De Benedictis
- Department of Mechanical and Aerospace Engineering, Politecnico of Torino, Torino, Italy
| | - Silvestro Roatta
- Laboratory of Integrative Physiology, Department of Neuroscience, University of Torino, Torino, Italy.
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Messere A, Pertusio R, Macrì C, Maffiodo D, Franco W, De Benedictis C, Ferraresi C, Roatta S. Delivery of customizable compressive patterns to human limbs to investigate vascular reactivity. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae5c0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Messere A, Tschakovsky M, Seddone S, Lulli G, Franco W, Maffiodo D, Ferraresi C, Roatta S. Hyper-Oxygenation Attenuates the Rapid Vasodilatory Response to Muscle Contraction and Compression. Front Physiol 2018; 9:1078. [PMID: 30158874 PMCID: PMC6104350 DOI: 10.3389/fphys.2018.01078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
A single muscle compression (MC) with accompanying hyperemia and hyper-oxygenation results in attenuation of a subsequent MC hyperemia, as long as the subsequent MC takes place when muscle oxygenation is still elevated. Whether this is due to the hyper-oxygenation, or compression-induced de-activation of mechano-sensitive structures is unclear. We hypothesized that increased oxygenation and not de-activation of mechano-sensitive structures was responsible for this attenuation and that both compression and contraction-induced hyperemia attenuate the hyperemic response to a subsequent muscle contraction, and vice-versa. Protocol-1) In eight subjects two MCs separated by a 25 s interval were delivered to the forearm without or with partial occlusion of the axillary artery, aimed at preventing hyperemia and increased oxygenation in response to the first MC. Tissue oxygenation [oxygenated (hemoglobin + myoglobin)/total (hemoglobin + myoglobin)] from forearm muscles and brachial artery blood flow were continuously monitored by means of spatially-resolved near-infrared spectroscopy (NIRS) and Doppler ultrasound, respectively. With unrestrained blood flow, the hyperemic response to the second MC was attenuated, compared to the first (5.7 ± 3.3 vs. 14.8 ± 3.9 ml, P < 0.05). This attenuation was abolished with partial occlusion of the auxillary artery (14.4 ± 3.9 ml). Protocol-2) In 10 healthy subjects, hemodynamic changes were assessed in response to MC and electrically stimulated contraction (ESC, 0.5 s duration, 20 Hz) of calf muscles, as single stimuli or delivered in sequences of two separated by a 25 s interval. When MC or ESC were delivered 25 s following MC or ESC the response to the second stimulus was always attenuated (range: 60–90%). These findings support a role for excess tissue oxygenation in the attenuation of mechanically-stimulated rapid dilation and rule out inactivation of mechano-sensitive structures. Furthermore, both MC and ESC rapid vasodilatation are attenuated by prior transient hyperemia, regardless of whether the hyperemia is due to MC or ESC. Previously, mechanisms responsible for this dilation have not been considered to be oxygen sensitive. This study identifies muscle oxygenation state as relevant blunting factor, and reveals the need to investigate how these feedforward mechanisms might actually be affected by oxygenation.
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Affiliation(s)
| | - Michael Tschakovsky
- Human Vascular Control Lab, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Stefano Seddone
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Gabriella Lulli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Walter Franco
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Daniela Maffiodo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
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