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Kemmler W, Kohl M, von Stengel S, Willert S, Kast S, Uder M. Effects of whole-body electromyostimulation with different impulse intensity on blood pressure changes in hyper- and normotensive overweight people. A pilot study. Front Physiol 2024; 15:1349750. [PMID: 38455842 PMCID: PMC10918690 DOI: 10.3389/fphys.2024.1349750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Hypertension is a frequent condition in untrained middle-aged to older adults, who form the core group of whole-body electromyostimulation (WB-EMS) applicants. So far, the acute effects of varying impulse intensities on blood pressure responses have not been evaluated in normo- and hypertensive people. Thirteen hypertensive and twelve normotensive overweight WB-EMS novices, 40-70 years old, conducted the same WB-EMS protocol (20 min, bipolar, 85 Hz, 350 µs, 4 s impulse-4 s rest; combined with easy movements) with increasing impulse intensity (low, moderate, advanced) per session. Mean arterial blood pressure (MAP) as determined by automatic sphygmomanometry rose significantly (p < .001) from rest, 5 min pre-WB-EMS to immediately pre-WB-EMS assessment. Of importance, a 20-min WB-EMS application does not increase MAP further. In detail, maximum individual MAP does not exceed 128 mmHg (177 mmHg systolic or 110 mmHg diastolic) in any case. Two-min post-WB-EMS, MAP was significantly lower (p = .016) compared to immediately pre-WB-EMS. In contrast, heart rate increased significantly from immediately pre to immediately post-exercise (p < .001), though individual peak values did not exceed 140 beats/min-1 and heart rate decreased rapidly (p < .001) post-exercise. No significant differences in MAP and HR kinetics were observed for impulse intensity categories or hypertensive status. In summary, largely independently of impulse intensity and status, the acute effect of WB-EMS on MAP in novice applicants seem to be largely negligible. Although definite evidence might not have been provided by the present study, we conclude that hypertension, at least under treatment, should not be considered as a barrier for WB-EMS application in moderately old or older cohorts.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Simon von Stengel
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
| | - Sebastian Willert
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
| | - Stephanie Kast
- Institute of Medical Physics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Nürnberg, Erlangen, Germany
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Hackett DA, Li J, Wang B, Way KL, Cross T, Tran DL. Acute Effects of Resistance Exercise on Intraocular Pressure in Healthy Adults: A Systematic Review. J Strength Cond Res 2024; 38:394-404. [PMID: 38090981 DOI: 10.1519/jsc.0000000000004668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
ABSTRACT Hackett, DA, Li, J, Wang, B, Way, KL, Cross, T, and Tran, DL. Acute effects of resistance exercise on intraocular pressure in healthy adults: A systematic review. J Strength Cond Res 38(2): 394-404, 2024-Intraocular pressure (IOP) tends to fluctuate during a resistance exercise (RE). This systematic review examines the acute effects of RE on IOP in healthy adults and factors that influence changes in IOP. Five electronic databases were searched using terms related to RE and IOP. A strict inclusion criterion was applied, which included being 55 years or younger with no medical conditions and RE intensity needing to be quantifiable (e.g., based on a maximal effort). Thirty-four studies met the inclusion criteria for this review. Isometric and isotonic contractions produced similar changes in IOP during RE up to 28.7 mm Hg. Exercises that involved larger muscle mass, such as squats and leg press, were found to produce changes in IOP during exercise ranging from 3.1 to 28.7 mm Hg. Smaller changes in IOP during RE were found for exercises engaging less muscle mass (e.g., handgrip and bicep curls). Intraocular pressure was found to increase during RE when lifting heavier loads and with longer exercise durations (e.g., greater repetitions). The Valsalva maneuver (VM) and breath-hold during RE accentuated the change in IOP, with more extreme changes observed with the VM. However, most studies showed that postexercise IOP returned to baseline after approximately 1 minute of recovery. An acute increase in IOP is observed during RE in healthy adults with fluctuations of varying magnitude. Factors that independently increase IOP during RE include exercises involving larger muscle mass, heavy loads, greater set duration, and when the VM or breath-hold is performed.
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Affiliation(s)
- Daniel A Hackett
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Jiuzhang Li
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Boliang Wang
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Kimberley L Way
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Troy Cross
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Derek L Tran
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- The University of Sydney School of Medicine, Central Clinical School, Camperdown, Australia; and
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Australia
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Dias C, Nery JTC, Hounsell MDS, Leal AB. A Multimodal Software Architecture for Serious Exergames and Its Use in Respiratory Rehabilitation. SENSORS (BASEL, SWITZERLAND) 2023; 23:8870. [PMID: 37960567 PMCID: PMC10650421 DOI: 10.3390/s23218870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 11/15/2023]
Abstract
Serious Exergames (SEGs) have been little concerned with flexibility/equivalence, complementarity, and monitoring (functionalities of systems that deal with a wide variety of inputs). These functionalities are necessary for health SEGs due to the variety of treatments and measuring requirements. No known SEG architectures include these three functionalities altogether. In this paper, we present the 123-SGR software architecture for the creation of an SEG that is appropriate to the needs of professionals and patients in the area of rehabilitation. An existing SEG was adapted and therapy-related sensor devices (Pneumotachograph, Manovacuometer, Pressure Belt, and Oximeter) were built to help the patient interact with the SEG. The architecture allows the most varied input combinations, with and without fusion, and these combinations are possible for both conscious and unconscious signals. Health and Technology professionals have assessed the SEG and found that it had the functionalities of flexibility/equivalence, complementarity, and monitoring, and that these are really important and necessary functionalities. The 123-SGR architecture can be used as a blueprint for future SEG development.
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Affiliation(s)
- Claudinei Dias
- Department of Electrical Engineering, Santa Catarina State University, Joinville 89219-710, Brazil; (J.T.C.N.); (M.d.S.H.); (A.B.L.)
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Gottlieb R, Arnskov K, Henriksen M, Prescott E, Rasmusen H, Dall CH. Hemodynamic Response in Ascending Aorta Surgery Patients during Moderate Intensity Resistance Training. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:7616007. [PMID: 38654911 PMCID: PMC11022775 DOI: 10.1155/2023/7616007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 04/26/2024]
Abstract
Background In patients undergoing ascending aortic surgery (AAS), postsurgical physical exercise with a safe and effective exercise prescription is recommended. Resistance training is associated with blood pressure (BP) elevations that may increase the risk of new aortic dissection or rupture. However, the acute hemodynamic response to resistance training for this patient group is unknown. Aim The aim of this study was to investigate peak systolic BP (SBP) increases in AAS patients during moderate intensity resistance training. Methods SBP was measured continuously beat-to-beat with a noninvasive method during three sets of leg presses at moderate intensity. A 15-repetition maximum strength test was performed to estimate the maximal amount of resistance a participant could manage 15 times consecutively (equivalent to approximately 60-65% of their maximum strength). Results The study had 48 participants in total, i.e., 24 cases and 24 controls. Both groups consisted of 10 females (42%) and 14 males (58%). The case group had a mean age of 60.0 (SD ± 11.9) years and a mean of 16.3 months since surgery (minimum 4.4 and maximum 39.6 months). 22 of the 24 cases received antihypertensive medication. The median baseline BP was 119/74 mmHg among cases and 120/73 mmHg among controls. During the first set of leg presses, the median peak SBP was 152 mmHg, in the second set 154 mmHg, and in the third set 165 mmHg. Corresponding values in controls were 170 mmHg, 181 mmHg, and 179 mmHg. The highest peak SBP registered in an AAS patient was 190 mmHg and in any healthy control was 287 mmHg. Conclusion The findings indicate that AAS patients in control of their BP have the endurance to perform 3 sets of resistance training at moderate intensity as their SBP increases with a maximum of 39% from the baseline compared to the 51% increase in the control group.
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Affiliation(s)
- Rikke Gottlieb
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Occupational Therapy and Physical Therapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kasper Arnskov
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Marius Henriksen
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- The Parker Institute, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Eva Prescott
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Hanne Rasmusen
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | - Christian Have Dall
- Department of Physical Therapy and Occupational Therapy, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
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Stavres J, Faulkner B, Haynes H, Newsome TA, Dearmon M, Ladner KR, Luck JC. Additive influence of exercise pressor reflex activation on Valsalva responses in white and black adults. Eur J Appl Physiol 2023; 123:2259-2270. [PMID: 37269380 DOI: 10.1007/s00421-023-05240-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
AIM This study aimed to determine if activation of the exercise pressor reflex exerts additive or redundant influences on the autonomic responses to the Valsalva maneuver (VL), and if these responses differ between White and Black or African American (B/AA) individuals. METHODS Twenty participants (B/AA n = 10, White n = 10) performed three separate experimental trials. In the first trial, participants performed two VLs in a resting condition. In a second trial, participants performed 5 min of continuous handgrip (HG) exercise at 35% of the predetermined maximal voluntary contraction. In a third and final trial, participants repeated the 5-min bout of HG while also performing two VLs during the 4th and 5th minutes. Beat by beat blood pressure and heart rate (HR) were recorded continuously and the absolute systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and heart rate (HR) responses were reported for phases I-IV of each VL. RESULTS No significant group by trial interactions or main effects of group were observed for any phase of the VL (all p ≥ 0.36). However, significant main effects of time were observed for blood pressure and heart rate during phases IIa-IV (all p ≤ 0.02). Specifically, the addition of HG exercise exaggerated the hypertensive responses during phases IIb and IV (all p ≤ 0.04) and blunted the hypotensive responses during phases IIa and III (all p ≤ 0.01). CONCLUSIONS These results suggest that activation of the exercise pressor reflex exerts an additive influence on autonomic responses to the VL maneuver in both White and B/AA adults.
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Affiliation(s)
- Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Barry Faulkner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hunter Haynes
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Ta'Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Marshall Dearmon
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Kenneth R Ladner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - J Carter Luck
- Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Ezzy M, Alameer E. Predictors and Preventive Strategies of Bleeding After Thyroid Surgery. Cureus 2023; 15:e47575. [PMID: 38021981 PMCID: PMC10666654 DOI: 10.7759/cureus.47575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Postoperative compressive neck hematoma occurs in approximately 0.1% to 1.7% of cases, most occurring within the first six hours after surgery. Thyroid pathology, patient predisposition, and surgical technique are major risk factors for postoperative hematoma. This narrative review describes current perspectives on predicting and preventing bleeding following thyroid surgery. Predictors of bleeding after thyroid surgery include patient-related factors such as male sex and age, surgery-related factors like total thyroidectomy and operations for thyroid malignancy, and surgeon-related factors. Hemostasis is the primary focus after preserving critical structures in thyroid surgery. The clamp-and-tie technique has been the standard method for dividing the thyroid gland's main vascular pedicles for many years. Bipolar electrocautery has been used for vessels of small size. However, advanced bipolar and ultrasound energy and hybrid devices are now available options that may reduce operative time without increasing costs or complications. In cases where small bleeders close to critical structures are present and the clamp-and-tie technique is not feasible, hemostatic agents are commonly used. Drains do not appear to provide any significant benefits in preventing the sequelae of bleeding after thyroid surgery.
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Affiliation(s)
- Mohsen Ezzy
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
| | - Ehab Alameer
- Department of Surgery, College of Medicine, Jazan University, Jazan, SAU
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7
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Michaud A. Prone restraint death: Possible role of the Valsalva maneuver. MEDICINE, SCIENCE, AND THE LAW 2023; 63:324-333. [PMID: 36949719 DOI: 10.1177/00258024231162841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
There is an on-going debate about the safety of prone restraint and the exact role of the prone position in physical restraint death. Cardiac arrest in prone restraint death is essentially the end-result of a violent physical altercation wherein a combative individual suddenly loses consciousness while trying to counteract an opposing force. The direct correlations of increased static weight force with decreased inferior vena cava diameter, decreased cardiac output, and decreased stroke volume in prone restraint studies suggest that decreased venous return and decreased cardiac output could have a significant role to play in prone restraint death. Although the degree of changes observed in those studies might not be sufficient to cause cardiac arrest, they could predispose people who instinctively try to free themselves of the restraints to severe complications. The Valsalva maneuver, or forceful expiration against a closed airway, is frequently performed spontaneously in daily activities involving straining and resistance exercise, but has never been considered in restraint death. Pre-existing diminished venous return could increase the risk of major complications in individuals performing the Valsalva maneuver. A substantial decrease in venous return and cardiac output could increase the risk of cerebral hypoperfusion, loss of consciousness, hypoventilation, and sudden death. By increasing the risk of increased intra-abdominal pressure and its negative effect on venous return, high body mass index may be a significant risk factor in prone restraint death. The Valsalva maneuver may have different roles in prone restraint cardiac arrest and might be overlooked in prone restraint death.
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Soltani M, Sarvestan A, Hoseinzadeh F, Ahmadizad S, Kingsley JD. The effects of type of recovery in resistance exercise on responses of platelet indices and hemodynamic variables. PLoS One 2023; 18:e0290076. [PMID: 37595001 PMCID: PMC10437857 DOI: 10.1371/journal.pone.0290076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023] Open
Abstract
To examine the effects of two different volume-matched resistance exercise (RE) recovery protocols (passive and active) on platelet indices and hemodynamic variables. Twelve Healthy participants (mean ± SD; 25 ± 3 yrs) completed a traditional resistance exercise (TRE) protocol that included three sets of six repetitions at 80% one repetition maximum (1RM) with two minutes passive recovery between sets, exercises and an interval resistance exercise (IRE) protocol that included three sets of six repetitions at 60%1RM followed by active recovery including six repetitions of the same exercise at 20%1RM. Blood samples for multiple platelet indices were taken before the protocols, immediately-post (IP), and after 1-hour recovery. Hemodynamic variables were measured before, IP, and every five minutes during recovery. Mean platelet volume and platelet large cell ratio P_LCR decreased from baseline to recovery. Heart rate (HR) and rate pressure product (RPP) were augmented at IP following IRE compared to TRE. HR was significantly elevated for 20 minutes after both RE protocols, and RPP recovered by five minutes. Systolic blood pressure was increased at IP compared to baseline and all recovery time points for both RE protocols. Our research demonstrated that both RE protocols, produced transient increases in platelet indices (MPV, and P_LCR) and hemodynamic variables (SBP, HR, and RPP), all of which returned to baseline within an hour. Notably, the IRE protocol elicited a greater increase in HR and RPP compared to the TRE protocol.
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Affiliation(s)
- Mohammad Soltani
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Atefe Sarvestan
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Hoseinzadeh
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Sajad Ahmadizad
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - J. Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH, United States of America
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Niederauer S, Hunt G, Foreman KB, Merryweather A, Hitchcock R. Intrinsic factors contributing to elevated intra-abdominal pressure. Comput Methods Biomech Biomed Engin 2023; 26:941-951. [PMID: 35837994 PMCID: PMC9840719 DOI: 10.1080/10255842.2022.2100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/02/2022] [Accepted: 06/22/2022] [Indexed: 01/18/2023]
Abstract
Pelvic floor disorders affect 24% of US women, and elevated intra-abdominal pressure may cause pelvic injury through musculoskeletal strain. Activity restrictions meant to reduce pelvic strain after traumatic events, such as childbirth, have shown little benefit to patients. Reported high variability in abdominal pressure suggests that technique plays a substantial role in pressure generation. Understanding these techniques could inform evidence-based recommendations for protective pelvic care. We hypothesized use of a motion-capture methodology could identify four major contributors to elevated pressure: gravity, acceleration, abdominal muscle contraction, and respiration. Twelve women completed nineteen activities while instrumented for whole body motion capture, abdominal pressure, hip acceleration, and respiration volume. Correlation and partial least squares regression were utilized to determine primary technique factors that increase abdominal pressure. The partial least squares model identified two principal components that explained 59.63% of relative intra-abdominal pressure variability. The first component was primarily loaded by hip acceleration and relative respiration volume, and the second component was primarily loaded by flexion moments of the abdomen and thorax. While reducing abdominal muscle use has been a primary strategy in protective pelvic floor care, the influence of hip acceleration and breathing patterns should be considered with similar importance in future work.
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Affiliation(s)
- Stefan Niederauer
- Department of Biomedical Engineering, University of Utah, Salt Lake City, United States
| | - Grace Hunt
- Department of Mechanical Engineering, University of Utah, Salt Lake City, United States
| | - K Bo Foreman
- Department of Mechanical Engineering, University of Utah, Salt Lake City, United States
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, United States
| | - Andrew Merryweather
- Department of Mechanical Engineering, University of Utah, Salt Lake City, United States
| | - Robert Hitchcock
- Department of Biomedical Engineering, University of Utah, Salt Lake City, United States
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Lässing J, Maudrich T, Kenville R, Uyar Z, Bischoff C, Fikenzer S, Busse M, Falz R. Intensity-dependent cardiopulmonary response during and after strength training. Sci Rep 2023; 13:6632. [PMID: 37095279 PMCID: PMC10126007 DOI: 10.1038/s41598-023-33873-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/20/2023] [Indexed: 04/26/2023] Open
Abstract
Whereas cardiopulmonary responses are well understood in endurance training, they are rarely described in strength training. This cross-over study examined acute cardiopulmonary responses in strength training. Fourteen healthy male strength training-experienced participants (age 24.5 ± 2.9 years; BMI 24.1 ± 2.0 kg/m2) were randomly assigned into three strength training sessions (three sets of ten repetitions) with different intensities (50%, 62,5%, and 75% of the 3-Repetition Maximum) of squats in a smith machine. Cardiopulmonary (impedance cardiography, ergo-spirometry) responses were continuously monitored. During exercise period, heart rate (HR 143 ± 16 vs. 132 ± 15 vs. 129 ± 18 bpm, respectively; p < 0.01; η2p 0.54) and cardiac output (CO: 16.7 ± 3.7 vs. 14.3 ± 2.5 vs. 13.6 ± 2.4 l/min, respectively; p < 0.01; η2p 0.56) were higher at 75% of 3-RM compared to those at the other intensities. We noted similar stroke volume (SV: p = 0.08; η2p 0.18) and end-diastolic volume (EDV: p = 0.49). Ventilation (VE) was higher at 75% compared to 62.5% and 50% (44.0 ± 8.0 vs. 39.6 ± 10.4 vs. 37.6 ± 7.7 l/min, respectively; p < 0.01; η2p 0.56). Respiration rate (RR; p = .16; η2p 0.13), tidal volume (VT: p = 0.41; η2p 0.07) and oxygen uptake (VO2: p = 0.11; η2p 0.16) did not differ between intensities. High systolic and diastolic blood pressure were evident (62.5% 3-RM 197 ± 22.4/108.8 ± 13.4 mmHG). During the post-exercise period (60 s), SV, CO, VE, VO2, and VCO2 were higher (p < 0.01) than during the exercise period, and the pulmonary parameters differed markedly between intensities (VE p < 0.01; RR p < 0.01; VT p = 0.02; VO2 p < 0.01; VCO2 p < 0.01). Despite the differences in strength training intensity, the cardiopulmonary response reveals significant differences predominantly during the post-exercise period. Intensity-induced breath holding induces high blood pressure peaks and cardiopulmonary recovery effects after exercise.
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Affiliation(s)
- Johannes Lässing
- Department of Exercise Science and Sports Medicine, Martin Luther University Halle-Wittenberg, Von-Seckendorff-Platz 2, 06120, Halle (Saale), Germany
| | - Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sports Science, Leipzig University, 04109, Leipzig, Germany
| | - Rouven Kenville
- Department of Movement Neuroscience, Faculty of Sports Science, Leipzig University, 04109, Leipzig, Germany
| | - Zarah Uyar
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Sven Fikenzer
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Rosa-Luxemburg-Straße 20-30, 04103, Leipzig, Germany.
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11
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Zheng X, Headley SA, Maris SA, Smith DM. Acute cardiovascular responses to unilateral bicep curls with blood flow restriction. J Exerc Sci Fit 2023; 21:179-185. [PMID: 36816779 PMCID: PMC9906011 DOI: 10.1016/j.jesf.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/27/2022] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
A consensus on the acute cardiovascular responses to low intensity (LI) resistance exercise (RE) combined with blood flow restriction (BFR) has not yet been reached. This study was designed to compare acute cardiovascular responses to a single bout of LIRE, high intensity (HI) RE, and LIRE with BFR in physically active young males. Participants completed 3 RE sessions in random order, where each session consists of 4 sets of unilateral dumbbell bicep curls. Cardiovascular hemodynamics were measured at baseline and right after each set of RE. Aortic augmentation index (AIx) was significantly higher after set 2,3,4 of RE in LI + BFR session compared to LI session (P < 0.05). Brachial systolic blood pressure (SBP), heart rate (HR), brachial rate pressure product (RPP), and central RPP responses did not differ between LI and LI + BFR sessions (P > 0.05). HI session had a higher central SBP, brachial RPP, central RPP, and aortic AIx compared to LI session after each set of RE (P < 0.05), but not brachial SBP (P > 0.05). Taken together, this study showed that LIRE combined with BFR acutely augmented aortic stiffness, as also observed in HI session, but myocardial oxygen consumption was only higher in HI session when compared to LI session. Thus, although BFR did not exaggerate cardiovascular responses nor cause extra myocardial oxygen consumption, it should be prescribed with caution when control of acute aortic stiffening is necessary during RE.
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Affiliation(s)
- Xiangyu Zheng
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA,Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA,Corresponding author. Springfield College, 263 Alden Street, Athletic Training and Exercise Science Facilities, Rm 214, Springfield, MA, 01109, USA.
| | - Samuel A.E. Headley
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
| | - Stephen A. Maris
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
| | - Daniel M. Smith
- Springfield College, Department of Athletic Training and Exercise Science, Springfield, MA, USA
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12
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Vallance JK, Hale I, Hansen G. Commentary: Physical activity after patent foramen ovale (PFO)-associated stroke: a personal narrative and call to action. Top Stroke Rehabil 2023; 30:304-308. [PMID: 35045804 DOI: 10.1080/10749357.2021.2021729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - I Hale
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Hansen
- Department of Pediatric Critical Care, Jim Pattison Children's Hospital, Saskatoon, Saskatchewan, Canada
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13
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Lüdtke L, Stahl A, Tost F. [Sudden painless unilateral visual deterioration in a young male patient]. DIE OPHTHALMOLOGIE 2023; 120:437-439. [PMID: 36445476 DOI: 10.1007/s00347-022-01762-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/16/2022] [Accepted: 10/20/2022] [Indexed: 04/29/2023]
Affiliation(s)
- Lisa Lüdtke
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland.
| | - Andreas Stahl
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
| | - Frank Tost
- Klinik und Poliklinik für Augenheilkunde, Universitätsmedizin Greifswald (UMG), Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland
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14
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Kheram N, Boraschi A, Pfender N, Friedl S, Rasenack M, Fritz B, Kurtcuoglu V, Schubert M, Curt A, Zipser CM. Cerebrospinal Fluid Pressure Dynamics as a Bedside Test in Traumatic Spinal Cord Injury to Assess Surgical Spinal Cord Decompression: Safety, Feasibility, and Proof-of-Concept. Neurorehabil Neural Repair 2023; 37:171-182. [PMID: 36919616 PMCID: PMC10152574 DOI: 10.1177/15459683231159662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Sufficient and timely spinal cord decompression is a critical surgical objective for neurological recovery in spinal cord injury (SCI). Residual cord compression may be associated with disturbed cerebrospinal fluid pressure (CSFP) dynamics. OBJECTIVES This study aims to assess whether intrathecal CSFP dynamics in SCI following surgical decompression are feasible and safe, and to explore the diagnostic utility. METHODS Prospective cohort study. Bedside lumbar CSFP dynamics and cervical MRI were obtained following surgical decompression in N = 9 with mostly cervical acute-subacute SCI and N = 2 patients with non-traumatic SCI. CSFP measurements included mean CSFP, cardiac-driven CSFP peak-to-valley amplitudes (CSFPp), Valsalva maneuver, and Queckenstedt's test (firm pressure on jugular veins, QT). From QT, proxies for cerebrospinal fluid pulsatility curve were calculated (ie, relative pulse pressure coefficient; RPPC-Q). CSFP metrics were compared to spine-healthy patients. computer tomography (CT)-myelography was done in 3/8 simultaneous to CSFP measurements. RESULTS Mean age was 45 ± 9 years (range 17-67; 3F), SCI was complete (AIS A, N = 5) or incomplete (AIS B-D, N = 6). No adverse events related to CSFP assessments. CSFP rise during QT was induced in all patients [range 9.6-26.6 mmHg]. However, CSFPp was reduced in 3/11 (0.1-0.3 mmHg), and in 3/11 RPPC-Q was abnormal (0.01-0.05). Valsalva response was reduced in 8/11 (2.6-23.4 mmHg). CSFP dynamics corresponded to CT-myelography. CONCLUSIONS Comprehensive bedside lumbar CSFP dynamics in SCI following decompression are safe, feasible, and can reveal distinct patterns of residual spinal cord compression. Longitudinal studies are required to define critical thresholds of impaired CSFP dynamics that may impact neurological recovery and requiring surgical revisions.
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Affiliation(s)
- Najmeh Kheram
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.,Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Andrea Boraschi
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Nikolai Pfender
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Susanne Friedl
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Maria Rasenack
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Benjamin Fritz
- Department of Radiology, Balgrist University Hospital, Zurich, Switzerland
| | | | - Martin Schubert
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Armin Curt
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - Carl M Zipser
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
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15
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Influence of the body positions adopted for resistance training on intraocular pressure: a comparison between the supine and seated positions. Graefes Arch Clin Exp Ophthalmol 2023:10.1007/s00417-023-06009-0. [PMID: 36795163 DOI: 10.1007/s00417-023-06009-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A variety of factors are known to mediate on the intraocular pressure (IOP) response to resistance training. However, the influence of the body position adopted during resistance training on IOP remain unknown. The objective of this study was to determine the IOP response to the bench press exercise at three levels of intensity when performed in supine and seated positions. METHODS Twenty-three physically active healthy young adults (10 men and 13 women) performed 6 sets of 10 repetitions against the 10-RM (repetition maximum) load during the bench press exercise against three levels of intensity (high intensity: 10-RM load; medium intensity: 50% of the 10-RM load; and control: no external load) and while adopting two different body positions (supine and seated). A rebound tonometer was employed to measure IOP in baseline conditions (after 60 s in the corresponding body position), after each of the 10 repetitions, and after 10 s of recovery. RESULTS The body position adopted during the execution of the bench press exercise significantly affected the changes in IOP (p < 0.001, ηp2 = 0.83), with the seated position providing lower increases in IOP levels compared to the supine position. There was an association between IOP and exercise intensity, with greater IOP values in the more physically demanding conditions (p < 0.001, ηp2 = 0.80). CONCLUSIONS The use of seated positions, instead of supine positions, for the execution of resistance training should be prioritized for maintaining more stable IOP levels. This set of findings incorporates novel insights into the mediating factors on the IOP response to resistance training. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings.
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16
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Prevett C, Kimber ML, Forner L, de Vivo M, Davenport MH. Impact of heavy resistance training on pregnancy and postpartum health outcomes. Int Urogynecol J 2023; 34:405-411. [PMID: 36331580 DOI: 10.1007/s00192-022-05393-1] [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: 08/04/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Participation in Olympic weightlifting, the Valsalva maneuver, and acute or prolonged supine weightlifting during pregnancy are cautioned against; however, these recommendations are based on expert opinions as opposed to empirical evidence. The aim of this study was to examine the training and health outcomes of individuals who engaged in heavy resistance training during pregnancy. METHODS A total of 679 individuals who lifted at least 80% one-repetition maximum during pregnancy participated in an online survey. RESULTS Participants were primarily recreational athletes (88%, 332 out of 675) engaged in CrossFit™ (61%, 410 out of 675) and/or weightlifting (49%, 332 out of 675) during pregnancy. Most participants reported no complications during pregnancy or delivery (66%, 388 out of 589), whereas 57% (241 out of 426) reported urinary incontinence following pregnancy. Participants who maintained pre-pregnancy training levels until delivery reported significantly less reproductive complications than those who ceased training levels prior to delivery (p = 0.006). Most respondents engaged in Olympic lifting (72%, 311 out of 432) and lifting in a supine position (71%, 306 out of 437), whereas fewer reported use of the Valsalva maneuver during pregnancy (34%, 142 out of 412). Most returned to weightlifting following delivery (89%, 400 out of 447, average: 3.2 ± 3.0 months), including Olympic lifting (81%, 300 out of 372, average: 4.0 ± 3.4 months) and Valsalva (62%, 213 out of 341, average: 4.5 ± 3.6 months). CONCLUSIONS Individuals who engaged in heavy prenatal resistance training had typical perinatal and pelvic floor health outcomes that were not altered whether they engaged in, or avoided Olympic lifting, Valsalva or supine weightlifting.
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Affiliation(s)
| | - Miranda L Kimber
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Lori Forner
- The University of Queensland, Brisbane, Australia
| | - Marlize de Vivo
- Active Pregnancy Foundation, Canterbury Christ Church University, Canterbury, UK
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
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17
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Jacobs E, Rolnick N, Wezenbeek E, Stroobant L, Capelleman R, Arnout N, Witvrouw E, Schuermans J. Investigating the autoregulation of applied blood flow restriction training pressures in healthy, physically active adults: an intervention study evaluating acute training responses and safety. Br J Sports Med 2023:bjsports-2022-106069. [PMID: 36604156 DOI: 10.1136/bjsports-2022-106069] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the effects of autoregulated (AUTO) and non-autoregulated (NAUTO) blood flow restriction (BFR) application on adverse effects, performance, cardiovascular and perceptual responses during resistance exercise. METHODS Fifty-six healthy participants underwent AUTO and NAUTO BFR resistance exercise in a randomised crossover design using a training session with fixed amount of repetitions and a training session until volitional failure. Cardiovascular parameters, rate of perceived effort (RPE), rate of perceived discomfort (RPD) and number of repetitions were investigated after training, while the presence of delayed onset muscle soreness (DOMS) was verified 24 hours post-session. Adverse events during or following training were also monitored. RESULTS AUTO outperformed NAUTO in the failure protocol (p<0.001), while AUTO scored significantly lower for DOMS 24 hours after exercise (p<0.001). Perceptions of effort and discomfort were significantly higher in NAUTO compared with AUTO in both fixed (RPE: p=0.014, RPD: p<0.001) and failure protocol (RPE: p=0.028, RPD: p<0.001). Sixteen adverse events (7.14%) were recorded, with a sevenfold incidence in the fixed protocol for NAUTO compared with AUTO (NAUTO: n=7 vs AUTO: n=1) and five (NAUTO) vs three (AUTO) adverse events in the failure protocol. No significant differences in cardiovascular parameters were found comparing both pressure applications. CONCLUSION Autoregulation appears to enhance safety and performance in both fixed and failure BFR-training protocols. AUTO BFR training did not seem to affect cardiovascular stress differently, but was associated with lower DOMS, perceived effort and discomfort compared with NAUTO. TRIAL REGISTRATION NUMBER NCT04996680.
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Affiliation(s)
- Ewoud Jacobs
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Nicholas Rolnick
- The Human Performance Mechanic, Lehman College, New York City, New York, USA
| | - Evi Wezenbeek
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Lenka Stroobant
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Robbe Capelleman
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Nele Arnout
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium
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18
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Madle K, Svoboda P, Stribrny M, Novak J, Kolar P, Busch A, Kobesova A, Bitnar P. Abdominal wall tension increases using Dynamic Neuromuscular Stabilization principles in different postural positions. Musculoskelet Sci Pract 2022; 62:102655. [PMID: 35998419 DOI: 10.1016/j.msksp.2022.102655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Intra-abdominal pressure (IAP) is an important mechanism stabilizing the spine and trunk. IAP regulation depends on the coordination of abdominal muscles, diaphragm and pelvic floor muscles. OBJECTIVE To determine the differences in abdominal wall tension (AWT) of various postural positions, first without any correction, then after verbal and manual instructions according to Dynamic Neuromuscular Stabilization (DNS) principles. METHODS In a cross-sectional observational study, thirty healthy individuals (mean age = 22.73 ± 1.91 years) were fitted with two Ohmbelt sensors contralaterally above the inguinal ligament and in the upper lumbar triangle. AWT was measured during five postural positions: sitting, supine with legs raised, squat, bear and hang position. First, spontaneous AWT was measured, then again after manual and verbal instructions following DNS principles. RESULTS AWT increased significantly with DNS instructions compared to spontaneous activation. Both sensors recorded significant increases (p < .01; Cohen's d = -1.13 to -2.06) in all observed postural situations. The increase in activity occurred simultaneously on both sensors, with no significant differences noted in pressure increases between the sensors. The greatest activation for both sensors occurred in the bear position. Significant increases in activity were identified for both sensors in the supine leg raise position and in the bear position compared to spontaneous activation in sitting (p < .001). There were no statistically significant differences (for both sensors) between women and men in any position. CONCLUSION The amount of AWT significantly increases after verbal and manual instructions according to DNS. The greatest abdominal wall activation was achieved in the bear position.
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Affiliation(s)
- Katerina Madle
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - Petr Svoboda
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Martin Stribrny
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jakub Novak
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Pavel Kolar
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Andrew Busch
- Department of Health and Human Kinetics, Ohio Wesleyan University, Delaware, OH, USA
| | - Alena Kobesova
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Petr Bitnar
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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19
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Wikander L, Kirshbaum MN, Waheed N, Gahreman DE. Urinary Incontinence in Competitive Women Weightlifters. J Strength Cond Res 2022; 36:3130-3135. [PMID: 34100787 PMCID: PMC9592169 DOI: 10.1519/jsc.0000000000004052] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Wikander, L, Kirshbaum, MN, Waheed, N, and Gahreman, DE. Urinary incontinence in competitive women weightlifters. J Strength Cond Res 36(11): 3130-3135, 2022-Urinary incontinence has the potential to diminish athletic performance and discourage women from participating in sport and exercise. This study determined the prevalence and possible risk factors for urinary incontinence in competitive women weightlifters. This research was a cross-sectional, survey-based study completed by 191 competitive women weightlifters. The frequency and severity of urinary incontinence was determined using the Incontinence Severity Index. Urinary incontinence was defined as an Incontinence Severity Index score >0. The survey questions focused on risk factors, the context and triggers for urinary incontinence, and self-care strategies. Approximately, 31.9% of subjects experienced urinary incontinence within 3 months of completing the survey. Incontinence Severity Index scores were significantly correlated with parity ( r = 0.283, p = 0.01) and age ( r = 0.216, p = 0.01). There was no significant correlation between the Incontinence Severity Index score and the number of years participating in any form of resistance training ( r = -0.010, p = 0.886) or weightlifting ( r = -0.045, p = 0.534), body mass index ( r = 0.058, p = 0.422), or competition total ( r = -0.114, p = 0.115). The squat was the most likely exercise to provoke urinary incontinence. Although the number of repetitions, weight lifted, body position, and ground impact may increase the likelihood of urinary incontinence occurring during a lift, it is difficult to determine which factor has the greatest influence. Some self-care strategies used by competitive women weightlifters who experience urinary incontinence, such as training while dehydrated, have the potential to diminish athletic performance.
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Affiliation(s)
- Lolita Wikander
- College of Health and Human Sciences, Charles Darwin University, Northern Territory, Australia
| | | | - Nasreena Waheed
- College of Nursing and Midwifery, Charles Darwin University, Northern Territory, Australia
| | - Daniel E. Gahreman
- College of Health and Human Sciences, Charles Darwin University, Northern Territory, Australia
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20
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Saunders AM, Jones RL, Richards J. Cardiac structure and function in resistance-trained and untrained adults: A systematic review and meta-analysis. J Sports Sci 2022; 40:2191-2199. [PMID: 36399498 DOI: 10.1080/02640414.2022.2147658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Variations in the haemodynamic demands of specific training modalities may explain characteristic differences in cardiac structure and function amongst athletes. However, current consensus regarding these adaptations in highly resistance-trained athletes is yet to be established. The current invetsigation aimed to collate research investigating cardiac structure and function in resistance-trained athletes, exploring the defining characteristics of Athlete's Heart within these individuals. Seven electronic databases were searched. Studies which examined at least one measure of cardiac structure or function, included healthy, normotensive male or females (>18 years) and compared athletes engaged in a resistance training programme (>12 months) to an untrained group engaged in no structured training programme were included. Systematic selection and quality appraisal of articles was performed by two reviewers, with a random effects meta-analysis model applied to suitable studies. Studies were limited to orginal peer-reviewed articles published in English. Resistance-trained athletes (n = 949) demonstrated greater cardiac dimensions compared to their untrained counterparts (n = 1053). No clear impairments to systolic or diastolic cardiac function were observed in athletic population studied here. Resistance-trained athletes display some characteristics of the Athlete's Heart phenomenon, including greater wall thickening and chamber dilation compared to their untrained counterparts.
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Affiliation(s)
- Abigail M Saunders
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK
| | - Rebecca L Jones
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK.,Health Advancement Research Team (HART), School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Joanna Richards
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford, UK
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21
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Kambic T, Šarabon N, Hadžić V, Lainscak M. High-Load and Low-Load Resistance Exercise in Patients with Coronary Artery Disease: Feasibility and Safety of a Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11133567. [PMID: 35806853 PMCID: PMC9267855 DOI: 10.3390/jcm11133567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Resistance exercise (RE) remains underused in cardiac rehabilitation; therefore, there is insufficient evidence on safety, feasibility, and hemodynamic adaptations to high-load (HL) and low-load (LL) RE in patients with coronary artery disease (CAD). This study aimed to compare the safety, feasibility of HL-RE and LL-RE when combined with aerobic exercise (AE), and hemodynamic adaptations to HL and LL resistance exercise following the intervention. Seventy-nine patients with CAD were randomized either to HL-RE (70−80% of one-repetition maximum [1-RM]) and AE, LL-RE (35−40% of 1-RM) and AE or solely AE (50−80% of maximal power output) as a standard care, and 59 patients completed this study. We assessed safety and feasibility of HL-RE and LL-RE and we measured 1-RM on leg extension machine and hemodynamic response during HL- and LL-RE at baseline and post-training. The training intervention was safe, well tolerated, and completed without any adverse events. Adherence to RE protocols was excellent (100%). LL-RE was better tolerated than HL-RE, especially from the third to the final mesocycle of this study (Borgs’ 0−10 scale difference: 1−2 points; p = 0.001−0.048). Improvement in 1-RM was greater following HL-RE (+31%, p < 0.001) and LL-RE (+23%, p < 0.001) compared with AE. Participation in HL-RE and LL-RE resulted in a decreased rating of perceived exertion during post-training HL- and LL-RE, but in the absence of post-training hemodynamic adaptations. The implementation of HL-RE or LL-RE combined with AE was safe, well tolerated and can be applied in the early phase of cardiac rehabilitation for patients with stable CAD.
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Affiliation(s)
- Tim Kambic
- Cardiac Rehabilitation Unit, Department of Research and Education, General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, Rakičan, 9000 Murska Sobota, Slovenia
- Correspondence: (T.K.); (M.L.); Tel.: +386-(02)-5123-238 (T.K.); +386-(02)-5123-733 (M.L.)
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia;
- InnoRenew CoE, Human Health Department, Livade 6, 6310 Izola, Slovenia
- S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Tehnološki Park 19, 1000 Ljubljana, Slovenia
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Gortanova Ulica 22, 1000 Ljubljana, Slovenia;
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Ulica dr. Vrbnjaka 6, Rakičan, 9000 Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
- Correspondence: (T.K.); (M.L.); Tel.: +386-(02)-5123-238 (T.K.); +386-(02)-5123-733 (M.L.)
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22
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Mang ZA, Moriarty TA, Realzola RA, Millender DJ, Wells AD, Houck JM, Bellissimo GF, Fennel ZJ, Beam JR, Mermier CM, Amorim FT, Kravitz L. A Metabolic Profile of Peripheral Heart Action Training. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:412-422. [PMID: 34252341 DOI: 10.1080/02701367.2020.1856315] [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: 06/23/2020] [Accepted: 11/17/2020] [Indexed: 06/13/2023]
Abstract
Purpose: Peripheral heart action (PHA) is a style of circuit training that alternates upper and lower body resistance exercises with minimal rest between sets. The purpose of this study was to compare the metabolic demands of PHA to traditional hypertrophy training (TRAD) and to provide between sex comparison for both types of resistance training (RT). Methods: Twenty resistance-trained individuals underwent two bouts of volume-load matched RT: PHA and TRAD. We measured oxygen uptake (VO2), heart rate (HR), blood lactate (BL) concentration, rating of perceived exertion (RPE), excess post-exercise oxygen consumption (EPOC), and duration of each session. Results: PHA elicited significantly greater %VO2max (p < .001), %HRmax (p < .001), RPE (p < .001), and EPOC (p < .001) compared to TRAD. PHA was also completed in less time (p < .001). Compared to TRAD, BL was significantly higher at mid-exercise (p < .001), post-exercise (p < .001), and 5-min post-exercise (p < .001) during PHA. There were no between-sex differences for BL at any time-point for TRAD. However, during PHA, BL was significantly higher for males at mid-exercise (p = .04), post-exercise (p = .02), and 5-min post-exercise (p = .002). No between-sex differences were detected for HR, VO2, RPE, or duration for either style of RT. Conclusions: PHA is a time-effective and metabolically demanding circuit that may lead to strength and cardiorespiratory adaptations. Males produced more BL than females during PHA, but not TRAD, suggesting that they incurred more metabolic stress during the bout of circuit training.
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23
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Preliminary study of reliability of transcutaneous sensors in measuring intraabdominal pressure. Sci Rep 2022; 12:8268. [PMID: 35585106 PMCID: PMC9117299 DOI: 10.1038/s41598-022-12388-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/25/2022] [Indexed: 11/11/2022] Open
Abstract
Early recognition of elevated intraabdominal pressure (IAP) in critically ill patients is essential, since it can result in abdominal compartment syndrome, which is a life-threatening condition. The measurement of intravesical pressure is currently considered the gold standard for IAP assessment. Alternative methods have been proposed, where IAP assessment is based on measuring abdominal wall tension, which reflects the pressure in the abdominal cavity. The aim of this study was to evaluate the feasibility of using patch-like transcutaneous sensors to estimate changes in IAP, which could facilitate the monitoring of IAP in clinical practice. This study was performed with 30 patients during early postoperative care. All patients still had an indwelling urinary catheter postoperatively. Four wearable sensors were attached to the outer surface of the abdominal region to detect the changes in abdominal wall tension. Additionally, surface EMG was used to monitor the activity of the abdominal muscles. The thickness of the subcutaneous tissue was measured with ultrasound. Patients performed 4 cycles of the Valsalva manoeuvre, with a resting period in between (the minimal resting period was 30 s, with a prolongation as necessary to ensure that the fluid level in the measuring system had equilibrated). The IAP was estimated with intravesical pressure measurements during all resting periods and all Valsalva manoeuvres, while the sensors continuously measured changes in abdominal wall tension. The association between the subcutaneous thickness and tension changes on the surface and the intraabdominal pressure was statistically significant, but a large part of the variability was explained by individual patient factors. As a consequence, the predictions of IAP using transcutaneous sensors were not biased, but they were quite variable. The specificity of detecting intraabdominal pressure of 20 mmHg and above is 88%, with an NPV of 96%, while its sensitivity and PPV are currently far lower. There are inherent limitations of the chosen preliminary study design that directly caused the low sensitivity of our method as well as the poor agreement with the gold standard method; in spite of that, we have shown that these sensors have the potential to be used to monitor intraabdominal pressure. We are planning a study that would more closely resemble the intended clinical use and expect it to show more consistent results with a far smaller error.
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24
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Rúa-Alonso M, Mayo X, Rial-Vázquez J, Fariñas J, Aracama A, Iglesias-Soler E. Hemodynamic response to different set configurations of a moderate-load resistance exercise. Int J Sports Med 2022; 43:1118-1128. [PMID: 35508201 DOI: 10.1055/a-1843-8778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We aimed to determine the cardiovascular responses to two different set configuration resistance-exercise protocols during a knee extension composed of 40 repetitions with a 15RM load and a total resting time of 360 seconds. Twenty-four healthy sport science students randomly performed two sessions: (a) a long set configuration session (LSC: 4 sets of 10 repetitions with 2 min rest between sets) and (b) a short set configuration session (SSC: 8 sets of 5 repetitions with 51 s rest between sets). Before and during exercise, peak and mean values of heart rate, blood pressure, rate pressure product, and pulse pressure were obtained. Results showed that both protocols increased the overall peak and mean blood pressure values (p < 0.001). However, LSC entailed a higher peak blood pressure response at the last set (p = 0.041) and an increase throughout the first 30 repetitions (p ≤ 0.007), while SSC kept steady after the first 20 repetitions. Additionally, LSC caused higher overall peak and mean heart rate and rate pressure product values (p ≤ 0.003). Summarily, although both protocols raised blood pressure, SSC reduced the extent of the pressure and chronotropic response during resistance exercise.
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Tsuchiya Y, Morishima T, Ochi E. Slow-Speed Low-Intensity but Not Normal-Speed High-Intensity Resistance Exercise Maintains Endothelial Function. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-8. [PMID: 35446201 DOI: 10.1080/02701367.2021.2022586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Purpose: High-intensity resistance exercise two or three times a week has been considered optimal for muscle hypertrophy, although it can remarkably elevate blood pressure (BP). In contrast, slow-speed resistance exercise with low intensity and tonic force generation (slow-low) can induce muscle hypertrophy without elevating BP. However, it is unclear how endothelial function changes after slow-low. Therefore, this study examined whether slow-low would maintain brachial artery endothelial function in comparison with normal-speed with high intensity resistance exercise (normal-high) and normal-speed with low-intensity resistance exercise (normal-low). Methods: Eleven healthy young men performed leg-extensions with slow-low (3 sets of 8 repetitions at 50% of 1RM), normal-high (3 sets of 8 repetitions at 80% of 1RM), and normal-low (3 sets of 8 repetitions at 50% of 1RM). Flow-mediated dilation (FMD) in the brachial artery was evaluated at pre-exercise and at 10, 30, and 60 min after exercise. Result: The results showed that normal-high caused significant impairment of FMD at 30 (3.7 ± 2.7%) and 60 (3.7 ± 2.8%) min after exercise (P < .05). In contrast, slow-low and normal-low showed no significant difference from baseline. FMD was significantly lower in normal-high compared with slow-low and normal-low at 30 and 60 min after exercise (P < .05). Additionally, systolic BP was significantly higher during normal-high compared with slow-low and normal-low (P < .05). Conclusion: We concluded that slow-low did not impair brachial artery FMD concomitant with lower systolic BP, and may therefore be a useful mode of exercise training to improve muscle hypertrophy without provoking transient endothelial dysfunction.
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Pérez-Gosalvez A, García-Muro San José F, Carrión-Otero O, Pérez-Fernández T, Fernández-Rosa L. Blood Pressure and Heart Rate Responses to an Isokinetic Testing Protocol in Professional Soccer Players. J Clin Med 2022; 11:1539. [PMID: 35329865 PMCID: PMC8952197 DOI: 10.3390/jcm11061539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using purposive sampling, 63 professional soccer players were recruited. Cardiovascular responses were measured noninvasively during a bilateral testing protocol of knee flexion and extension. Treadmill ergospirometry following an incremental speed protocol was performed to analyze the same cardiovascular parameters at rest and at completion of this test. There were significant differences in diastolic blood pressure (DBP) and HR according to field position. The parameters presented high homogeneity at both competitive levels. Systolic blood pressure, mean arterial pressure, HR, and rate pressure product at completion of the treadmill test were significantly higher than those at completion of the isokinetic protocol. Intermittent isokinetic testing protocol of the knee triggers normal and safe BP and HR responses in healthy professional soccer players. The HR of the defenders was higher than those of the forwards and midfielders but was independent of the competitive level. The values of cardiovascular parameters at isokinetic protocol completion were lower than those during the treadmill test.
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Affiliation(s)
| | - Francisco García-Muro San José
- Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Boadilla, 28660 Madrid, Spain; (A.P.-G.); (O.C.-O.); (T.P.-F.); (L.F.-R.)
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Zheng Y, Li H, Gao K, Gallo PM. Developing a Home-Based Body Weight Physical Activity/Exercise Program. ACSM'S HEALTH & FITNESS JOURNAL 2022. [DOI: 10.1249/fit.0000000000000746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jezek F, Randall EB, Carlson BE, Beard DA. Systems analysis of the mechanisms governing the cardiovascular response to changes in posture and in peripheral demand during exercise. J Mol Cell Cardiol 2022; 163:33-55. [PMID: 34626617 DOI: 10.1016/j.yjmcc.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 08/25/2021] [Accepted: 09/29/2021] [Indexed: 12/21/2022]
Abstract
Blood flows and pressures throughout the human cardiovascular system are regulated in response to various dynamic perturbations, such as changes to peripheral demands in exercise, rapid changes in posture, or loss of blood from hemorrhage, via the coordinated action of the heart, the vasculature, and autonomic reflexes. To assess how the systemic and pulmonary arterial and venous circulation, the heart, and the baroreflex work together to effect the whole-body responses to these perturbations, we integrated an anatomically-based large-vessel arterial tree model with the TriSeg heart model, models capturing nonlinear characteristics of the large and small veins, and baroreflex-mediated regulation of vascular tone and cardiac chronotropy and inotropy. The model was identified by matching data from the Valsalva maneuver (VM), exercise, and head-up tilt (HUT). Thirty-one parameters were optimized using a custom parameter-fitting tool chain, resulting in an unique, high-fidelity whole-body human cardiovascular systems model. Because the model captures the effects of exercise and posture changes, it can be used to simulate numerous clinical assessments, such as HUT, the VM, and cardiopulmonary exercise stress testing. The model can also be applied as a framework for representing and simulating individual patients and pathologies. Moreover, it can serve as a framework for integrating multi-scale organ-level models, such as for the heart or the kidneys, into a whole-body model. Here, the model is used to analyze the relative importance of chronotropic, inotropic, and peripheral vascular contributions to the whole-body cardiovascular response to exercise. It is predicted that in normal physiological conditions chronotropy and inotropy make roughly equal contributions to increasing cardiac output and cardiac power output during exercise. Under upright exercise conditions, the nonlinear pressure-volume relationship of the large veins and sympathetic-mediated venous vasoconstriction are both required to maintain preload to achieve physiological exercise levels. The developed modeling framework is built using the open Modelica modeling language and is freely distributed.
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Affiliation(s)
- Filip Jezek
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, United States; Institute of Pathophysiology, First Faculty of Medicine, Charles University in Prague, Czech Republic.
| | - E Benjamin Randall
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, United States.
| | - Brian E Carlson
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, United States.
| | - Daniel A Beard
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, United States.
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Hendrycks R, Yang M, Hitchcock R, Leitner M, Niederauer S, Nygaard IE, Sheng X, Shaw JM. Temporal trends in trunk flexor endurance and intra-abdominal pressure in postpartum women. Physiother Theory Pract 2021; 37:1217-1226. [PMID: 31686567 PMCID: PMC7198326 DOI: 10.1080/09593985.2019.1686792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 07/12/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
Objectives: To describe change in trunk flexor endurance and intra-abdominal pressure (IAP) associated with trunk flexor assessment and explore factors associated with change in trunk flexor endurance during the first postpartum year.Design: Ancillary analysis of an ongoing prospective cohort study.Methods: Participants (N = 282) were primiparous women delivered vaginally. They completed trunk flexor endurance testing while assessing IAP, body habitus measures (body mass index, waist circumference, and body composition), and questionnaires 5-10 weeks and 11-15 months postpartum. We investigated change in trunk flexor endurance by quartile of improvement and factors associated with improvement (Q4 vs. Q1-Q3) using multivariable models, adjusted for baseline endurance.Results: Mean age was 28 ± 5 years. The median (IQR) trunk flexor hold time increased from early to late postpartum (129/IQR = 68, 217 vs 148/IQR = 80, 265 seconds, p = .01) and mean (SD) IAP decreased (55/SD = 13 vs 48/SD = 14 cmH20, p < .0001). The most improved group (Q4) increased endurance time by 176 seconds (95% CI = 103, 254), were less likely to be Hispanic, more likely to be older, more educated, and have lower measures of body habitus than women in Q1-Q3. Conclusion: Trunk flexor endurance increased and IAP decreased over one year postpartum. Lower body habitus and higher age early postpartum predicted greatest improvement in trunk flexor endurance at 1 year.
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Affiliation(s)
- Russell Hendrycks
- Department of Health, Kinesiology, and Recreation, 250 S. 1850 E. Room 241, University of Utah, Salt Lake City, UT, 84112
| | - Meng Yang
- Department of Family and Preventive Medicine, 375 Chipeta Way Ste. A, University of Utah, Salt Lake City, UT, 84108
| | - Robert Hitchcock
- Department of Biomedical Engineering, 36 S. Wasatch Drive, University of Utah, Salt Lake City, UT, 84112
| | - Monika Leitner
- Department of Health Professions, Murtenstrasse 10, Bern University of Applied Sciences, CH-3008 Bern, Switzerland
| | - Stefan Niederauer
- Department of Biomedical Engineering, 36 S. Wasatch Drive, University of Utah, Salt Lake City, UT, 84112
| | - Ingrid E. Nygaard
- Department of Obstetrics and Gynecology, 30 N. 1900 E. Room 2B200, University of Utah, Salt Lake City, UT, 84132
| | - Xiaoming Sheng
- College of Nursing, 10 S. 2000 E., University of Utah, Salt Lake City, UT, 84112
| | - Janet M. Shaw
- Department of Health, Kinesiology, and Recreation, 250 S. 1850 E. Room 241, University of Utah, Salt Lake City, UT, 84112
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Watanabe H, Washio T, Saito S, Ogoh S. Effect of breath-hold on the responses of arterial blood pressure and cerebral blood velocity to isometric exercise. Eur J Appl Physiol 2021; 122:157-168. [PMID: 34618221 DOI: 10.1007/s00421-021-04822-1] [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: 04/07/2021] [Accepted: 09/25/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The present study examined the effect of breath-hold without a Valsalva maneuver during isometric exercise on arterial blood pressure (ABP) and cerebral blood flow (CBF). METHODS Twenty healthy adults (15 men and five women) randomly performed only breath-hold without a Valsalva maneuver (BH), and an isometric handgrip exercise for 30 s at 40% of individual maximal voluntary contraction with continuous breathing (IHG) and with breath-hold without the Valsalva maneuver (IHG-BH). Mean ABP (MAP) and blood velocity in the middle (MCA Vmean) and posterior cerebral arteries (PCA Vmean) were continuously measured throughout each protocol. RESULTS MAP was elevated during the IHG-BH compared with IHG (P < 0.001) and BH (P = 0.001). Similarly, both MCA Vmean and PCA Vmean were higher during IHG-BH compared with IHG and BH (all P < 0.001). Moreover, the relative change in MAP from the baseline was correlated with that in both cerebral blood velocities during the BH (MCA Vmean: r = 0.739, P < 0.001 and PCA Vmean: r = 0.570, P = 0.009) and IHG-BH (MCA Vmean: r = 0.755, P < 0.001 and PCA Vmean: r = 0.617, P = 0.003) condition, but not the IHG condition (P = 0.154 and P = 0.306). CONCLUSION These results indicate that during isometric exercise, a breath-hold enhances an exercise-induced increase in MAP and, consequently, MCA Vmean and PCA Vmean.
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Affiliation(s)
- Hironori Watanabe
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Takuro Washio
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shotaro Saito
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan. .,Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
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Wolpern AE, de Gennaro JD, Brusseau TA, Byun W, Egger MJ, Hitchcock RW, Nygaard IE, Sheng X, Shaw JM. Relationship of heart rate, perceived exertion, and intra-abdominal pressure in women. ACTA ACUST UNITED AC 2021; 9:97-103. [PMID: 34532155 DOI: 10.31189/2165-6193-9.3.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Exercise increases intra-abdominal pressure (IAP) acutely, which may impact the pelvic floor of women. IAP during exercise demonstrates high variability among women but is not routinely assessed. Assessing less invasive measures related to IAP during exercise may facilitate study of how IAP impacts the pelvic floor. Methods The objective of this study was to investigate the relationship of heart rate and rating of perceived exertion (RPE) with IAP during a standard treadmill test. We describe the trend of IAP by predicted aerobic fitness during incremental exercise. IAP was measured using a validated transducer placed in the upper vagina. Heart rate and RPE were collected during the first 3 stages of the standard Bruce treadmill protocol. Relationships of heart rate and RPE with IAP were determined by Pearson correlation coefficients. Predicted aerobic fitness values for each participant were ranked in tertiles with IAP by treadmill stage. Results Twenty-four women participated in this study (mean age: 24.7 (5.4) years; body mass index: 22.5 (2.2) kg/m2). There were significant relationships between heart rate and IAP (r= 0.67, p < 0.001) and RPE and IAP (r= 0.60, p < 0.001) across treadmill stages. Tertiles of predicted aerobic fitness and IAP displayed similar trends as other exercise measures during incremental exercise, such as, heart rate and ventilation. Conclusion Heart rate and RPE could be used as proxy measures of IAP during incremental exercise. Aerobic fitness may help explain IAP variability in women and provide context for future research on IAP and pelvic floor health.
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Affiliation(s)
- Ali E Wolpern
- Department of Health, Kinesiology, and Recreation, University of Utah College of Health, Salt Lake City, United States
| | - Johanna D de Gennaro
- Department of Biomedical Engineering, University of Utah College of Engineering, Salt Lake City, United States
| | - Timothy A Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah College of Health, Salt Lake City, United States
| | - Wonwoo Byun
- Department of Health, Kinesiology, and Recreation, University of Utah College of Health, Salt Lake City, United States
| | - Marlene J Egger
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, United States
| | - Robert W Hitchcock
- Department of Biomedical Engineering, University of Utah College of Engineering, Salt Lake City, United States
| | - Ingrid E Nygaard
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, United States
| | - Xiaoming Sheng
- University of Utah College of Nursing, Salt Lake City, United States
| | - Janet M Shaw
- Department of Health, Kinesiology, and Recreation, University of Utah College of Health, Salt Lake City, United States
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The effect of breathing technique on sticking region during maximal bench press. Biol Sport 2021; 38:445-450. [PMID: 34475625 PMCID: PMC8329978 DOI: 10.5114/biolsport.2021.100362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/21/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
The intrathoracic pressure and breathing strategy on bench press (BP) performance is highly discussed in strength competition practice. Therefore, the purpose of this study was to analyze whether different breathing techniques can influence the time and track characteristics of the sticking region (SR) during the 1RM BP exercise. 24 healthy, male adults (age 23 ± 2.4 yrs., body mass 85 ± 9.2 kg, height 181 ± 5.4 cm) performed a 1 repetition BP using the breathing technique of Valsalva maneuver (VM), hold breath, lung packing (PAC), and reverse breathing (REVB), while maximum lifted load and concentric phase kinematics were recorded. The results of ANOVA showed that the REVB breathing decreased absolute (p < 0.04) and relative lifted load (p < 0.01). The VM showed lower (p = 0.01) concentric time of the lift than the other breathing techniques. The VM and PAC showed lower SR time than other breathing techniques, where PAC showed a lower SR time than VM (p = 0.02). The PAC techniques resulted in shorter SR and pre-SR track than other breathing techniques and the REVB showed longer SR track than the other considered breathing techniques (p = 0.04). Thus, PAC or VM should be used for 1RM BP lifting according to preferences, experiences and lifting comfort of an athlete. The hold breath technique does not seem to excessively decrease the lifting load, but this method will increase the lifting time and the time spend in the sticking region, therefore its use does not provide any lifting benefit. The authors suggest that the REVB should not be used during 1 RM lifts.
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Meah VL, Strynadka MC, Steinback CD, Davenport MH. Cardiac Responses to Prenatal Resistance Exercise with and without the Valsalva Maneuver. Med Sci Sports Exerc 2021; 53:1260-1269. [PMID: 33394898 DOI: 10.1249/mss.0000000000002577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Exercise guidelines recommend incorporating resistance exercise (RE) into a regular aerobic training program during pregnancy. However, few women do so because of uncertainties about the safety of prenatal RE, particularly regarding the Valsalva maneuver (VM). The aim of this study was to determine the acute cardiovascular responses to prenatal RE at different intensities, with and without VM. METHODS Healthy pregnant (n = 15; 22.9 ± 5.9 wk of gestation) and nonpregnant women (n = 15) were recruited. Maximal strength over 10 repetitions (10RM) for semireclined leg press was determined. Women underwent standardized assessments of cardiac structure, function and mechanics (echocardiography), heart rate (ECG), and blood pressure (photoplethysmography) at baseline, during RE at 20%, 40%, and 60% 10RM while free-breathing, and at 40% 10RM with VM. Significant differences were identified between subjects at baseline (independent t-tests), between and within subjects during free-breathing RE (general linear model, baseline as a covariate), and between and within subjects for 40% 10RM free-breathing versus VM (mixed-effects model). RESULTS Resting cardiac output, heart rate, and stroke volume were greater in pregnant women, without differences in blood pressure, ejection fraction, or cardiac mechanics. During free-breathing RE, pregnant women had a greater ejection fraction compared with nonpregnant women; however, all other hemodynamic variables were not different between groups. Cardiac mechanics during free-breathing RE across all intensities were not different between groups, with the exception that pregnant women had a lower apical circumferential strain that did not affect global cardiac function. No differences were observed between groups during 40% 10RM RE with and without VM. CONCLUSIONS Pregnant women have proportionate cardiac responses to light-moderate RE, both with and without the VM. These findings reinforce the safety of RE in healthy pregnancy.
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Affiliation(s)
- Victoria L Meah
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, CANADA
| | - Morgan C Strynadka
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, CANADA
| | - Craig D Steinback
- Neurovascular Health Lab, Faculty of Kinesiology, Sport, and Recreation, Neuroscience and Mental Health Institute, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, CANADA
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, CANADA
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Yavuzsan AH, Baloğlu IH, Albayrak AT, Bursali K, Demirel HC. Spontaneous Kidney Rupture: Two Case Reports With Unusual Presentations. Cureus 2021; 13:e15332. [PMID: 34221775 PMCID: PMC8240417 DOI: 10.7759/cureus.15332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Two patients came to the emergency department with sudden-onset abdominal pain. The first case was a 20-year-old male; a contrast-enhanced computed tomography (CT) scan revealed a 17 cm x 7 cm hematoma in the abdomen and left retroperitoneal space. Furthermore, the left kidney was not visualized by CT. With an emergent diagnostic laparotomy, the etiology of the bleeding was determined to be left atrophic-hydronephrotic kidney rupture. Thus, a left nephrectomy was performed. The second case was a 38-year-old male with a history of chronic hypertension; a CT scan revealed a 7 cm x 6 cm left perirenal hematoma. A left nephrectomy was performed due to hemodynamic instability on the second day of follow-up. A pathology specimen revealed a 1-cm renal cell carcinoma (RCC) in the kidney. In case of hemodynamic instability, spontaneous kidney rupture requires immediate surgical intervention; its causes include atrophic-hydronephrotic kidney and RCC.
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Affiliation(s)
- Abdullah H Yavuzsan
- Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Ibrahim H Baloğlu
- Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Ahmet T Albayrak
- Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Kerem Bursali
- Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
| | - Huseyin C Demirel
- Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR
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Perry BG, Lucas SJE. The Acute Cardiorespiratory and Cerebrovascular Response to Resistance Exercise. SPORTS MEDICINE-OPEN 2021; 7:36. [PMID: 34046740 PMCID: PMC8160070 DOI: 10.1186/s40798-021-00314-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/07/2021] [Indexed: 12/18/2022]
Abstract
Resistance exercise (RE) is a popular modality for the general population and athletes alike, due to the numerous benefits of regular participation. The acute response to dynamic RE is characterised by temporary and bidirectional physiological extremes, not typically seen in continuous aerobic exercise (e.g. cycling) and headlined by phasic perturbations in blood pressure that challenge cerebral blood flow (CBF) regulation. Cerebral autoregulation has been heavily scrutinised over the last decade with new data challenging the effectiveness of this intrinsic flow regulating mechanism, particularly to abrupt changes in blood pressure over the course of seconds (i.e. dynamic cerebral autoregulation), like those observed during RE. Acutely, RE can challenge CBF regulation, resulting in adverse responses (e.g. syncope). Compared with aerobic exercise, RE is relatively understudied, particularly high-intensity dynamic RE with a concurrent Valsalva manoeuvre (VM). However, the VM alone challenges CBF regulation and generates additional complexity when trying to dissociate the mechanisms underpinning the circulatory response to RE. Given the disparate circulatory response between aerobic and RE, primarily the blood pressure profiles, regulation of CBF is ostensibly different. In this review, we summarise current literature and highlight the acute physiological responses to RE, with a focus on the cerebral circulation.
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Affiliation(s)
- Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand.
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences & Centre for Human Brain Health, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Kambic T, Hadžić V, Lainscak M. Hemodynamic Response to High- and Low-Load Resistance Exercise in Patients with Coronary Artery Disease: A Randomized, Crossover Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083905. [PMID: 33917770 PMCID: PMC8068143 DOI: 10.3390/ijerph18083905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022]
Abstract
Low-load resistance exercise (LL-RE) is recommended as an adjunct therapy to aerobic exercise during cardiac rehabilitation in patients with coronary artery disease. The safety and hemodynamic response to high-load (HL) RE remain unknown. The aim of this study was to evaluate the hemodynamic response during both HL-RE and LL-RE prior to cardiac rehabilitation. Forty-three patients with coronary artery disease and/or percutaneous coronary intervention performed three sets of leg-press exercise using HL-RE (eight repetitions at the intensity of 80% of one repetition maximum (1-RM)) and LL-RE (16 repetitions at the intensity of 40% 1-RM) in a randomized crossover sequence. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rating of perceived exertion were measured at baseline, after each set of RE and post-exercise. No clinically relevant changes in HR and BP or in patient-reported symptoms were recorded during HL-RE or LL-RE. Compared with baseline, HR and SBP increased during LL-RE (from 66 bpm to 86 bpm, time effect: p < 0.001; from 129 mmHg to 146 mmHg, time effect: p < 0.001) and HL-RE (from 68 bpm to 86 bpm, time effect: p < 0.001; from 130 mmHg to 146 mmHg, time effect: p < 0.001). Compared with HL-RE, the increase in HR was greater after the final set of LL-RE (32% vs. 28%, p = 0.015), without significant differences in SBP and DBP between LL-RE and HL-RE. Rating of perceived exertion was higher after the 1st set of HL-RE compared with LL-RE (median (interquartile range): 6 (5–7) vs. 6 (5–6), p = 0.010). In patients with coronary artery disease, both HL-RE and LL-RE were safe and well-tolerated. Hemodynamic changes were similar and within the physiological response to RE.
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Affiliation(s)
- Tim Kambic
- Department of Research and Education, General Hospital Murska Sobota, 9000 Murska Sobota, Slovenia;
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, 9000 Murska Sobota, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Natural Sciences and Mathematics, University of Maribor, 2000 Maribor, Slovenia
- Correspondence: ; Tel.: +386-(02)-512-3733
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Edvinsson B, Thilén U, Nielsen NE, Christersson C, Dellborg M, Eriksson P, Hlebowicz J. Does persistent (patent) foramen ovale closure reduce the risk of recurrent decompression sickness in scuba divers? Diving Hyperb Med 2021; 51:63-67. [PMID: 33761542 DOI: 10.28920/dhm51.1.63-67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/20/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Interatrial communication is associated with an increased risk of decompression sickness (DCS) in scuba diving. It has been proposed that there would be a decreased risk of DCS after closure of the interatrial communication, i.e., persistent (patent) foramen ovale (PFO). However, the clinical evidence supporting this is limited. METHODS Medical records were reviewed to identify Swedish scuba divers with a history of DCS and catheter closure of an interatrial communication. Thereafter, phone interviews were conducted with questions regarding diving and DCS. All Swedish divers who had had catheter-based PFO-closure because of DCS were followed up, assessing post-closure diving habits and recurrent DCS. RESULTS Nine divers, all with a PFO, were included. Eight were diving post-closure. These divers had performed 6,835 dives (median 410, range 140-2,200) before closure, and 4,708 dives (median 413, range 11-2,000) after closure. Seven cases with mild and 10 with serious DCS symptoms were reported before the PFO closure. One diver with a small residual shunt suffered serious DCS post-closure; however, that dive was performed with a provocative diving profile. CONCLUSION Divers with PFO and DCS continue to dive after PFO closure and this seems to be fairly safe. Our study suggests a conservative diving profile when there is a residual shunt after PFO closure, to prevent recurrent DCS events.
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Affiliation(s)
- Björn Edvinsson
- Department of Cardiology, Department of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ulf Thilén
- Department of Cardiology, Department of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden
| | - Niels Erik Nielsen
- Department of Cardiology, Department of Clinical Science, University Hospital Linköping, Linköping University, Linköping, Sweden
| | | | - Mikael Dellborg
- Department of Cardiology, Department of Clinical Science, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Peter Eriksson
- Department of Cardiology, Department of Clinical Science, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Joanna Hlebowicz
- Department of Cardiology, Department of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden.,Corresponding author: Dr Joanna Hlebowicz, Department of Cardiology, Skåne University Hospital, Lund University, SE-221, 85 Lund, Sweden,
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Abstract
The esophagogastric junction (EGJ) is a complex barrier between the thoracic and abdominal luminal gut compartments, comprised primarily of the lower esophageal sphincter (LES) and crural diaphragm. Although closed at rest, the EGJ relaxes to allow antegrade bolus transit and retrograde venting of air. Abnormal relaxation is the hallmark of achalasia spectrum disorders, while increased frequency of transient lower esophageal sphincter relaxations and/or EGJ disruption are seen in gastroesophageal reflux disease. High resolution manometry (HRM) is the modern day gold standard for assessment of EGJ morphology and function, with better performance characteristics compared with endoscopy and barium esophagography. Conventional LES metrics defining EGJ function include resting LES pressure as well as postswallow residual pressures. Newer HRM-based metrics include EGJ contractile integral, which measures static barrier function at rest, and EGJ morphology, which characterizes the relationship between LES and crural diaphragm. Provocative maneuvers assess dynamic EGJ function during physiological or pharmacologic stress. The most useful of these maneuvers, the rapid drink challenge, assesses for latent obstruction, while multiple rapid swallows evaluate adequacy of deglutitive inhibition. Amyl nitrate and cholecystokinin administration can segregate motor from structural obstruction. Newer provocative tests (straight leg raise maneuver, abdominal compression) and novel diagnostic tools (functional lumen imaging probe) complement HRM evaluation of the EGJ. Although current HRM metrics and maneuvers show promise in identifying clinically relevant EGJ abnormalities, future investigations evaluating management outcomes will improve segregation of normal from abnormal EGJ morphology and function.
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Hitchcock R, Shaw JM, Niederauer S, Zhou J, Sheng X, Yang M, Nygaard IE. Association Between Measures of Trunk Recovery 5 to 10 Weeks Postpartum and Pelvic Floor Support and Symptoms 1 Year Postpartum in Primiparas Delivered Vaginally. Female Pelvic Med Reconstr Surg 2021; 27:e427-e435. [PMID: 32925422 DOI: 10.1097/spv.0000000000000953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine whether 2 aspects of trunk recovery after childbirth, intraabdominal pressure (IAP) generation and trunk flexor endurance (TFE), predict measures of pelvic floor health 1 year postpartum. METHODS In this prospective cohort study, we enrolled nulliparas in their third trimester and followed up those delivered vaginally for 1 year. We measured IAP while lifting a weighted car seat (IAPLIFT), IAP during TFE testing (IAPTFE), and TFE duration 5 to 10 weeks postpartum and assessed pelvic floor support and symptoms 1 year postpartum. RESULTS Mean age of the 624 participants was 28.7 years. At 5 to 10 weeks postpartum, mean (SD) maximal IAPLIFT and IAPTFE were 47.67 (11.13) and 51.57 (12.34) cm H2O, respectively. Median TFE duration was 126 seconds (Interquartile range, 74-211). At 1 year postpartum, 9.3% demonstrated worse support (maximal vaginal descent at or below hymen) and 54% met criteria for symptom burden (bothersome symptoms in ≥2 domains of Epidemiology of Prolapse and Incontinence Questionnaire). In multivariable models, neither IAPLIFT nor IAPTFE were associated with worse support or symptom burden (P = 0.54-1.00). Trunk flexor endurance duration increased prevalence of worse support (prevalence ratio, 1.05; 95% confidence interval, 1.01-1.08) per 60-second increase, P = 0.005) but not symptom burden (prevalence ratio, 1.00; 95% confidence interval, 0.98-1.03; P = 0.92). CONCLUSIONS These results provide some reassurance to early postpartum women, who are unlikely to perform routine activities that generate IAP far outside the range tested. Further research is needed to understand why women with long TFE durations have increased prevalence of worse support.
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Affiliation(s)
| | - Janet M Shaw
- Department of Health, Kinesiology, and Recreation, University of Utah, College of Health
| | | | - Jing Zhou
- Department of Family and Preventive Medicine, University of Utah School of Medicine, UT
| | | | - Meng Yang
- Department of Surgery, University of Utah
| | - Ingrid E Nygaard
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT
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Zdravkovic A, Hasenoehrl T, Crevenna R. Resistance Exercise in Prostate Cancer Patients: a Short Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00307-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Purpose of Review
The aim of this paper is to provide an overview of recent findings concerning the utilization of resistance exercise (RE) in prostate cancer (PCa), in particular as pertaining to the management of cancer therapy side effects.
Recent Findings
As of late, studies investigating the effects of RE in PCa patients have found positive effects on muscle strength, body composition, physical functioning, quality of life, and fatigue. The combination of RE and impact training appears to decrease the loss of bone mineral density. RE seems to be well accepted and tolerated, even by patients with bone metastatic disease, although a modification of the RE prescription is often necessary.
Summary
In PCa patients, RE has been well-researched and the data are clear that it is beneficial in multiple ways. Future directions should look at the long-term effects of RE, including mortality and relapse, as well as implementation of exercise programs.
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Hackett DA, Sabag A. Lung function and respiratory muscle strength and their relationship with weightlifting strength and body composition in non-athletic males. Respir Physiol Neurobiol 2021; 286:103616. [PMID: 33454350 DOI: 10.1016/j.resp.2021.103616] [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: 08/13/2020] [Revised: 12/28/2020] [Accepted: 01/01/2021] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine whether lung function and respiratory muscle strength are associated with weightlifting strength and body composition in non-athletic males. A total 51 males with resistance training experience participated. One-repetition maximum tests were performed for the bench press, squat and deadlift and body composition was assessed. Lung function was evaluated with a pulmonary testing system and respiratory muscle strength was assessed with a handheld mouth-pressure manometer. Moderate to strong positive relationships were found between all weightlifting strength variables and maximal expiratory pressure (r = 0.36-0.54, p = ≤0.01). Small to strong positive correlations were found between fat-free mass, appendicular lean mass and most lung function variables (r = 0.29-0.54, p ≤ 0.039). However, fat-free mass and appendicular lean mass indexes were only related with respiratory muscle strength and not lung function. Expiratory muscle strength appears to influence weightlifting performance. Special exercises targeting the expiratory muscles may assist with improving weightlifting performance, especially for squats and deadlifts.
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Affiliation(s)
- Daniel A Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia.
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
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Wolke R, Kuhtz-Buschbeck JP, Deuschl G, Margraf NG. Insufficiency of trunk extension and impaired control of muscle force in Parkinson's disease with camptocormia. Clin Neurophysiol 2020; 131:2621-2629. [PMID: 32932021 DOI: 10.1016/j.clinph.2020.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/04/2020] [Accepted: 07/12/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the aetiology of parkinsonian camptocormia, a non-fixed pathological forward bending of the trunk, by measuring trunk muscle activation and force regulation in Parkinson patients with (PD + CC) and without (PD) camptocormia matched for disease severity, and in age- and sex-matched healthy controls (HC). METHODS The isometric forces of trunk extension and flexion were measured in PD + CC, PD and HC. Neuromuscular efficiency (increase of extension force per increase of paravertebral muscle surface electromyography signal) and the ability to maintain a constant submaximal trunk extension force were examined. RESULTS Peak trunk extension force was significantly lower in PD + CC and PD than in HC, with PD + CC non-significantly weaker than PD. Compared with HC and with PD, the neuromuscular efficiency of trunk extension was significantly reduced in PD + CC. The variability of the force output (coefficient of variation) was significantly larger for PD + CC than for HC or PD. CONCLUSION The reduced neuromuscular efficiency of trunk extension separates PD + CC from PD. Moreover, control of the trunk extensor force is impaired in PD + CC. SIGNIFICANCE There is weakness and a force control deficit in parkinsonian camptocormia suggesting a disturbed sensory-motor integration, which may contribute to myopathic changes in the trunk extensor muscles.
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Affiliation(s)
- R Wolke
- Department of Neurology, Kiel University, UKSH, Germany
| | | | - G Deuschl
- Department of Neurology, Kiel University, UKSH, Germany.
| | - N G Margraf
- Department of Neurology, Kiel University, UKSH, Germany
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Callender NA, Hayes TN, Tiller NB. Cardiorespiratory demands of competitive rock climbing. Appl Physiol Nutr Metab 2020; 46:161-168. [PMID: 32813982 DOI: 10.1139/apnm-2020-0566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Rock climbing has become a mainstream sport, contested on the Olympic stage. The work/rest pattern of bouldering is unique among disciplines, and little is known about its physiological demands. This study characterised the cardiorespiratory responses to simulated competition. Eleven elite boulderers (7 male) volunteered to participate (age = 23.3 ± 4.5 years; mass = 68.2 ± 9.7 kg; stature = 1.73 ± 0.06 m; body fat = 10.4% ± 5%). Subjects completed incremental treadmill running to determine maximal capacities. On a separate day, they undertook a simulated Olympic-style climbing competition comprising 5 boulder problems, each separated by 5 min of rest. Pulmonary ventilation, gas exchange, and heart rate were assessed throughout. Total climbing time was 18.9 ± 2.7 min. Bouldering elicited a peak oxygen uptake of 35.8 ± 7.3 mL·kg-1·min-1 (∼75% of treadmill maximum) and a peak heart rate of 162 ± 14 beats·min-1 (∼88% of maximum). Subjects spent 22.9% ± 8.6% of climbing time above the gas exchange threshold. At exercise cessation, there was an abrupt and significant increase in tidal volume (1.4 ± 0.4 vs. 1.8 ± 0.4 L; p = 0.006, d = 0.83) despite unchanged minute ventilation. Cardiorespiratory parameters returned to baseline within 4 min of the rest period. In conclusion, competitive bouldering elicits substantial cardiorespiratory demand and evidence of tidal volume constraint. Further studies are warranted to explore the effect of cardiorespiratory training on climbing performance. Novelty: Competitive bouldering evokes a high fraction of maximal oxygen uptake and prolonged periods above the gas exchange threshold. Climbing appears to impose a constraint on tidal volume expansion. Cardiorespiratory indices in elite climbers return to baseline within 2-4 min.
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Affiliation(s)
- Nigel A Callender
- Department of Anaesthetics, Northumbria Specialist Emergency Care Hospital, Cramlington, Northumberland, NE23 6NZ, UK.,School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, LS1 3HE, UK
| | - Tara N Hayes
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Centre, Torrance, CA 90502, USA
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Callender NA, Hart PW, Ramchandani GM, Chaggar PS, Porter AJ, Billington CP, Tiller NB. The exercise pressor response to indoor rock climbing. J Appl Physiol (1985) 2020; 129:404-409. [PMID: 32644913 DOI: 10.1152/japplphysiol.00357.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This paper assessed the blood pressure, heart rate, and mouth-pressure responses to indoor rock climbing (bouldering) and associated training exercises. Six well-trained male rock climbers (mean ± SD age, 27.7 ± 4.7 yr; stature, 177.7 ± 7.3 cm; mass, 69.8 ± 12.1 kg) completed two boulder problems (6b and 7a+ on the Fontainebleau Scale) and three typical training exercises [maximum voluntary contraction (MVC) isometric pull-up, 80% MVC pull-ups to fatigue, and campus board to fatigue]. Blood pressure and heart rate were measured via an indwelling femoral arterial catheter, and mouth pressure via a mouthpiece manometer. Bouldering evoked a peak systolic pressure of 200 ± 17 mmHg (44 ± 21% increase from baseline), diastolic pressure of 142 ± 26 mmHg (70 ± 32% increase), mean arterial pressure of 163 ± 18 mmHg (56 ± 25% increase), and heart rate of 176 ± 22 beats/min (76 ± 35% increase). The highest systolic pressure was observed during the campus board exercise (218 ± 33 mmHg), although individual values as high as 273/189 mmHg were recorded. Peak mouth pressure during climbing was 31 ± 46 mmHg, and this increased independently of climb difficulty. We concluded that indoor rock climbing and associated exercises evoke a substantial pressor response resulting in high blood pressures that may exceed those observed during other upper-limb resistance exercises. These findings may inform risk stratification for climbers.NEW & NOTEWORTHY This case study provides original data on the exercise pressor response to indoor rock climbing and associated training exercises through the use of an indwelling femoral arterial catheter. Our subjects exhibited systolic/diastolic blood pressures that exceeded values often reported during upper-limb resistance exercise. Our data extend the understanding of the cardiovascular stress associated with indoor rock climbing.
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Affiliation(s)
- Nigel A Callender
- Department of Anaesthetics, Northumbria Specialist Emergency Care Hospital, Cramlington, United Kingdom.,School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Peter W Hart
- Department of Anaesthetics and Critical Care, Bradford Teaching Hospitals Foundation Trust, Bradford, United Kingdom
| | - Girish M Ramchandani
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, United Kingdom
| | | | - Andrew J Porter
- Newcastle University Protein and Proteome Analysis, Newcastle University, Newcastle, United Kingdom
| | - Charlie P Billington
- Department of Anaesthetics, Dumfries and Galloway Royal Infirmary, Dumfries, United Kingdom
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
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Tjøsvoll SO, Mork PJ, Iversen VM, Rise MB, Fimland MS. Periodized resistance training for persistent non-specific low back pain: a mixed methods feasibility study. BMC Sports Sci Med Rehabil 2020; 12:30. [PMID: 32411374 PMCID: PMC7206666 DOI: 10.1186/s13102-020-00181-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/01/2020] [Indexed: 12/29/2022]
Abstract
Background We investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP). Methods Twenty-five adults with persistent non-specific LBP participated in this mixed methods feasibility study. Participants trained a whole-body program consisting of squat, bench press, deadlift and pendlay row two times per week for 16 weeks. We assessed pain intensity, pain-related disability, pain self-efficacy and one-repetition maximum strength at baseline, 8 weeks and 16 weeks. Three focus group interviews were conducted at the end of the program. Linear mixed models were used to assess changes in outcomes, and the qualitative data was assessed using systematic text condensation. Results We observed clinically meaningful reductions in pain intensity after 8 and 16 weeks of training. The mean difference on the numeric pain rating scale (0–10) in the last 2 weeks from baseline to 8 weeks was 2.6 (95% CI: 1.8–3.6) and from baseline to 16 weeks 3.4 (95% CI: 2.5–4.4). In addition, there were improvements in pain-related disability (3.9, 95% CI: 2.3–5.5), pain self-efficacy (7.7, 95% CI: 5.4–10.1) and muscle strength. In the focus group interviews, participants talked about challenges regarding technique, the importance of supervision and the advantages of periodizing the training. Perceived benefits were improved pain, daily functioning, energy level and sleep, and changes in views on physical activity. Conclusion Periodized resistance training with weekly undulating periodization is a feasible training method for this group of individuals with persistent non-specific LBP. A randomized clinical trial should assess the efficacy of such an intervention. Trial registration clinicaltrials.gov/ Identifier – NCT04284982, Registered on February 24th 2020.
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Affiliation(s)
- Svein O Tjøsvoll
- 1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Paul J Mork
- 2Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard M Iversen
- 2Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit B Rise
- 3Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marius S Fimland
- 1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
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Fogarty MJ, Sieck GC. Spinal cord injury and diaphragm neuromotor control. Expert Rev Respir Med 2020; 14:453-464. [PMID: 32077350 PMCID: PMC7176525 DOI: 10.1080/17476348.2020.1732822] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/18/2020] [Indexed: 12/22/2022]
Abstract
Introduction: Neuromotor control of diaphragm muscle and the recovery of diaphragm activity following spinal cord injury have been narrowly focused on ventilation. By contrast, the understanding of neuromotor control for non-ventilatory expulsive/straining maneuvers (including coughing, defecation, and parturition) is relatively impoverished. This variety of behaviors are achieved via the recruitment of the diverse array of motor units that comprise the diaphragm muscle.Areas covered: The neuromotor control of ventilatory and non-ventilatory behaviors in health and in the context of spinal cord injury is explored. Particular attention is played to the neuroplasticity of phrenic motor neurons in various models of cervical spinal cord injury.Expert opinion: There is a remarkable paucity in our understanding of neuromotor control of maneuvers in spinal cord injury patients. Dysfunction of these expulsive/straining maneuvers reduces patient quality of life and contributes to severe morbidity and mortality. As spinal cord injury patient life expectancies continue to climb steadily, a nexus of spinal cord injury and age-associated comorbidities are likely to occur. While current research remains concerned only with the minutiae of ventilation, the major functional deficits of this clinical cohort will persist intractably. We posit some future research directions to avoid this scenario.
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Affiliation(s)
- Matthew J Fogarty
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA
| | - Gary C Sieck
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, USA
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Shieh AK, Saiz AM, Hallare DA. Spontaneous pubic symphysis disruption and concomitant bladder rupture during competitive squatting: A case report. Trauma Case Rep 2020; 27:100299. [PMID: 32322649 PMCID: PMC7168765 DOI: 10.1016/j.tcr.2020.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Pubic symphysis disruption is typically secondary to external blunt force trauma. This report presents a case of concomitant bladder wall rupture and pubic symphysis diastasis during competitive squatting. This required open bladder repair, small artery embolization, and internal fixation of the pubic symphysis. Surgeons should be aware that pelvic ring instability and organ damage can result even without any external trauma.
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Affiliation(s)
- Alvin K Shieh
- Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA, United States of America
| | - Augustine M Saiz
- Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA, United States of America
| | - Domingo A Hallare
- Department of Orthopaedic Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, CA, United States of America
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48
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Intra-abdominal Pressure and Pelvic Floor Health: Should We Be Thinking About This Relationship Differently? Female Pelvic Med Reconstr Surg 2020; 26:409-414. [DOI: 10.1097/spv.0000000000000799] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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49
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Shoemaker MJ, Dias KJ, Lefebvre KM, Heick JD, Collins SM. Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure. Phys Ther 2020; 100:14-43. [PMID: 31972027 DOI: 10.1093/ptj/pzz127] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/15/2019] [Accepted: 06/10/2019] [Indexed: 12/12/2022]
Abstract
The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, have commissioned the development of this clinical practice guideline to assist physical therapists in their clinical decision making when managing patients with heart failure. Physical therapists treat patients with varying degrees of impairments and limitations in activity and participation associated with heart failure pathology across the continuum of care. This document will guide physical therapist practice in the examination and treatment of patients with a known diagnosis of heart failure. The development of this clinical practice guideline followed a structured process and resulted in 9 key action statements to guide physical therapist practice. The level and quality of available evidence were graded based on specific criteria to determine the strength of each action statement. Clinical algorithms were developed to guide the physical therapist in appropriate clinical decision making. Physical therapists are encouraged to work collaboratively with other members of the health care team in implementing these action statements to improve the activity, participation, and quality of life in individuals with heart failure and reduce the incidence of heart failure-related re-admissions.
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Affiliation(s)
- Michael J Shoemaker
- Department of Physical Therapy, Grand Valley State University, 301 Michigan NE, Suite 200, Grand Rapids, MI 49503 (USA). Dr Shoemaker is a board-certified clinical specialist in geriatric physical therapy
| | - Konrad J Dias
- Physical Therapy Program, Maryville University of St Louis, St Louis, Missouri. Dr Dias is a board-certified clinical specialist in cardiovascular and pulmonary physical therapy
| | - Kristin M Lefebvre
- Department of Physical Therapy, Concordia University St Paul, St Paul, Minnesota. Dr Lefebvre is a board-certified clinical specialist in cardiovascular and pulmonary physical therapy
| | - John D Heick
- Department of Physical Therapy, Northern Arizona University, Flagstaff, Arizona. Dr Heick is a board-certified clinical specialist in orthopaedic physical therapy, neurologic physical therapy, and sports physical therapy
| | - Sean M Collins
- Physical Therapy Program, Plymouth State University, Plymouth, New Hampshire
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Cerebrovascular haemodynamics during isometric resistance exercise with and without the Valsalva manoeuvre. Eur J Appl Physiol 2020; 120:467-479. [PMID: 31912226 DOI: 10.1007/s00421-019-04291-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/20/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE To examine the interactive effects of VM and isometric resistance exercise on cerebral haemodynamics. METHODS Eleven healthy participants (mean ± SD 28 ± 9 years; 2 females) completed 20-s bilateral isometric leg extension at 50% of maximal voluntary contraction with continued ventilation (RE), a 20-s VM at mouth pressure of 40 mmHg (VM), and a combination (RE + VM), in randomised order. Mean beat-to-beat blood velocity in the posterior (PCAvmean) and middle cerebral arteries (MCAvmean), vertebral artery blood flow, end-tidal partial pressure of CO2 and mean arterial pressure (MAP) were measured. RE data were time aligned to RE + VM and analysed according to standard VM phases. RESULTS Interaction effects (VM phase × condition) were observed for MCAvmean, PCAvmean, vertebral artery blood flow and MAP (all ≤ 0.010). Phase I MCAvmean was greatest for RE [88 ± 19, vs. 71 ± 11 and 78 ± 12 cm s-1 for VM (P = 0.008) and RE + VM (P = 0.021), respectively]. Greater increases in MCAvmean than PCAvmean occurred in phase I of RE only (24 ± 15% vs. 16 ± 16%, post hoc P = 0.044). In phase IIb, MAP was lower in RE than RE + VM (115 ± 15 vs. 138 ± 21 mmHg, P = 0.004), but did not reduce MCAvmean (78 ± 8 vs. 79 ± 9 cm s-1, P = 0.579) or PCAvmean (45 ± 11 vs .46 ± 11 cm s-1, P = 0.617). Phase IIb MCAvmean and PCAvmean was lowest in VM (66 ± 6 and 39 ± 8 cm s-1, respectively, all P < 0.001), whereas in Phase IV, MCAvmean, PCAvmean and MAP were greater in VM than in RE and RE + VM (all P < 0.020). CONCLUSION RE and RE + VM produce similar cerebrovascular responses despite different MAP profiles. However, the VM produced the greatest cerebrovascular challenge afterward.
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