Cardiovascular Response to Defecating Postures with and without Valsalva Maneuver in Healthy Individuals

Abstract

Aims: To assess the cardiovascular response to defecating postures of bridging and sitting lean forward with and without Valsalva maneuver in healthy individuals. Study design: Prospective interventional cross-over study in healthy population. Study material: Stop watch, Rubber tube, Nostril clip, Pillow, Mercury Sphygmomanometer, Cardioscope (Model no.: Iris 50, Maestros company). Materials and methods: A total of 100 healthy individuals participated in the study. They maintained sitting lean forward and in bridging position for 5 minutes with and without Valsalva maneuver. Valsalva maneuver was performed at 40 mm Hg pressure for 15 seconds. Blood pressure and heart rate were recorded. Mean arterial pressure and rate pressure product were derived. Data analysis: The data was analyzed using Statistical Package for the Social Sciences v 16. Shapiro–Wilk test was used to test normality, and nonparametric Mann-Whitney test was used with p < 0.05 as statistically significant. Results: Sitting in lean forward position showed statistical significant increase in heart rate (p < 0.05) compared to bridging position with Valsalva maneuver. There was a significant rise in blood pressure with bridging as compared to sitting lean forward with Valsalva. There was no statistically significant difference in heart rate and blood pressure between sitting lean forward position and bridging position without Valsalva maneuver. Conclusion: Sitting lean forward position and bridging position increase hemodynamic load compared to relaxed sitting posture. With Valsalva maneuver sitting lean forward posture causes greater rise in heart rate compared to bridging position.