Delaying orthostatic syncope with mental challenge: A pilot study

Goswami, Nandu; Roessler, Andreas; Hinghofer‐Szalkay, Helmut; Montani, Jean‐Pierre; Steptoe, Andrew

doi:10.1016/j.physbeh.2012.02.022

Cited by 18 publications

(19 citation statements)

References 24 publications

(33 reference statements)

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“…To sum up, this holistic analysis showed that MAP is the most salient variable to predict failure to complete the experiment. This is in agreement with the observation that blood pressure is a primarily related variable during stress application, as was reported first by Julius (Julius 1991) and confirmed in subsequent studies (Goswami et al 2010, 2011, 2012; Patel et al 2016). …”

Section: Discussionsupporting

confidence: 92%

The effects of varying gravito-inertial stressors on grip strength and hemodynamic responses in men and women

2019

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PurposeThe body behaves as a global system with many interconnected subsystems. While the effects of a gravitational change on body responses have been extensively studied in isolation, we are not aware of any study that has examined these two types of body responses concurrently. Here, we examined how the cognitive and cardiovascular systems respond during application of varying gravito-inertial stressors in men and women.MethodsTen men and nine women underwent three 5-min centrifugation sessions (2.4 g at the feet, 1.5 g at the heart) in which participants rhythmically moved a hand-held object for 20 s. Grip force and hemodynamic responses were continuously measured during centrifugation and rest periods.ResultMen optimized the modulation between grip force and the destabilizing load force, but not women. Exposure to artificial gravity induced higher heart rate and mean arterial pressure in both sexes compared to baseline. However, during artificial gravity exposure, only women decreased heart rate across sessions. Interestingly, we found that finishers of the protocol (mostly men) and Non-finishers (mostly women) exhibited divergent patterns of hemodynamic responses.ConclusionWe speculate that the lack of grip force adaptation reported in women could be linked to the challenged hemodynamic responses during artificial gravity. By deriving a simple model to predict failure to complete the protocol, we found that mean arterial pressure—and not sex of the participant—was the most relevant factor. As artificial gravity is being proposed as a countermeasure in long-term manned missions, the observed effects in grip force adaptation and hemodynamic responses during varying gravito-inertial stressors application are particularly important.

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Section: Discussionsupporting

confidence: 92%

The effects of varying gravito-inertial stressors on grip strength and hemodynamic responses in men and women

2019

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“…We have also previously reported that mental challenge–induced increases in sympathetic activity could lead to improvements in orthostatic tolerance times in subjects undergoing graded lower body negative pressure until presyncope. 21 …”

Section: Discussionmentioning

confidence: 99%

Effect of computerized cognitive training with virtual spatial navigation task during bed rest immobilization and recovery on vascular function: A pilot study

Goswami¹,

Kavcic²,

Marušič³

et al. 2015

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We investigated the effects of bed rest (BR) immobilization, with and without computerized cognitive training with virtual spatial navigation task (CCT), on vascular endothelium on older subjects. The effects of 14-day BR immobilization in healthy older males (n=16) of ages 53–65 years on endothelial function were studied using EndoPAT®, a noninvasive and user-independent method. From the group of 16 older men, 8 randomly received CCT during the BR, using virtual navigation tasks in a virtual environment with joystick device. In all the cases, EndoPAT assessments were done at pre- and post-BR immobilization as well as following 28 days of ambulatory recovery. The EndoPAT index increased from 1.53±0.09 (mean ± standard error of the mean) at baseline to 1.61±0.16 following immobilization (P=0.62) in the group with CCT. The EndoPAT index decreased from 2.06±0.13 (mean ± standard error of the mean) at baseline to 1.70±0.09 at the last day of BR study, day 14 (BR14) (P=0.09) in the control group. Additionally, there were no statistically significant differences between BR14 and at 28 days of follow-up (rehabilitation program) (R28). Our results show a trend of immobilization in older persons affecting the vasoconstrictory endothelial response. As the control subjects had a greater increase in EndoPAT index after R28 (+0.018) compared to subjects who had cognitive training (+0.11) (calculated from the first day of BR study), it is possible that cognitive training during BR does not improve endothelial function but rather contributes to slowing down the impairment of endothelial function. Finally, our results also show that EndoPAT may be a useful noninvasive tool to assess the vascular reactivity.

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“…In addition to reviewing the state of the art knowledge regarding orthostatic intolerance, this review also examines specific countermeasures that can be used against orthostatic intolerance. For instance, orthostatic tolerance has been shown to be improved by exercise (Howden et al, 2004 ), water drinking (Schroeder et al, 2002 ), and mental arithmetic (Goswami et al, 2012a ). Other countermeasures that could potentially prevent or mitigate orthostatic intolerance can include simple measures such as standing up slowly (de Bruïne et al, 2017 ) and/or compression of abdominal region (Figueroa et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Orthostatic Intolerance in Older Persons: Etiology and Countermeasures

et al. 2017

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Orthostatic challenge produced by upright posture may lead to syncope if the cardiovascular system is unable to maintain adequate brain perfusion. This review outlines orthostatic intolerance related to the aging process, long-term bedrest confinement, drugs, and disease. Aging-associated illness or injury due to falls often leads to hospitalization. Older patients spend up to 83% of hospital admission lying in bed and thus the consequences of bedrest confinement such as physiological deconditioning, functional decline, and orthostatic intolerance represent a central challenge in the care of the vulnerable older population. This review examines current scientific knowledge regarding orthostatic intolerance and how it comes about and provides a framework for understanding of (patho-) physiological concepts of cardiovascular (in-) stability in ambulatory and bedrest confined senior citizens as well as in individuals with disease conditions [e.g., orthostatic intolerance in patients with diabetes mellitus, multiple sclerosis, Parkinson's, spinal cord injury (SCI)] or those on multiple medications (polypharmacy). Understanding these aspects, along with cardio-postural interactions, is particularly important as blood pressure destabilization leading to orthostatic intolerance affects 3–4% of the general population, and in 4 out of 10 cases the exact cause remains elusive. Reviewed also are countermeasures to orthostatic intolerance such as exercise, water drinking, mental arithmetic, cognitive training, and respiration training in SCI patients. We speculate that optimally applied countermeasures such as mental challenge maintain sympathetic activity, and improve venous return, stroke volume, and consequently, blood pressure during upright standing. Finally, this paper emphasizes the importance of an active life style in old age and why early re-mobilization following bedrest confinement or bedrest is crucial in preventing orthostatic intolerance, falls and falls-related injuries in older persons.

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Delaying orthostatic syncope with mental challenge: A pilot study

Cited by 18 publications

References 24 publications

The effects of varying gravito-inertial stressors on grip strength and hemodynamic responses in men and women

The effects of varying gravito-inertial stressors on grip strength and hemodynamic responses in men and women

Effect of computerized cognitive training with virtual spatial navigation task during bed rest immobilization and recovery on vascular function: A pilot study

Orthostatic Intolerance in Older Persons: Etiology and Countermeasures

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