Impact of body position on central and peripheral hemodynamic contributions to movement-induced hyperemia: implications for rehabilitative medicine

Trinity, Joel D.; McDaniel, John; Venturelli, Massimo; Fjeldstad, Anette S.; Ives, Stephen J.; Witman, Melissa A. H.; Barrett-O’Keefe, Zachary; Amann, Markus; Wray, D. Walter; Richardson, Russell S.

doi:10.1152/ajpheart.00038.2011

Cited by 38 publications

(43 citation statements)

References 41 publications

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“…It has also been well documented that, in the intact human, passive limb movement induces a transitory increase in peripheral hemodynamic variables (leg blood flow and vascular conductance) (17,22,23). This was again the case in the present subjects with a SCI, who also exhibited a significant transient increase in both leg blood flow and leg vascular conductance as a consequence of passive limb movement (Fig.…”

Section: Discussionsupporting

confidence: 81%

“…At the onset of exercise, a complex combination of both peripheral and central hemodynamic factors contribute to the increase in blood flow to active skeletal muscle. Recently, our group (12,18,22,23) has used passive movement as a reductionist model in which exercise-induced hyperemia can be studied without the increased complexity of altered muscle metabolism. To better understand the integration of mechanical and neurological factors that contribute to the immediate increase in blood flow to a moving limb, we (12,22) studied heart transplant recipients with denervated hearts and young subjects with a partial block of afferent nerve fibers.…”

Section: Discussionmentioning

confidence: 99%

“…A 3-s rolling average was applied to the data for HR, SV, CO, MAP, blood flow, and vascular conductance. For this study and in other our investigations (12,18,22,23), we compared data that were averaged across 3, 5, 10, and 15 s. The 3-s averages provided the best balance between the quality and real variance of the signal. V E was measured breath by breath and averaged second by second; V O2 and V CO2 were assessed with 20-s averaging throughout the protocols.…”

Section: Subjectsmentioning

confidence: 99%

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Central and peripheral hemodynamic responses to passive limb movement: the role of arousal

Venturelli

Amann

McDaniel

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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The exact role of arousal in central and peripheral hemodynamic responses to passive limb movement in humans is unclear but has been proposed as a potential contributor. Thus, we used a human model with no lower limb afferent feedback to determine the role of arousal on the hemodynamic response to passive leg movement. In nine people with a spinal cord injury, we compared central and peripheral hemodynamic and ventilatory responses to one-leg passive knee extension with and without visual feedback (M+VF and M-VF, respectively) as well as in a third trial with no movement or visual feedback but the perception of movement (F). Ventilation (V̇e), heart rate, stroke volume, cardiac output, mean arterial pressure, and leg blood flow (LBF) were evaluated during the three protocols. V̇e increased rapidly from baseline in M+VF (55 ± 11%), M-VF (63 ± 13%), and F (48 ± 12%) trials. Central hemodynamics (heart rate, stroke volume, cardiac output, and mean arterial pressure) were unchanged in all trials. LBF increased from baseline by 126 ± 18 ml/min in the M+VF protocol and 109 ± 23 ml/min in the M-VF protocol but was unchanged in the F protocol. Therefore, with the use of model that is devoid of afferent feedback from the legs, the results of this study reveal that, although arousal is invoked by passive movement or the thought of passive movement, as evidenced by the increase in V̇e, there is no central or peripheral hemodynamic impact of this increased neural activity. Additionally, this study revealed that a central hemodynamic response is not an obligatory component of movement-induced LBF.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

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Central and peripheral hemodynamic responses to passive limb movement: the role of arousal

Venturelli

Amann

McDaniel

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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“…Together, the in vivo and in vitro data from the current study indicate that the enhanced blood flow response with the arm below the heart is due to a combination of the higher driving pressure coupled with greater dilation in the resistance vessels. An effect of body position on both perfusion pressure and dilation has been noted previously in a different model (13,33). In these experiments, alterations in body position (supine vs. seated) were used to alter hemodynamic responses to passive leg movement.…”

Section: Discussionmentioning

confidence: 73%

“…Since the strongest evidence in support of the muscle pump theory comes from experiments in which limb position has been manipulated, it is essential to determine whether vascular challenges other than muscle contraction also produce different responses when limb position is altered. Previous experiments in humans in which changes in body position were used to alter femoral artery perfusion pressure during passive leg movement (13,33) indicate that altered perfusion pressure changes both leg blood flow and vascular conductance independent of muscle contraction. Additionally, changing arm position during muscle contractions caused a change in fore-arm vascular conductance that was attributed to vascular smooth muscle myogenic responses because it was independent of changes in muscle contraction or metabolism (40).…”

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confidence: 99%

Positional differences in reactive hyperemia provide insight into initial phase of exercise hyperemia

Jasperse

Shoemaker

Gray

et al. 2015

Journal of Applied Physiology

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Jasperse JL, Shoemaker JK, Gray EJ, Clifford PS. Positional differences in reactive hyperemia provide insight into initial phase of exercise hyperemia. J Appl Physiol 119: 569 -575, 2015. First published July 2, 2015; doi:10.1152/japplphysiol.01253.2013.-Studies have reported a greater blood flow response to muscle contractions when the limb is below the heart compared with above the heart, and these results have been interpreted as evidence for a skeletal muscle pump contribution to exercise hyperemia. If limb position affects the blood flow response to other vascular challenges such as reactive hyperemia, this interpretation may not be correct. We hypothesized that the magnitude of reactive hyperemia would be greater with the limb below the heart. Brachial artery blood flow (Doppler ultrasound) and blood pressure (finger-cuff plethysmography) were measured in 10 healthy volunteers. Subjects lay supine with one arm supported in two different positions: above or below the heart. Reactive hyperemia was produced by occlusion of arterial inflow for varying durations: 0.5 min, 1 min, 2 min, or 5 min in randomized order. Peak increases in blood flow were 77 Ϯ 11, 178 Ϯ 24, 291 Ϯ 25, and 398 Ϯ 33 ml/min above the heart and 96 Ϯ 19, 279 Ϯ 62, 550 Ϯ 60, and 711 Ϯ 69 ml/min below the heart (P Ͻ 0.05). Thus a standard stimulus (vascular occlusion) elicited different responses depending on limb position. To determine whether these differences were due to mechanisms intrinsic to the arterial wall, a second set of experiments was performed in which acute intraluminal pressure reduction for 0.5 min, 1 min, 2 min, or 5 min was performed in isolated rat soleus feed arteries (n ϭ 12). The magnitude of dilation upon pressure restoration was greater when acute pressure reduction occurred from 85 mmHg (mimicking pressure in the arm below the heart; 28.3 Ϯ 7.9, 37.5 Ϯ 5.9, 55.1 Ϯ 9.9, and 68.9 Ϯ 8.6% dilation) than from 48 mmHg (mimicking pressure in the arm above the heart; 20.8 Ϯ 4.8, 22.6 Ϯ 4.4, 31.2 Ϯ 5.8, and 49.2 Ϯ 7.1% dilation). These data support the hypothesis that arm position differences in reactive hyperemia are at least partially mediated by mechanisms intrinsic to the arterial wall. Overall, these results suggest the need to reevaluate studies employing positional changes to examine muscle pump influences on exercise hyperemia. muscle blood flow; muscle contraction; skeletal muscle pump; functional hyperemia AT THE ONSET OF DYNAMIC EXERCISE, there is a rapid increase in blood flow [30,31,41, and see Fig. 2 in Clifford and Hellsten (5)]. In fact, even a single muscle contraction produces a prompt increase in blood flow (1,7,14,26,36,39). There has been a debate over the last few decades about whether this rapid hyperemia is due to the muscle pump mechanism or to rapid vasodilation (5, 35).The muscle pump, as described by Laughlin (20), depends on an increased pressure gradient across the skeletal muscle vascular bed. Muscle contraction compresses the veins within the contracting muscle, expelling blood from the veins. ...

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Hemodynamic changes in the temporalis and masseter muscles during acute stress in healthy humans

Rashid,

Roatta

2023

Eur J Appl Physiol

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Purpose Autonomic control of orofacial areas is an integral part of the stress response, controlling functions such as pupil dilatation, salivation, and skin blood flow. However, the specific control of blood flow in head muscles during stress is unknown. This study aims to investigate the hemodynamic response of temporalis and masseter muscles in response to five different stressors. Methods Sixteen healthy individuals were subjected to a randomized series of stressors, including cold pressor test, mental arithmetic test, apnea, isometric handgrip, and post-handgrip muscle ischemia, while in the sitting posture. Finger-pulse photoplethysmography was used to measure arterial blood pressure, heart rate, and cardiac output. Near-infrared spectroscopy was used to measure changes in tissue oxygenation and hemoglobin indices from the temporalis and masseter muscles. Results All stressors effectively and significantly increased arterial blood pressure. Tissue oxygenation index significantly increased in both investigated head muscles during mental arithmetic test (temporalis: 4.22 ± 3.52%; masseter: 3.43 ± 3.63%) and isometric handgrip (temporalis: 3.45 ± 3.09%; masseter: 3.26 ± 3.07%), suggesting increased muscle blood flow. Neither the masseter nor the temporalis muscles evidenced a vasoconstrictive response to any of the stressors tested. Conclusion In the different conditions, temporalis and masseter muscles exhibited similar hemodynamic patterns of response, which do not include the marked vasoconstriction generally observed in limb muscles. The peculiar sympathetic control of head muscles is possibly related to the involvement of these muscles in aggressive/defensive reactions and/or to their unfavorable position with regard to hydrostatic blood levels.

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Impact of body position on central and peripheral hemodynamic contributions to movement-induced hyperemia: implications for rehabilitative medicine

Cited by 38 publications

References 41 publications

Central and peripheral hemodynamic responses to passive limb movement: the role of arousal

Central and peripheral hemodynamic responses to passive limb movement: the role of arousal

Positional differences in reactive hyperemia provide insight into initial phase of exercise hyperemia

Hemodynamic changes in the temporalis and masseter muscles during acute stress in healthy humans

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