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Title: Cardiovascular and Respiratory responses to Valsalva maneuver Isometric hand grip exercise and Harvard step test and recovery in healthy individuals
Researcher: Dr Sanjiv Kumar
Guide(s): Dr. A V Kothiwale
Keywords: Double product
Galvanic skin resistance
Healthy individuals
Isometric sustained hand grip
Isotonic Harvard step test
Rate pressure product
Valsalva maneuver
University: KLE University
Completed Date: 01/04/2011
Abstract: TITLE Cardiovascular and respiratory responses to Valsalva maneuver, Isometric hand grip exercise and Harvard step test and recovery in healthy individuals . Introduction - Cardiovascular respiratory System is a most vital system in the body and responds to any alteration in physical, mental and social changes. On application of physical stress, the cardiovascular system responds by increasing cardiac output up to maximum of 8 folds of the normal. Exercise facilitates the muscular activities, which in turns demand more oxygen and nutrition to fulfill the demand, causing local vasodilatation and increased sympathetic stimulation. The response of the cardiovascular and respiratory systems to three different stressors like Valsalva maneuver, Isometric Sustained hand grip, Isotonic Harvard steps test on healthy individuals was assessed in this study. Objectives (1) To assess the responses of Cardiovascular and respiratory system to Valsalva maneuver, Isometric handgrip exercise, and isotonic Harvard step test in healthy individuals. (2) To compare responses of all three physical stress factors in healthy individuals. (3) To identify the individual at risk and un-cover sub clinical cardio-respiratory problems, from the response evoked following exercise, and the speed of recovery, using many variables. Design: Randomized clinical trial (RCT) design is used in this study to find out the effect of 3 different physical stressors on healthy individual. Setting: OPD of KLES College of Physiotherapy, Hubli. Sample: 900 Healthy individuals were randomly allotted into 3groups (A, B, C) with homogeneous gender distribution and of age group between 16 to 30 years. Each group consisted of 300 individuals and was sub-divided into 3 sub-groups (like A1, A2, A3) with 100 individuals in each sub-group. Sub-groups were, made based on age, .e.g. A1 16 to 20 years; A2 21 to 25 years and A3 - 26 to 30 years. Method: Group A (A1, A2, A3) Valsalva Maneuver - Empty syringe was fixed at one end of manometer tube which individual blows through, till the mercury column reading reached 40 mmHg and sustained it for 15 seconds in upright sitting position. Group B (B1, B2, B3)-- Isometric sustained hand-grip exercise. In this, the participant sits with straight back, feet flat on the floor, shoulders adducted, arms in neutral position, elbows unsupported and flexed at 90 degrees, forearm rotation neutral, wrist 0-30 degrees dorsiflexion and 0 -15 degrees ulnar deviated. Group C (C1, C2, C3) - Isotonic Harvard step test was used in which the participant has to climb up and down 30 steps per minute with metronome (beat set at 120/minute) and stop watch by the side. Result: Total 900 individuals underwent the test and of this 99 were dropouts (10% approx.) as they failed to complete the test. On inter-group comparison using ANOVA analysis significant p value was seen for PR (Pulse rate), SBP (Systolic blood pressure), DBP (diastolic blood pressure), RPP (Rate pressure product), DoP (Double product) in inter-group comparison of sub-group 1(A1 Vs B1 Vs C1), sub-group 2 (A2 Vs B2 Vs C2) and sub-group 3 (A3 Vs B3 Vs C3), Whereas no significant p values were observed in RR, GSR (Galvanic skin resistance) actual and GSR basal for all 3 groups. On intra group comparison within group A and B, none of the values of PR, SBP, DBP, RPP, DoP, RR, GSR actual and GSR Basal was found significant, whereas, in C1 Vs C2 Vs C3 Pulse rate and rate pressure product values were found to be significant with p value lt 0.0001. On assessing Co-efficient of correlation between Gender Vs Age and BMI separate analysis for female alone, male alone, male and female together, it was found that, there were no correlation or very poor correlation on comparing male and female together. Very poor or weak correlation was found among females of group A1 for Age, Group A2 and B3 for BMI. Also poor correlation was found between males and BMI. Hence conclusion may be drawn that Gender Vs Age and BMI has poor correlation. Conclusion: The greater stress levels have significant changes in parameter even in normal young individuals. Few individuals have shown poor cardiovascular responses during exercise and at the recovery period. Hence, risk for sub clinical heart ailment cannot be overruled just by looking at the baseline parameter at rest. Sedentary individuals were slow to recover than active individuals. newline
Appears in Departments:Faculty of Physiotherapy

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