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Dorff A, Bradford C, Hunsaker A, Atkinson J, Rhees J, Leach OK, Gifford JR. Vascular dysfunction and the age-related decline in critical power. Exp Physiol 2024; 109:240-254. [PMID: 37934136 PMCID: PMC10988715 DOI: 10.1113/ep091571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/08/2023]
Abstract
Ageing results in lower exercise tolerance, manifested as decreased critical power (CP). We examined whether the age-related decrease in CP occurs independently of changes in muscle mass and whether it is related to impaired vascular function. Ten older (63.1 ± 2.5 years) and 10 younger (24.4 ± 4.0 years) physically active volunteers participated. Physical activity was measured with accelerometry. Leg muscle mass was quantified with dual X-ray absorptiometry. The CP and maximum power during a graded exercise test (PGXT ) of single-leg knee-extension exercise were determined over the course of four visits. During a fifth visit, vascular function of the leg was assessed with passive leg movement (PLM) hyperaemia and leg blood flow and vascular conductance during knee-extension exercise at 10 W, 20 W, slightly below CP (90% CP) and PGXT . Despite not differing in leg lean mass (P = 0.901) and physical activity (e.g., steps per day, P = 0.735), older subjects had ∼30% lower mass-specific CP (old = 3.20 ± 0.94 W kg-1 vs. young = 4.60 ± 0.87 W kg-1 ; P < 0.001). The PLM-induced hyperaemia and leg blood flow and/or conductance were blunted in the old at 20 W, 90% CP and PGXT (P < 0.05). When normalized for leg muscle mass, CP was strongly correlated with PLM-induced hyperaemia (R2 = 0.52; P < 0.001) and vascular conductance during knee-extension exercise at 20 W (R2 = 0.34; P = 0.014) and 90% CP (R2 = 0.39; P = 0.004). In conclusion, the age-related decline in CP is not only an issue of muscle quantity, but also of impaired muscle quality that corresponds to impaired vascular function.
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Affiliation(s)
- Abigail Dorff
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
| | - Christy Bradford
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Ashley Hunsaker
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Jake Atkinson
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Joshua Rhees
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
| | - Olivia K. Leach
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
| | - Jayson R. Gifford
- Department of Exercise SciencesBrigham Young UniversityProvoUtahUSA
- Program of GerontologyBrigham Young UniversityProvoUtahUSA
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2
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Fermoyle CC, La Salle DT, Alpenglow JK, Craig JC, Jarrett CL, Broxterman RM, McKenzie AI, Morgan DE, Birgenheier NM, Wray DW, Richardson RS, Trinity JD. Pharmacological modulation of adrenergic tone alters the vasodilatory response to passive leg movement in young but not in old adults. J Appl Physiol (1985) 2023; 134:1124-1134. [PMID: 36927146 PMCID: PMC10125034 DOI: 10.1152/japplphysiol.00682.2022] [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: 11/11/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
The age-related increase in α-adrenergic tone may contribute to decreased leg vascular conductance (LVC) both at rest and during exercise in the old. However, the effect on passive leg movement (PLM)-induced LVC, a measure of vascular function, which is markedly attenuated in this population, is unknown. Thus, in eight young (25 ± 5 yr) and seven old (65 ± 7 yr) subjects, this investigation examined the impact of systemic β-adrenergic blockade (propanalol, PROP) alone, and PROP combined with either α1-adrenergic stimulation (phenylephrine, PE) or α-adrenergic inhibition (phentolamine, PHEN), on PLM-induced vasodilation. LVC, calculated from femoral artery blood flow and pressure, was determined and PLM-induced Δ peak (LVCΔpeak) and total vasodilation (LVCAUC, area under curve) were documented. PROP decreased LVCΔpeak (PROP: 4.8 ± 1.8, Saline: 7.7 ± 2.7 mL·mmHg-1, P < 0.001) and LVCAUC (PROP: 1.1 ± 0.7, Saline: 2.4 ± 1.6 mL·mmHg-1, P = 0.002) in the young, but not in the old (LVCΔpeak, P = 0.931; LVCAUC, P = 0.999). PE reduced baseline LVC (PE: 1.6 ± 0.4, PROP: 2.3 ± 0.4 mL·min-1·mmHg-1, P < 0.01), LVCΔpeak (PE: 3.2 ± 1.3, PROP: 4.8 ± 1.8 mL·min-1·mmHg-1, P = 0.004), and LVCAUC (PE: 0.5 ± 0.4, PROP: 1.1 ± 0.7 mL·mmHg-1, P = 0.011) in the young, but not in the old (baseline LVC, P = 0.199; LVCΔpeak, P = 0.904; LVCAUC, P = 0.823). PHEN increased LVC at rest and throughout PLM in both groups (drug effect: P < 0.05), however LVCΔpeak was only improved in the young (PHEN: 6.4 ± 3.1, PROP: 4.4 ± 1.5 mL·min-1·mmHg-1, P = 0.004), and not in the old (P = 0.904). Furthermore, the magnitude of α-adrenergic modulation (PHEN - PE) of LVCΔpeak was greater in the young compared with the old (Young: 3.35 ± 2.32, Old: 0.40 ± 1.59 mL·min-1·mmHg-1, P = 0.019). Therefore, elevated α-adrenergic tone does not appear to contribute to the attenuated vascular function with age identified by PLM.NEW & NOTEWORTHY Stimulation of α1-adrenergic receptors eliminated age-related differences in passive leg movement (PLM) by decreasing PLM-induced vasodilation in the young. Systemic β-blockade attenuated the central hemodynamic component of the PLM response in young individuals. Inhibition of α-adrenergic receptors did not improve the PLM response in older individuals, though withdrawal of α-adrenergic modulation augmented baseline and maximal vasodilation in both groups. Accordingly, α-adrenergic signaling plays a role in modulating the PLM vasodilatory response in young but not in old adults, and elevated α-adrenergic tone does not appear to contribute to the attenuated vascular function with age identified by PLM.
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Affiliation(s)
- Caitlin C Fermoyle
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - D Taylor La Salle
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Jeremy K Alpenglow
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Jesse C Craig
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - Catherine L Jarrett
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - Ryan M Broxterman
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Alec I McKenzie
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
| | - David E Morgan
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Nathaniel M Birgenheier
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - D Walter Wray
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Russell S Richardson
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
| | - Joel D Trinity
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, Utah, United States
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, United States
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3
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Weggen JB, Hogwood AC, Decker KP, Darling AM, Chiu A, Richardson J, Garten RS. Vascular Responses to Passive and Active Movement in Premenopausal Females: Comparisons across Sex and Menstrual Cycle Phase. Med Sci Sports Exerc 2023; 55:900-910. [PMID: 36728956 DOI: 10.1249/mss.0000000000003107] [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: 02/03/2023]
Abstract
PURPOSE Adequate, robust vascular responses to passive and active movement represent two distinct components linked to normal, healthy cardiovascular function. Currently, limited research exists determining if these vascular responses are altered in premenopausal females (PMF) when compared across sex or menstrual cycle phase. METHODS Vascular responses to passive leg movement (PLM) and handgrip (HG) exercise were assessed in PMF ( n = 21) and age-matched men ( n = 21). A subset of PMF subjects ( n = 11) completed both assessments during the early and late follicular phase of their menstrual cycle. Microvascular function was assessed during PLM via changes in leg blood flow, and during HG exercise, via steady-state arm vascular conductance. Macrovascular (brachial artery [BA]) function was assessed during HG exercise via BA dilation responses as well as BA shear rate-dilation slopes. RESULTS Leg microvascular function, determined by PLM, was not different between sexes or across menstrual cycle phase. However, arm microvascular function, demonstrated by arm vascular conductance, was lower in PMF compared with men at rest and during HG exercise. Macrovascular function was not different between sexes or across menstrual cycle phase. CONCLUSIONS This study identified similar vascular function across sex and menstrual cycle phase seen in microvasculature of the leg and macrovascular (BA) of the arm. Although arm microvascular function was unaltered by menstrual cycle phase in PMF, it was revealed to be significantly lower when compared with age-matched men highlighting a sex difference in vascular/blood flow regulation during small muscle mass exercise.
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Affiliation(s)
- Jennifer B Weggen
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Austin C Hogwood
- Department of Kinesiology, University of Virginia, Charlottesville, VA
| | - Kevin P Decker
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE
| | - Ashley M Darling
- Department of Kinesiology, The University of Texas at Arlington, Arlington, TX
| | - Alex Chiu
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Jacob Richardson
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Ryan S Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
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D’Agata MN, Matias AA, Witman MA. We like to move it, move it: A perspective on performing passive leg movement as a non-invasive assessment of vascular function in pediatric populations. Front Physiol 2023; 14:1165800. [PMID: 37179828 PMCID: PMC10169695 DOI: 10.3389/fphys.2023.1165800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
The passive leg movement (PLM) technique is a non-invasive assessment of lower-limb vascular function. PLM is methodologically simple to perform and utilizes Doppler ultrasound to determine leg blood flow (LBF) through the common femoral artery at rest and in response to passive movement of the lower leg. LBF responses to PLM have been reported to be mostly nitric oxide (NO)-mediated when performed in young adults. Moreover, PLM-induced LBF responses, as well as the NO contribution to PLM-induced LBF responses, are reduced with age and in various diseased populations, demonstrating the clinical utility of this non-invasive test. However, no PLM studies to date have included children or adolescents. Since its conception in 2015, our laboratory has performed PLM on hundreds of individuals including a large cohort of children and adolescents. Thus, the purpose of this perspective article is threefold: 1) to uniquely discuss the feasibility of performing PLM in children and adolescents, 2) to report PLM-induced LBF values from our laboratory in 7-17-year-olds, and 3) to discuss considerations for making comparisons among pediatric populations. Based on our experiences performing PLM in children and adolescents (among various other age groups), it is our perspective that PLM can feasibly be performed in this population. Further, data from our laboratory may be used to provide context for typical PLM-induced LBF values that could be observed in children and adolescents, as well as across the lifespan.
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Affiliation(s)
| | | | - Melissa A. Witman
- Vascular Function in Chronic Disease Research Laboratory, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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5
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Arterial Stiffness and Endothelial Function are Comparable in Young Healthy Vegetarians and Omnivores. Nutr Res 2022; 105:163-172. [DOI: 10.1016/j.nutres.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/26/2022] [Accepted: 07/06/2022] [Indexed: 11/15/2022]
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Groot HJ, Broxterman RM, Gifford JR, Garten RS, Rossman MJ, Jarrett CL, Kwon OS, Hydren JR, Richardson RS. Reliability of the passive leg movement assessment of vascular function in men. Exp Physiol 2022; 107:541-552. [PMID: 35294784 PMCID: PMC9058221 DOI: 10.1113/ep090312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Use of the passive leg movement (PLM) test, a non-invasive assessment of microvascular function, is on the rise. However, PLM reliability in men has not been adequately investigated, nor has such reliability data, in men, been compared to the most commonly employed vascular function assessment, flow-mediated vasodilation (FMD). What is the main finding and its importance? PLM is a reliable method to assess vascular function in men, and is comparable to values previously reported for PLM in women, and for FMD. Given the importance of vascular function as a predictor of cardiovascular disease risk, these data support the utility of PLM as a clinically relevant measurement. ABSTRACT Although vascular function is an independent predictor of cardiovascular disease risk, and therefore has significant prognostic value, there is currently not a single clinically accepted method of assessment. The passive leg movement (PLM) assessment predominantly reflects microvascular endothelium-dependent vasodilation and can identify decrements in vascular function with advancing age and pathology. Reliability of the PLM model was only recently determined in women, and has not been adequately investigated in men. Twenty healthy men (age: 27 ± 2 year) were studied on three separate experimental days, resulting in three within-day and three between-day trials. The hyperemic response to PLM was assessed with Doppler ultrasound, and expressed as the absolute peak in leg blood flow (LBFpeak ), change from baseline to peak (ΔLBFpeak ), absolute area under the curve (LBFAUC ), and change in AUC from baseline (ΔLBFAUC ). PLM-induced hyperemia yielded within-day coefficients of variation (CV) from 10.9 to 22.9%, intraclass correlation coefficients (ICC) from 0.82 to 0.90, standard error of the measurement (SEM) from 8.3 to 17.2%, and Pearson's correlation coefficients (r) from 0.56 to 0.81. Between-day assessments of PLM hyperemia resulted in CV from 14.4 to 25%, ICC from 0.75 to 0.87, SEM from 9.8 to 19.8%, and r from 0.46 to 0.75. Similar to previous reports in women, the hyperemic responses to PLM in men display moderate-to-high reliability, and are comparable to reliability data for brachial artery flow mediated vasodilation. These positive reliability findings further support the utility of PLM as a clinical measurement of vascular function and cardiovascular disease risk.
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Affiliation(s)
- H. Jonathan Groot
- Department of Health & Kinesiology University of Utah, Salt Lake City, UT
| | - Ryan M. Broxterman
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Jayson R. Gifford
- Department of Exercise Sciences, Brigham Young University, Provo, UT
| | - Ryan S. Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Matthew J. Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Catherine L. Jarrett
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Jay R. Hydren
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Russell S. Richardson
- Geriatric Research, Education, and Clinical Center, Salt Lake City VAMC, UT;,Department of Internal Medicine, University of Utah, Salt Lake City, UT;,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
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7
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Hoopes EK, Berube FR, D'Agata MN, Patterson F, Farquhar WB, Edwards DG, Witman MAH. Sleep duration regularity, but not sleep duration, is associated with microvascular function in college students. Sleep 2021; 44:5903410. [PMID: 32905591 DOI: 10.1093/sleep/zsaa175] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/28/2020] [Indexed: 12/16/2022] Open
Abstract
STUDY OBJECTIVES Vascular dysfunction is a hypothesized mechanism linking poor sleep habits to an increased incidence of cardiovascular diseases (CVDs). However, the vascular profile associated with free-living sleep duration and sleep regularity has not been well elucidated, particularly in young adults. Thus, this study aimed to evaluate the associations between mean sleep duration, regularity in sleep duration, and peripheral vascular function in young adult college students. METHODS Fifty-one healthy undergraduate students (20 ± 1 years) completed 14 days of 24-hour wrist actigraphy and subsequent vascular assessments. Macrovascular function was measured using brachial artery flow-mediated dilation (FMD) while microvascular function was measured via passive leg movement (PLM). RESULTS Mean sleep duration was unrelated to FMD and PLM. Conversely, more irregular sleep duration (14-day sleep duration standard deviation [SD]) was unfavorably associated with all three measures of PLM-induced hyperemia (peak leg blood flow [LBF], p = 0.01; change in LBF from baseline to peak, p < 0.01; LBF area under the curve, p < 0.01), and remained significant in regression models which adjusted for sex, body mass index, blood pressure, physical activity, alcohol and caffeine consumption, and sleep duration (all p < 0.05). When using a median split to dichotomize "low" and "high" sleep duration SD groups, those demonstrating high variability in sleep duration exhibited ~45% lower PLM responses compared with those demonstrating low variability. CONCLUSIONS Irregular sleep duration is associated with poorer microvascular function as early as young adulthood. These findings support the growing body of evidence that irregular sleep patterns may be an independent and modifiable risk factor for CVD.
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Affiliation(s)
- Elissa K Hoopes
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Felicia R Berube
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Michele N D'Agata
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
| | - Melissa A H Witman
- Department of Kinesiology and Applied Physiology, College of Health Sciences, University of Delaware, Newark, DE
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8
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Trinity JD, Kwon OS, Broxterman RM, Gifford JR, Kithas AC, Hydren JR, Jarrett CL, Shields KL, Bisconti AV, Park SH, Craig JC, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. The role of the endothelium in the hyperemic response to passive leg movement: looking beyond nitric oxide. Am J Physiol Heart Circ Physiol 2020; 320:H668-H678. [PMID: 33306447 DOI: 10.1152/ajpheart.00784.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Passive leg movement (PLM) evokes a robust and predominantly nitric oxide (NO)-mediated increase in blood flow that declines with age and disease. Consequently, PLM is becoming increasingly accepted as a sensitive assessment of endothelium-mediated vascular function. However, a substantial PLM-induced hyperemic response is still evoked despite nitric oxide synthase (NOS) inhibition. Therefore, in nine young healthy men (25 ± 4 yr), this investigation aimed to determine whether the combination of two potent endothelium-dependent vasodilators, specifically prostaglandin (PG) and endothelium-derived hyperpolarizing factor (EDHF), account for the remaining hyperemic response to the two variants of PLM, PLM (60 movements) and single PLM (sPLM, 1 movement), when NOS is inhibited. The leg blood flow (LBF, Doppler ultrasound) response to PLM and sPLM following the intra-arterial infusion of NG-monomethyl-l-arginine (l-NMMA), to inhibit NOS, was compared to the combined inhibition of NOS, cyclooxygenase (COX), and cytochrome P-450 (CYP450) by l-NMMA, ketorolac tromethamine (KET), and fluconazole (FLUC), respectively. NOS inhibition attenuated the overall LBF [area under the curve (LBFAUC)] response to both PLM (control: 456 ± 194, l-NMMA: 168 ± 127 mL, P < 0.01) and sPLM (control: 185 ± 171, l-NMMA: 62 ± 31 mL, P = 0.03). The combined inhibition of NOS, COX, and CYP450 (i.e., l-NMMA+KET+FLUC) did not further attenuate the hyperemic responses to PLM (LBFAUC: 271 ± 97 mL, P > 0.05) or sPLM (LBFAUC: 72 ± 45 mL, P > 0.05). Therefore, PG and EDHF do not collectively contribute to the non-NOS-derived NO-mediated, endothelium-dependent hyperemic response to either PLM or sPLM in healthy young men. These findings add to the mounting evidence and understanding of the vasodilatory pathways assessed by the PLM and sPLM vascular function tests.NEW & NOTEWORTHY Passive leg movement (PLM) evokes a highly nitric oxide (NO)-mediated hyperemic response and may provide a novel evaluation of vascular function. The contributions of endothelium-dependent vasodilatory pathways, beyond NO and including prostaglandins and endothelium-derived hyperpolarizing factor, to the PLM-induced hyperemic response to PLM have not been evaluated. With intra-arterial drug infusion, the combined inhibition of nitric oxide synthase (NOS), cyclooxygenase, and cytochrome P-450 (CYP450) pathways did not further diminish the hyperemic response to PLM compared with NOS inhibition alone.
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Affiliation(s)
- Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Oh Sung Kwon
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Exercise Science, Brigham Young University, Provo, Utah
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Catherine L Jarrett
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Katherine L Shields
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Angela V Bisconti
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Soung Hun Park
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Jesse C Craig
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - David E Morgan
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Jacob E Jessop
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Amber D Bledsoe
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
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9
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Abstract
Passive exercise/movement has a long history in both medicine and physiology. Early clinical applications of passive exercise/movement utilized pneumatic and direct limb compression to stimulate the vasculature and evoke changes in blood flow to avoid complications brought about by stasis and vascular disease. Over the last 50 years, passive exercise/movement has continued to progress and has provided physiologists with a reductionist approach to mechanistically examine the cardiorespiratory, hyperemic, and afferent responses to movement without the confounding influence of metabolism that accompanies active exercise. This review, in addition to providing an historical perspective, focuses on the recent advancements utilizing passive leg movement, and how the hyperemic response at the onset of this passive movement has evolved from a method to evaluate the central and peripheral regulation of blood flow during exercise to an innovative and promising tool to assess vascular function. As an assessment of vascular function, passive leg movement is relatively simple to perform and provides a nitric oxide-dependent evaluation of endothelial function across the lifespan that is sensitive to changes in activity/fitness and disease state (heart failure, peripheral artery disease, sepsis). The continual refinement and characterization of passive leg movement are aimed at improving our understanding of blood flow regulation and the development of a clinically ready approach to predict and monitor the progression of cardiovascular disease.
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Affiliation(s)
- Joel D Trinity
- George E Wahlen Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Bldg 2, RM 1D29A, 500 Foothill Dr., Salt Lake City, UT, 84148, USA.
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
| | - Russell S Richardson
- George E Wahlen Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Bldg 2, RM 1D29A, 500 Foothill Dr., Salt Lake City, UT, 84148, USA
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
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10
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Venturelli M, Rampichini S, Coratella G, Limonta E, Bisconti AV, Cè E, Esposito F. Heart and musculoskeletal hemodynamic responses to repetitive bouts of quadriceps static stretching. J Appl Physiol (1985) 2019; 127:376-384. [PMID: 31161884 DOI: 10.1152/japplphysiol.00823.2018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The role of sympathetic and parasympathetic activity in relation to the repetitive exposure to static stretching (SS) on heart and musculoskeletal hemodynamics in stretched and resting muscles is still a matter of debate. The aim of the study was to determine cardiac and musculoskeletal hemodynamics to repetitive bouts of unilateral SS. Sympathetic and parasympathetic activity contribution to the central hemodynamics and local difference in circulation of stretched and resting muscles were also investigated. In eight participants, heart rate (HR), cardiac output (CO), mean arterial pressure (MAP), HR variability (HRV), blood pressure variability (BPV), and blood flow in passively stretched limb (SL) and control (CL, resting limb) were measured during five bouts of unilateral SS (45 s of knee flexion and 15 s of knee extension). SS increased sympathetic (~20%) and decreased parasympathetic activity (~30%) with a prevalence of parasympathetic withdrawal. During SS, HR, CO, and MAP increased by ~18 beats/min, ~0.29 l/min, ~12 mmHg, respectively. Peak blood flow in response to the first stretching maneuver increased significantly (+377 ± 95 ml/min) in the SL and reduced significantly (-57 ± 48 ml/min) in the CL. This between-limb difference in local circulation response to SS disappeared after the second SS bout. These results indicate that heart hemodynamic responses to SS are primarily influenced by the parasympathetic withdrawal rather than by the increase in sympathetic activity. The balance between neural and local factors contributing to blood flow regulation was affected by the level of SS exposure, likely associated with differences in the bioavailability of local vasoactive factors throughout the stretching bouts.NEW & NOTEWORTHY Repetitive exposure to static stretching (SS) on heart and musculoskeletal hemodynamics in stretched and remote muscles may be influenced by neural and local factors. We documented that SS-induced heart hemodynamic responses are primarily influenced by parasympathetic withdrawal. The balance between neural and local factors contributing to the regulation of musculoskeletal hemodynamics is dependent on SS exposure possibly because of different local vasoactive factor bioavailability during the subsequent stretching bouts.
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Affiliation(s)
- Massimo Venturelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences. University of Verona, Verona, Italy.,Department of Internal Medicine, Section of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Coratella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Angela Valentina Bisconti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,Department of Internal Medicine, Section of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Emiliano Cè
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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11
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Katulka EK, Hirt AE, Kirkman DL, Edwards DG, Witman MAH. Altered vascular function in chronic kidney disease: evidence from passive leg movement. Physiol Rep 2019; 7:e14075. [PMID: 31016878 PMCID: PMC6478620 DOI: 10.14814/phy2.14075] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/06/2019] [Accepted: 04/09/2019] [Indexed: 12/30/2022] Open
Abstract
Chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease and is characterized by reduced nitric oxide (NO) bioavailability and vascular dysfunction, typically assessed using brachial artery flow-mediated dilation (FMD). It has been previously reported that passive leg movement (PLM)-induced hyperemia, an assessment of lower extremity vascular function, is highly dependent on NO, but has not yet been utilized to assess vascular function in patients with CKD. The purpose of this study was to comprehensively assess vascular function in patients with CKD using PLM, in addition to the traditional FMD technique. Assessment of vascular function via PLM and FMD was performed on 12 patients (CKD, 66 ± 3 years) and 16 age-matched healthy controls (CON, 60 ± 2 years). Blood velocity and artery diameters during PLM and FMD were measured using duplex ultrasound of the femoral and brachial arteries, respectively. Habitual physical activity, assessed by accelerometry, was performed in a subset of each group. CKD patients had reduced peak leg blood flow (LBF) (384 ± 39 vs. 569 ± 77 mL/min, P < 0.05) and change in LBF from baseline to peak (∆peakLBF) (143 ± 22 vs. 249 ± 34 mL/min, P < 0.05) during PLM compared to CON. Additionally, PLM responses were significantly associated with kidney function and physical activity levels. As anticipated, FMD was significantly attenuated in CKD patients (5.2 ± 1.1 vs. 8.8 ± 1.2%, P < 0.05). In conclusion, both upper and lower extremity measures of vascular function indicate impairment in CKD patients when compared to controls. PLM appears to be a novel and feasible approach to assessing lower extremity vascular function in CKD.
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Affiliation(s)
- Elissa K. Katulka
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelaware
| | - Alexandra E. Hirt
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelaware
| | - Danielle L. Kirkman
- Department of Kinesiology and Heath SciencesVirginia Commonwealth UniversityRichmondVirginia
| | - David G. Edwards
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelaware
| | - Melissa A. H. Witman
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelaware
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12
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Clifton HL, Machin DR, Groot HJ, Frech TM, Donato AJ, Richardson RS, Wray DW. Attenuated nitric oxide bioavailability in systemic sclerosis: Evidence from the novel assessment of passive leg movement. Exp Physiol 2018; 103:1412-1424. [PMID: 29790215 DOI: 10.1113/ep086991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/15/2018] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do systemic sclerosis patients exhibit impaired nitric oxide-mediated vascular function of the lower limb and are these decrements correlated with plasma biomarkers for inflammation and oxidative stress? What is the main finding and its importance? Findings indicate impaired nitric oxide-mediated vascular function, linked to the incidence of digital ulcers and a milieu of inflammation and oxidative stress. However, the absence of significant correlations between individual biomarkers and blood flow responses suggests that the vasculopathy observed in systemic sclerosis may not be solely the result of derangements in the redox balance or inflammatory signalling. ABSTRACT Systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy, which may be the consequence of inflammation and oxidative stress that ultimately leads to a reduced nitric oxide (NO) bioavailability. Passive leg movement (PLM) is a novel methodology for assessing lower limb vascular function that is predominantly NO dependent. We combined this vascular assessment with a comprehensive panel of plasma biomarkers to assess the axis of inflammation, oxidative stress and NO in SSc patients (n = 12; 62 ± 11 years of age) compared with healthy control subjects (n = 17; 60 ± 16 years of age). The PLM-induced changes in leg blood flow (LBF; 191 ± 104 versus 327 ± 217 ml min-1 ) and LBF area under the curve (39 ± 104 versus 125 ± 131 ml) were reduced in SSc compared with control subjects. Stratification of patients according to history of digital ulcer (DU) formation revealed a further reduction in LBF area under the curve in DU (-13 ± 83 ml) versus non-DU (91 ± 102 ml) patients. Biomarkers of inflammation (C-reactive protein) and oxidative stress (malondialdehyde and protein carbonyl) were all elevated in SSc (C-reactive protein, 3299 ± 2372 versus 984 ± 565 ng ml-1 ; malondialdehyde, 3.2 ± 1.1 versus 1.1 ± 0.7 μm; and protein carbonyl, 0.15 ± 0.05 versus 0.12 ± 0.03 nmol mg-1 ), and C-reactive protein was further elevated in patients with a history of DU (4551 ± 2752 versus 2047 ± 1019 ng ml-1 ) compared with non-DU, although these were not individually correlated with changes in LBF. These findings of impaired NO-mediated vascular function, linked to DU and a milieu of inflammation and oxidative stress, suggest that redox balance plays an important, but not necessarily deterministic, role in the vascular pathophysiology of SSc.
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Affiliation(s)
- Heather L Clifton
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA
| | - Daniel R Machin
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA
| | - H Jonathan Groot
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT, USA
| | - Tracy M Frech
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Rheumatology, University of Utah, Salt Lake City, UT, USA
| | - Anthony J Donato
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Department of Biochemistry, University of Utah, Salt Lake City, UT, USA
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - D Walter Wray
- Geriatric Research, Education, and Clinical Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, UT, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
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13
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Gifford JR, Richardson RS. CORP: Ultrasound assessment of vascular function with the passive leg movement technique. J Appl Physiol (1985) 2017; 123:1708-1720. [PMID: 28883048 DOI: 10.1152/japplphysiol.00557.2017] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As dysfunction of the vascular system is an early, modifiable step in the progression of many cardiovascular diseases, there is demand for methods to monitor the health of the vascular system noninvasively in clinical and research settings. Validated by very good agreement with more technical assessments of vascular function, like intra-arterial drug infusions and flow-mediated dilation, the passive leg movement (PLM) technique has emerged as a powerful, yet relatively simple, test of peripheral vascular function. In the PLM technique, the change in leg blood flow elicited by the passive movement of the leg through a 90° range of motion is quantified with Doppler ultrasound. This relatively easy-to-learn test has proven to be ≤80% dependent on nitric oxide bioavailability and is especially adept at determining peripheral vascular function across the spectrum of cardiovascular health. Indeed, multiple reports have documented that individuals with decreased cardiovascular health such as the elderly and those with heart failure tend to exhibit a substantially blunted PLM-induced hyperemic response (~50 and ~85% reduction, respectively) compared with populations with good cardiovascular health such as young individuals. As specific guidelines have not yet been put forth, the purpose of this Cores of Reproducibility in Physiology (CORP) article is to provide a comprehensive reference for the assessment and interpretation of vascular function with PLM with the aim to increase reproducibility and consistency among studies and facilitate the use of PLM as a research tool with clinical relevance.
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Affiliation(s)
- Jayson R Gifford
- Department of Exercise Sciences, Brigham Young University , Provo, Utah.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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14
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Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Kithas AC, Hydren JR, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. Single passive leg movement assessment of vascular function: contribution of nitric oxide. J Appl Physiol (1985) 2017; 123:1468-1476. [PMID: 28860173 DOI: 10.1152/japplphysiol.00533.2017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Broxterman RM, Trinity JD, Gifford JR, Kwon OS, Kithas AC, Hydren JR, Nelson AD, Morgan DE, Jessop JE, Bledsoe AD, Richardson RS. Single passive leg movement assessment of vascular function: contribution of nitric oxide. J Appl Physiol 123: 1468-1476, 2017. First published August 31, 2017; doi:10.1152/japplphysiol.00533.2017.-The assessment of passive leg movement (PLM)-induced leg blood flow (LBF) and vascular conductance (LVC) is a novel approach to assess vascular function that has recently been simplified to only a single PLM (sPLM), thereby increasing the clinical utility of this technique. As the physiological mechanisms mediating the robust increase in LBF and LVC with sPLM are unknown, we tested the hypothesis that nitric oxide (NO) is a major contributor to the sPLM-induced LBF and LVC response. In nine healthy men, sPLM was performed with and without NO synthase inhibition by intra-arterial infusion of NG-monomethyl-l-arginine (l-NMMA). Doppler ultrasound and femoral arterial pressure were used to determine LBF and LVC, which were characterized by the peak change (ΔLBFpeak and ΔLVCpeak) and area under the curve (LBFAUC and LVCAUC). l-NMMA significantly attenuated ΔLBFpeak [492 ± 153 (l-NMMA) vs. 719 ± 238 (control) ml/min], LBFAUC [57 ± 34 (l NMMA) vs. 147 ± 63 (control) ml], ΔLVCpeak [4.7 ± 1.1 (l-NMMA) vs. 8.0 ± 3.0 (control) ml·min-1·mmHg-1], and LVCAUC [0.5 ± 0.3 (l-NMMA) vs. 1.6 ± 0.9 (control) ml/mmHg]. The magnitude of the NO contribution to LBF and LVC was significantly correlated with the magnitude of the control responses ( r = 0.94 for ΔLBFpeak, r = 0.85 for LBFAUC, r = 0.94 for ΔLVCpeak, and r = 0.95 for LVCAUC). These data establish that the sPLM-induced hyperemic and vasodilatory response is predominantly (~65%) NO-mediated. As such, sPLM appears to be a promising, simple, in vivo assessment of NO-mediated vascular function and NO bioavailability. NEW & NOTEWORTHY Passive leg movement (PLM), a novel assessment of vascular function, has been simplified to a single PLM (sPLM), thereby increasing the clinical utility of this technique. However, the role of nitric oxide (NO) in mediating the robust sPLM hemodynamic responses is unknown. This study revealed that sPLM induces a hyperemic and vasodilatory response that is predominantly NO-mediated and, as such, appears to be a promising simple, in vivo, clinical assessment of NO-mediated vascular function and, therefore, NO bioavailability.
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Affiliation(s)
- Ryan M Broxterman
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Oh Sung Kwon
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Andrew C Kithas
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Jay R Hydren
- Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Ashley D Nelson
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - David E Morgan
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Jacob E Jessop
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Amber D Bledsoe
- Department of Anesthesiology, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Internal Medicine, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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15
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Venturelli M, Cè E, Limonta E, Bisconti AV, Devoto M, Rampichini S, Esposito F. Central and peripheral responses to static and dynamic stretch of skeletal muscle: mechano- and metaboreflex implications. J Appl Physiol (1985) 2016; 122:112-120. [PMID: 27856718 DOI: 10.1152/japplphysiol.00721.2016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/02/2016] [Accepted: 11/11/2016] [Indexed: 12/21/2022] Open
Abstract
Passive static stretching (SS), circulatory cuff occlusion (CCO), and the combination of both (SS + CCO) have been used to investigate the mechano- and metaboreflex, respectively. However, the effects of dynamic stretching (DS) alone or in combination with CCO (DS + CCO) on the same reflexes have never been explored. The aim of the study was to compare central and peripheral hemodynamic responses to DS, SS, DS + CCO, and SS + CCO. In 10 participants, femoral blood flow (FBF), heart rate (HR), cardiac output (CO), and mean arterial pressure (MAP) were assessed during DS and SS of the quadriceps muscle with and without CCO. Blood lactate concentration [La-] in the lower limb undergoing CCO was also measured. FBF increased significantly in DS and SS by 365 ± 98 and 377 ± 102 ml/min, respectively. Compared with baseline, hyperemia was negligible during DS + CCO and SS + CCO (+11 ± 98 and +5 ± 87 ml/min, respectively). DS generated a significant, sustained increase in HR and CO (∼40s), while SS induced a blunted and delayed cardioacceleration (∼20 s). After CCO, [La-] in the lower limb increased by 135%. Changes in HR and CO during DS + CCO and SS + CCO were similar to DS and SS alone. MAP decreased significantly by ∼5% during DS and SS, did not change in DS + CCO, and increased by 4% in SS + CCO. The present data indicate a reduced mechanoreflex response to SS compared with DS (i.e., different HR and CO changes). SS evoked a hyperemia similar to DS. The similar central hemodynamics recorded during stretching and [La-] accumulation suggest a marginal interaction between mechano- and metaboreflex. NEW & NOTEWORTHY Different modalities of passive stretching administration (dynamic or static) in combination with circulatory cuff occlusion may reduce or amplify the mechano- and metaboreflex. We showed a reduced mechanoreflex response to static compared with dynamic stretching. The lack of increase in central hemodynamics during the combined mechano- and metaboreflex stimulation implicates marginal interactions between these two pathways.
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Affiliation(s)
- Massimo Venturelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; .,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Emiliano Cè
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Eloisa Limonta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Michela Devoto
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Center of Sport Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Don Gnocchi Foundation, Milan, Italy; and
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