Effects of supine floating on heart rate,blood pressure and cardiac autonomic nervous system activity

It is known that heart rate, oxygen uptake and body temperature during exercise in water are affected by water temperature, buoyancy and so on. Relaxation in water (supine floating) has been performed in hydrotherapy and aqua exercise. But there were few reports about supine floating (Schulz and Kaspar 1994). The purpose of this study was to make clear the effects of supine floating on heart rate, blood pressure and cardiac autonomic nervous system activity in males.     

Adjustments in oxygen transport during head-out immersion in water at different temperatures

Respiratory gas exchange was investigated in human subjects immersed up to the shoulders in water at different temperatures (Tw = 25, 34, and 40 degrees C). Cardiac output (Qc) and pulmonary tissue volume (Vti) were measured by a rebreathing technique with the inert gas Freon 22, and O2 consumption (VO2) was determined by the closed-circuit technique. Arterial blood gases (PaO2, PaCO2) were analyzed by a micromethod, and alveolar gas (PAO2) was analyzed during quiet breathing with a mass spectrometer. The findings were as follows. 1) Immersion in a cold bath had no significant effect on Qc compared with the value measured at Tw = 34 degrees C, whereas immersion in a hot bath led to a considerable increase in Qc. Vti was not affected by immersion at any of the temperatures tested. 2) A large rise in metabolic rate VO2 was only observed at Tw = 25 degrees C (P less than 0.001). 3) Arterial blood gases were not significantly affected by immersion, whatever the water temperature. 4) O2 transport during immersion is affected by two main factors: hydrostatic pressure and temperature. Above neutral temperature, O2 transport is improved because of the marked increase in Qc resulting from the combined actions of hydrostatic counter pressure and body heating. Below neutral temperature, O2 transport is altered; an increase in O2 extraction of the tissue is even calculated.     

Alcohol and respiratory and body temperature changes during tepid water immersion

Resting subjects were immersed for 30 min in water at 22 and 30 degrees C after drinking alcohol. Total ventilation, end-tidal PCO2, rectal temperature, aural temperature, mean skin temperature, heart rate, and oxygen consumption were recorded during the experiments. Blood samples taken before the immersion period were analyzed by gas-liquid chromatography. The mean blood alcohol levels were 82.50 +/- 9.93 mg.(100 ml)-1 and 100.6 +/- 12.64 mg (100 ml)-1 for the immersions at 22 and 30 degrees C, respectively. There was no significant change in body temperature measured aurally or rectally, mean surface skin temperature, or heart rate at either water temperature tested. Total expired ventilation was significantly attenuated for the last 15 min of the immersion at 22 degrees C, after alcohol consumption as compared to the ventilation change in water at 22 degrees C without ethanol. This response was not consistently significantly altered during immersion in water at 30 degrees C. It is evident that during a 30-min immersion in tepid water with a high blood alcohol level, body heat loss is not affected but some changes in ventilation do occur.     

Head out of water immersion as simulation study: an heart rate variability study

During head out of water immersion (HOI), the hydrostatic pressure on the tissues of the lower limbs causes an increase in thoracic blood volume and a high vascular perfusion. This blood shift results in changes in autonomic balance. The aim of this study was to evaluate the activity of the autonomic nervous system, as obtained from the analysis of heart rate variability (HRV), during HOI at 2 different temperatures and compare these results with data obtained during parabolic flight. In HOI, two different positions (sitting and standing) were compared. Results showed a shift to vagal activity as well during HOI as in microgravity during parabolic flight.     

The increased oxygen uptake upon immersion. The raised external pressure could be a causative factor

The principal cause of the immediate transient elevation in ventilation (VE, L.min-1) and oxygen uptake (VO2, L.min-1), when a human subject is immersed in cold water is considered to be the stimulation of cutaneous cold receptors. The present study demonstrates that the initial VE and VO2 responses are comprised of a thermogenic and a hydrostatic component. The peak values in VE reached (mean +/- SD) 66.8 +/- 22.3, 53.9 +/- 38.1, 32.2 +/- 15.4, 22.5 +/- 3.6, 19.5 +/- 4.6 L.min-1 during the first minute of immersion in 10 degrees, 15 degrees, 20 degrees, 28 degrees and 40 degrees C water, respectively. Similarly, peaks (mean +/- SD) in VO2 of 1.22 +/- 0.25, 1.01 +/- 0.32, 0.98 +/- 0.39, 0.81 +/- 0.09, and 0.78 +/- 0.26 L.O2.min-1, were reached when subjects were immersed in 10 degrees, 15 degrees, 20 degrees, 28 degrees, and 40 degrees C water. It is concluded that the observed increases in VO2 during the first minute of immersion are partly due to the increased hydrostatic pressure causing a shift of venous blood towards the thoracic region, and a transient increase in the uptake of oxygen into the blood.     

The interstitial fluid content in working muscle modifies the cardiovascular response to exercise

The volume of interstitial fluid in the limbs varies considerably, due to hydrostatic effects. As signals from working muscle, responsible for much of the cardiovascular drive, are assumed to be transmitted in this compartment, blood pressure and heart rate could be affected by local or systemic variations in interstitial hydration. Using a special calf ergometer, eight male subjects performed rhythmic aerobic plantar flexions in a supine position with dependent calves for periods of 7 min. During exercise heart rate, blood pressure, oxygen uptake (VO2) and blood lactate concentrations were measured in two different tests, one before and after interstitial calf dehydration through limb elevation for 25 min, compared to the other, a control with unaltered fluid volume in a maintained working position. Impedance plethysmography showed calf volume to be stabilized in the control position. Leg elevation by passive hip flexion to 90 degrees resulted in a fast (vascular) volume decrease lasting less than 2 min, followed by a slow linear fluid loss from the interstitial compartment. Then, when returned to the control position, adjustment of vascular volume was completed within 2 min and exercise could be performed with dehydration remaining in the interstitium only. Cardiovascular response was identical at the start of both tests. However, exercising with dehydrated calves elicited a significantly larger increase in heart rate compared to the control, whereas VO2 was identical. The blood pressure response was shown to be only slightly enhanced. Structural interstitial features varying with hydration, most likely chemical or mechanical ones, may have been responsible for this amplification of signals.     

Diving response and arterial oxygen saturation during apnea and exercise in breath-hold divers.

This study addressed the effects of apnea in air and apnea with face immersion in cold water (10 degrees C) on the diving response and arterial oxygen saturation during dynamic exercise. Eight trained breath-hold divers performed steady-state exercise on a cycle ergometer at 100 W. During exercise, each subject performed 30-s apneas in air and 30-s apneas with face immersion. The heart rate and arterial oxygen saturation decreased and blood pressure increased during the apneas. Compared with apneas in air, apneas with face immersion augmented the heart rate reduction from 21 to 33% (P < 0.001) and the blood pressure increase from 34 to 42% (P < 0.05). The reduction in arterial oxygen saturation from eupneic control was 6.8% during apneas in air and 5.2% during apneas with face immersion (P < 0.05). The results indicate that augmentation of the diving response slows down the depletion of the lung oxygen store, possibly associated with a larger reduction in peripheral venous oxygen stores and increased anaerobiosis. This mechanism delays the fall in alveolar and arterial PO(2) and, thereby, the development of hypoxia in vital organs. Accordingly, we conclude that the human diving response has an oxygen-conserving effect during exercise.     

Interstitial transudation with postural changes in man]

Starling-Landis concepts of formation of interstitial fluids are in agreement with measurements of calf volume in normal young women, in horizontal recumbency or after horizontal immersion. The volume of the calf is reduced when the hydrostatic pressure of the blood column is diminished under the phlebostatic level and when the external pressure is increased by the hydrostatic pressure of the water bath.     

新理论CPET指导个体化精准运动整体方案有效改善“虚弱症”的整体功能状态*

目的: 探讨整体整合生理学医学新理论指导下,根据心肺运动试验（CPET）制定个体化精准运动整体方案对整体功能状态的影响。方法: 李xx,女,31岁,自幼心率快（90~100 bpm）,平时手脚冰凉,秋冬季为甚,既往体健。2019年9月底在阜外医院签署知情同意书后行CPET,峰值摄氧量、无氧阈（AT）和峰值心排量分别为（69~72）%pred,摄氧通气效率和二氧化碳排出通气效率基本正常（96~100）%pred。静息心率快、血压偏低,运动过程中血压反应弱,以心率升高为主。整体整合生理学医学理论认为其自身虚弱,且以心脏弱为主。以CPET指导个体化精准运动强度进行滴定,结合连续逐搏血压、心电、脉搏和血糖动态监测制定个体化定量运动整体方案,实施8周强化管理后复查CPET等。结果: 经整体强化管理8周后四肢温暖,发凉症状消失。复查CPET峰值摄氧量、无氧阈和峰值心排量分别为（90~98）%pred,分别提高30%~36%,虚弱的整体功能状态得到显著提升;基本正常的摄氧通气效率和二氧化碳排出通气效率也分别提高10%~37%;静息心率和血压基本恢复正常,运动中血压和心率反应均正常。连续动态血糖监测提示血糖平均水平略下降,更趋于平稳,连续心电、逐搏血压等的重复测定结果也提示静息、运动全程和睡眠期间的心率降低、血压提升,桡动脉脉搏波的重搏波幅度加大,变得更加明显。结论: 新理论体系指导CPET制定个体化精准运动整体方案可以安全有效增强心肌收缩力、增加每搏输出量,提升血压、降低心率,稳定并略降低血糖,提高整体功能状态。     

Cardiovascular and respiratory responses to apneas with and without face immersion in exercising humans.

The effect of the diving response on alveolar gas exchange was investigated in 15 subjects. During steady-state exercise (80 W) on a cycle ergometer, the subjects performed 40-s apneas in air and 40-s apneas with face immersion in cold (10 degrees C) water. Heart rate decreased and blood pressure increased during apneas, and the responses were augmented by face immersion. Oxygen uptake from the lungs decreased during apnea in air (-22% compared with eupneic control) and was further reduced during apnea with face immersion (-25% compared with eupneic control). The plasma lactate concentration increased from control (11%) after apnea in air and even more after apnea with face immersion (20%), suggesting an increased anaerobic metabolism during apneas. The lung oxygen store was depleted more slowly during apnea with face immersion because of the augmented diving response, probably including a decrease in cardiac output. Venous oxygen stores were probably reduced by the cardiovascular responses. The turnover times of these gas stores would have been prolonged, reducing their effect on the oxygen uptake in the lungs. Thus the human diving response has an oxygen-conserving effect.     

The role of posture on the changes in plasma atrial natriuretic factor and arginine vasopressin levels during immersion

In seven healthy male volunteers we investigated changes in plasma atrial natriuretic factor [( ANF]), arginine vasopressin [( AVP]) and plasma volume (PV) during supine immersion. Twenty minutes head-out water immersion in a supine position in a thermo-neutral water bath attenuated the increase in PV induced by 20 min in a supine position in air, but increased the mean plasma [ANF] from 32.0 pg.ml-1, SEM 5.1 to 53.3 pg.ml-1, SEM 3.6 and decreased the mean plasma [AVP] from 1.4 pg.ml-1, SEM 0.1 to 0.9 pg.ml-1, SEM 0.04. Simultaneously, diuresis and natriuresis increased markedly. During a 20-min control period in the supine posture without immersion, PV, plasma [ANF] and [AVP] remained unaffected while diuresis and natriuresis did not increase to the same extent. These data suggest that an increase in the central blood volume induced by a weak external hydrostatic pressure during supine immersion triggered the changes in plasma [ANF] and [AVP] and that the increase was probably due to a shift of blood volume from peripheral to central vessels. The changes in plasma [ANF] contributed to the changes in natriuresis.     

Catecholamines, circulation, and the kidney during water immersion in humans

Because results in literature are discrepant with regard to the effects of water immersion (WI) on the release of norepinephrine (NE) in humans, the following study was performed. Simultaneous measurements of plasma NE, central cardiovascular variables, and renal sodium excretion were conducted in eight normal male subjects on 2 study days; 6 h of thermoneutral (35.0 degrees C) WI to the neck were preceded and followed by 1 h in the seated posture outside the water and 8 h of a seated control period. During the control period, the subjects wore a water-perfused garment (water temperature 34.6 degrees C) to obtain the same skin temperature as during WI. The subjects were fluid restricted overnight and kept in this condition throughout the study. Compared with the prestudy, post-study, and control periods, plasma NE decreased significantly by 61% during WI. Simultaneously, central venous pressure, cardiac output, stroke volume, systolic arterial pressure, and arterial pulse pressure increased, whereas heart rate decreased. Renal sodium excretion and urine flow rate increased. In conclusion, the release of NE is suppressed in humans during immersion. This decrease probably reflects a decrease in sympathetic nervous activity initiated by stimulation of low- and high-pressure baroreceptors. It is possible that the decrease in NE acts as one of several mechanisms of the natriuresis and diuresis of immersion in humans.     

Immersion in CO<Subscript>2</Subscript>-rich water containing NaCl diminishes blood pressure fluctuation in anesthetized rats

Remarkably, bathing in hot springs containing high concentrations of carbon dioxide (CO₂) influences cardiovascular function more than bathing in fresh water. The CO₂-enriched water in hot springs generally contains many salts, whose interactions remain unknown. We separately evaluated the actions of individual factors in CO₂-enriched water and confirmed that CO₂ and NaCl have combined effects on blood pressure fluctuations in anesthetized rats. Animals equipped with sensor probes to monitor body temperature, skin blood flow and arterial blood pressure were immersed in bathwater (35°C) containing CO₂ with NaCl, KCl or sucrose. The effects of these factors on cardiovascular function were evaluated using power-spectral analysis of fluctuations in blood pressure and heart rate. Compared with immersion in tap water, heart rate and skin vascular resistance were reduced during immersion in CO₂-enriched water irrespective of the presence of other components. In terms of the very low frequency range (0.02–0.195 Hz), the power of blood pressure fluctuation during immersion was significantly reduced when the CO₂-enriched water contained more than 1.5% NaCl but was not influenced by other components of similar osmotic pressure and the same specific gravity. The results indicated that the coexistence of CO₂ and sodium ions in bathwater reduce blood pressure fluctuations, and suggested that this combination effect of CO₂ and salt contributes to the sedative effect on human cardiovascular functions while bathing in CO₂-hot springs.     

Effect of occluded venous return on core temperature during cold water immersion

Recent studies using inanimate and animal models suggest that the afterdrop observed upon rewarming from hypothermia is based entirely on physical laws of heat flow without involvement of the returning cooled blood from the limbs. During the investigation of thermoregulatory responses to cold water immersion (15 degrees C), blood flow to the limbs (minimized by the effects of hydrostatic pressure and vasoconstriction) was occluded in 17 male subjects (age, 29.0 +/- 3.3 yr). Comparisons of rectal (Tre) and esophageal temperature (Tes) responses were made during the 5 min before occlusion, during the 10-min occlusion period, and for 5 min immediately after the release of the cuffs (postocclusion). In the preocclusion phase, Tre and Tes showed similar cooling rates. The occlusion of blood flow to the extremities significantly arrested the cooling of Tes (P less than 0.05) with little effect on Tre. Upon release of the pressure cuffs, the returning extremity blood flow resulted in an increased rate of cooling, that was three times greater at the esophageal site (-0:149 +/- 0.052 vs. -0.050 +/- 0.026 degrees C.min-1). These results suggest that the cooled peripheral circulation, minimized during cold water immersion, may dramatically affect esophageal temperature and the complete neglect of the circulatory component to the afterdrop phenomenon is not warranted.     

Exercise versus immersion: antagonistic effects on water and electrolyte metabolism during swimming

Changes in blood composition, renal function, aldosterone and antidiuretic hormone (ADH) concentrations were investigated in 10 untrained male subjects when swimming (60 min at a heart rate of about 155 beats.min-1, water temperature 28 degrees C) and during the subsequent 3 h in a sitting position. Many specific effects of either exercise or immersion were abolished or attenuated; no significant changes in plasma aldosterone, [ADH], [K+], [Cl-], or of urinary volume, glomerular filtration rate, free water or osmolar clearance were observed. The urine was diluted resulting in lowered [Na+]. In blood some quantities which are only slightly influenced by immersion increased during swimming ([Na+], [Lac-], [H+], osmolality, [creatinine]). Exercise induced plasma volume loss, calculated from increasing [Hb], was small (110 ml), probably because interstitial fluid enters the vascular space during the initial phase of immersion. One might anticipate that the training effects on fluid and electrolyte metabolism and circulation are different when swimming and when performing endurance sports on land.     

Physiological [correction of Physilogical] cost of standard physical load after 7-day dry immersion

Working capacity and cardiovascular response to exercise were studied in men subjected to 7-days of dry immersion. Heart rate, ventilation, and oxygen uptake and consumption were measured before immersion and on the 4th and 7th days of immersion. No significant changes in heart rate were found, but some changes in ventilation and oxygen uptake dynamics indicate that gas exchange may be altered during immersion. Physiological adaptation and individual differences are discussed.     

Thermoregulatory, cardiovascular, and psychophysical response to alcohol in men in 40 degrees C water.

The goals of the study were to test the hypotheses that ethyl alcohol (ETOH) in low-to-moderate doses would alter thermo-regulation and/or disrupt the normal relationship between physiological and psychophysical indexes of heat stress during 40 degrees C water immersion and to characterize the cardiovascular response to the combined stimuli of heat, water immersion, and ETOH. Six healthy men underwent three trials of 21 min of immersion in water at 40.0 +/- 0.1 degrees C after consuming 0, 0.27, or 0.54 g ETOH/kg. Esophageal temperature (Tes) rose by approximately 1.0 degrees C during immersion for each trial. Per unit of Tes rise, changes during immersion in skin temperature, sweat rate, heart rate, systolic and diastolic blood pressure, and psychophysical assessments of comfort and overheating did not differ significantly by trial. Across trials, there was an apparent threshold for activation of thermoregulatory responses at an approximately 0.5 degrees C increase in Tes occurring after approximately 9 min of immersion. This threshold was identified psychophysically by increased ratings of overheating and decreased comfort. Above the threshold, there was an attenuation of the rate of increase of Tes. Cardiovascular stress was mild (rate-pressure product approximately 12,000) and not significantly increased by ETOH. Hypotension and tachycardia when subjects stood to exit the tub were observed. The data suggest that ETOH at the doses administered does not affect thermoregulatory, cardiovascular, or psychophysical indexes of heat stress during 40 degrees C water immersion.     

Acute plasma volume expansion: effect on metabolism during submaximal exercise.

To examine the effect of acute plasma volume expansion (PVE) on substrate selection during exercise, seven untrained men cycled for 40 min at 72 +/- 2% peak oxygen uptake (VO(2 peak)) on two occasions. On one occasion, subjects had their plasma volume expanded by 12 +/- 2% via an intravenous infusion of the plasma substitute Haemaccel, whereas on the other occasion no such infusion took place. Muscle samples were obtained before and immediately after exercise. In addition, heart rate and pulmonary gas and venous blood samples were obtained throughout exercise. No differences in oxygen uptake or heart rate during exercise were observed between trials, whereas respiratory exchange ratio, blood glucose, and lactate were unaffected by PVE. Muscle glycogen and lactate concentrations were not different either before or after exercise. In addition, there was no difference in total carbohydrate oxidation between trials (control: 108 +/- 2 g; PVE group: 105 +/- 2 g). Plasma catecholamine levels were not affected by PVE. These data indicate that substrate metabolism during submaximal exercise in untrained men is unaltered by acute hypervolemia.     

Respiratory metabolism in patients during exercise therapy in the early period of acute myocardial infarction

Respiratory and cardiocirculatory response to rehabilitation calisthenics in 30 patients, aged 39-66 years, with recent myocardial infarction was studied. Respiratory exchange (Douglas-Haldane method), heart rate, blood pressure, oxygen pulse and electrocardiogram during exercise were investigated. Rehabilitation was performed between the 4th and 21st day of myocardial infarction, in 4 periods with gradually increasing effort, according to the model A designed at the Cardiology Institute in Warsaw. The time of exercises was 10-18 min, depending on the period of rehabilitation. It was found that lung ventilation, tidal volume, oxygen uptake and carbon dioxide output were increased by 20-40% during exercise of the I and II periods of rehabilitation and by 60-100% in the III and IV periods of mobilization. Energy cost of calisthenics rehabilitation was in the lightest case 13 kJ/min. The most increase in respiratory exchange caused exercises performed in sitting position, walking and stair climbing. The last type produced also the highest rise in heart rate (mean 20%) and systolic blood pressure (mean 17% of resting values).     

Effects of water depth on abdominal [correction of abdominails] aorta and inferior vena cava during standing in water

During water immersion bradycardia and increase in stroke volume induce by changing in hydrostatic pressure. We hypothesised that the cardiac alterations with immersion are associates with an increase in venous return from lower body. Because the venous return reflects volume of capacitance vein e.g, inferior vena cava. Therefore, we clarified the effects of water immersion on the size in left ventricle, aorta, and vena cava.