Yoga's Effects on the Cardiovascular System of Healthy Women: Implications for Best Practices.

CONTEXT: Yoga as a form of physical activity is growing in popularity. During yoga, individuals interrupt the stress response, which is typically associated with high blood pressure (BP), impaired focus, and high levels of anxiety. Consequently, research into yoga's effects on stress should place a special emphasis upon the interplay of the nervous and cardiovascular systems during yoga practice. OBJECTIVE: The purpose of this study was to delineate the immediate cardiovascular effects of 12 Hatha yoga poses by means of RR (beat-to-beat) intervals and JT (cardiac repolarization) intervals. DESIGN: The research team designed controlled pilot studies based on half-year periods. SETTING: The study took place at the Lithuanian University of Health Sciences in Kaunas, Lithuania. PARTICIPANTS: Participants were women who were long-term yoga practitioners. Three studies occurred: (1) Study 1-10 women with a mean age of 30.1 ± 1.9 years, (2) Study 2-10 women with a mean age of 29.9 ± 1.9 years, and (3) Study 3-22 women with a mean age of 32.9 ± 1.8 years. INTERVENTION: The study examined the acute cardiovascular effects of 12 Hatha yoga poses by means of electrocardiogram parameters. OUTCOME MEASURES: Anthropometrical and physiological parameters were measured: (1) height and weight; (2) body mass index (BMI); (3) heart rate (HR); (4) systolic and diastolic blood pressure (DBP); and (5) electrocardiogram (ECG) RR and JT intervals. RESULTS: The lowest RR interval value was recorded during the Chaturanga Dandasana, at 456.0 ± 16.5 ms in Study 3, with P < .001 compared to the intervals for all the other poses. Significant differences in the JT interval also emerged during the Chaturanga Dandasana, at 177.3 ± 6.0 ms in Study 3 with P < .001 compared to all the other poses. The next lowest RR interval value was recorded in Study 3 during the Utkatasana, at 569.4 ± 17.6 ms. In the Savasana prior to the program, the RR interval increased in study 1 and decreased in studies 2 and 3. The JT interval in the Savasana prior to the program increased in studies 1 and 2 but decreased in study 3. CONCLUSIONS: Healthy women can practice a modified and/or a shorter duration of the Chaturanga Dandasana. Adjustments in the Utkatasana, including having the arms in the prayer position, may help prevent strain to the cardiovascular system. Also, practicing poses with a longer RR interval may aid stress-related health problems.

Exploring the Aortic Root Diameter and Left Ventricle Size Among Lithuanian Athletes.

Background and objectives: Aortic rupture is known as one of the potential causes of sudden cardiac death in athletes. Nevertheless, adaptation strategies for aortic root dilation in athletes vary. The purpose of this study was to investigate aortic root adaptation to physical workload and to determine if aortic roots and left ventricle sizes are contingent upon the physical workload. Materials and Methods: Echocardiography was applied to 151 subjects to measure the aortic root at aortic valve annulus (AA) and at sinus of Valsalva (VS). 122 were athletes (41 females and 81 males) and 29 were non-athletes (14 females and 15 males). Of the 41 female athletes, 32 were endurance athletes, and 9 were strength athletes. From 81 male athletes, 56 were endurance athletes, and 25 were strength athletes. AA and VS mean values for the body surface area were presented as AA relative index with body surface area (rAA) and VS relative index with body surface area (rVS). Left ventricle (LV) measures included LV end-diastolic diameter (LVEDD), interventricular septum thickness in diastole (IVSTd), LV posterior wall thickness in diastole (LVPWTd), LV mass (LVM), LV mass index, and LV end-diastolic diameter index (LVEDDI). Results: Results indicated that VS was higher in female athletes (28.9 ± 2.36 mm) than in non-athletes (27.19 ± 2.87 mm, p = 0.03). On the other hand, rAA was higher in strength athletes (12.19 ± 1.48 mm/m2) than in endurance athletes (11.12 ± 0.99 mm/m2, p = 0.04). Additionally, rVS and rAA were higher in female strength athletes (17.19 ± 1.78 mm/m2, 12.19 ± 1.48 mm/m2) than female basketball players (15.49 ± 1.08 mm/m2, p = 0.03, 10.75 ± 1.06 mm/m2, p = 0.02). No significant differences regarding aortic root were found between male athletes and non-athletes. Statistically significant positive moderate correlations were found between VS and LVEDD, LVM, IVSTd, LVPWTd, rVS, and LVEDDI parameters in all athletes. Conclusion: The diameter of Valsalva sinus was greater in female athletes compared to non-athletes. The rAA mean value for body surface area was greater in female athletes practising strength sports as compared to their counterparts who were practising endurance sports. The diameter of the aortic root at sinuses positively correlated with the LV size in all athletes.

Balancing financial incentives during COVID-19: A comparison of provider payment adjustments across 20 countries.

Provider payment mechanisms were adjusted in many countries in response to the COVID-19 pandemic in 2020. Our objective was to review adjustments for hospitals and healthcare professionals across 20 countries. We developed an analytical framework distinguishing between payment adjustments compensating income loss and those covering extra costs related to COVID-19. Information was extracted from the Covid-19 Health System Response Monitor (HSRM) and classified according to the framework. We found that income loss was not a problem in countries where professionals were paid by salary or capitation and hospitals received global budgets. In countries where payment was based on activity, income loss was compensated through budgets and higher fees. New FFS payments were introduced to incentivize remote services. Payments for COVID-19 related costs included new fees for out- and inpatient services but also new PD and DRG tariffs for hospitals. Budgets covered the costs of adjusting wards, creating new (ICU) beds, and hiring staff. We conclude that public payers assumed most of the COVID-19-related financial risk. In view of future pandemics policymakers should work to increase resilience of payment systems by: (1) having systems in place to rapidly adjust payment systems; (2) being aware of the economic incentives created by these adjustments such as cost-containment or increasing the number of patients or services, that can result in unintended consequences such as risk selection or overprovision of care; and (3) periodically evaluating the effects of payment adjustments on access and quality of care.

Interplay between adolescent physical activity and life satisfaction: gender as potential effect modifier.

OBJECTIVES: Recently, adolescents fall short of adequate physical activity (PA) requirements, though the benefits of active lifestyle are well documented. In this study, we analyzed how the PA is associated with life satisfaction among adolescent girls and boys. METHODS: Data for this study were collected in April-June 2018 during the international HBSC survey in Lithuania (n = 4191, aged 13.9 ± 1.69 years). From self-report questionnaire, the indicators reflecting PA, life satisfaction, body image, somatic complaints, wellbeing, demographic, and socioeconomic status were analyzed. Bivariate analysis used Chi-squared test, multivariate associations-logistic regression method. RESULTS: Moderate-to-vigorous PA was sufficient among 18% of schoolchildren, while 66% of respondents met vigorous PA requirements. For boys vigorous PA can be regarded as the predictor of better life satisfaction (OR = 1.63, p < 0.05), while for girls the moderate-to-vigorous PA is observed as a risk factor for lower life satisfaction at borderline significance (OR = 0.67, p = 0.053). CONCLUSIONS: Addressing the PA and life satisfaction interplay, we identify essential differences between genders. Schools, parents, and policy makers should enable the adolescents with more opportunities and equipment for vigorous rather than moderate-to-vigorous PA.

Baltic Adolescents' Health Behaviour: An International Comparison.

The aim of the study is to assess the time trends in Baltic adolescents' physical activity, dietary habits and BMI and compare the results with the average of the Health Behaviour in School-aged Children (HBSC) study. The research used HBSC data from 2006 to 2018. The total number of respondents was 17,458 in Estonia, 18,416 in Latvia and 20,466 in Lithuania. A logistic regression analysis was applied to estimate time trends in health behaviour indicators. The results demonstrated that Baltic adolescents' physical activity has declined over the study years, except for Lithuanian girls. The prevalence of overweight adolescents has significantly increased since 2006. Dietary habits improved in all three Baltic countries, as consumption of vegetables increased, and soft drink consumption decreased during this time period. This research shows that a nationwide, highly representative study with health behaviour indicators enables us to assess regional differences compared to the HBSC average. The prevalence of overweight and obese adolescents in the Baltic countries has increased and moved closer to the HBSC average. Although Baltic adolescents' daily vegetable consumption has increased over the last decade, it is still lower than the HBSC average.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform.

BACKGROUND: To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group. METHODS: Thirty-one male university basketball players (age: 21.35, SD = 0.605 years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later. RESULTS: The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8 weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041). CONCLUSIONS: An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

Not only static: Stabilization manoeuvres in dynamic exercises - A pilot study.

This study examined characteristics of trunk muscles electrical activity in young adults performed in the course of static and dynamic trunk muscles strengthening exercises using different lumbar spine stabilization manoeuvres. Twenty young adults (Mage = 25.5 SD = 2.91) participated in this study. Of the 20, 11 subjects (5 males and 6 females) reported no history of pain, 9 subjects (5 males and 4 females) reported lower back pain (LBP) within the last three months. Subjects performed lumbar spine stabilization manoeuvres (abdominal bracing (AB) and abdominal hollowing (AH)) with static and dynamic abdominal muscles strengthening exercises (i.e., plank, side-bridges, and curl-ups). Noraxon Telemyo twelve channel electromyography device (Noraxon USA, Inc.) was used to record EMG data from rectus abdominal muscle (RA), external oblique muscles (EO), internal oblique muscles (IO), and erector spine muscles (ES). In static exercises such as side-bridge exercise, significantly higher RA muscle electrical activity was recorded with AB manoeuvre compared to AH manoeuvre both on the right side and left side respectively (Z = -2.17; p = 0.03; Z = 3.40; p = 0.001). In dynamic exercises such as curl-up exercise, during the lifting phase, median value of RA muscle activity with AB was significantly higher than with AH (Z = -2.315; p = 0.021). Median value of IO muscles activity with AH was significantly higher than with AB (Z = -3.230; p = 0.001). Our findings indicated that although surface muscles are more activated with AB manoeuvre exercises, deep abdominal muscles are more activated in exercises with AH manoeuvre. These findings can help practitioners design interventions to integrate AH manoeuvre for benefiting persons with lumbar instability.

Metastable Pain-Attention Dynamics during Incremental Exhaustive Exercise.

Background: Pain attracts attention on the bodily regions. Attentional allocation toward pain results from the neural communication across the brain-wide network "connectome" which consists of pain-attention related circuits. Connectome is intrinsically dynamic and spontaneously fluctuating on multiple time-scales. The present study delineates the pain-attention dynamics during incremental cycling performed until volitional exhaustion and investigates the potential presence of nested metastable dynamics. Method: Fifteen young and physically active adults completed a progressive incremental cycling test and reported their discomfort and pain on a body map every 15 s. Results: The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout five temporal windows reaching an average of 4.26 ± 0.59 locations per participant. A total of 37 different locations were reported and marked as painful for all participants throughout the cycling task. Significant differences in entropy were observed between all temporal windows except the fourth and fifth windows. Transient dynamics of bodily locations with perceived discomfort and pain were spanned by three principal components. The metastable dynamics of the body pain locations groupings over time were discerned by three time scales: (1) the time scale of shifts (15 s); (2) the time scale of metastable configurations (100 s), and (3) the observational time scale (1000 s). Conclusion: The results of this study indicate that body locations perceived as painful increase throughout the incremental cycling task following a switching metastable and nested dynamics. These findings support the view that human brain is intrinsically organized into active, mutually interacting complex and nested functional networks, and that subjective experiences inherent in pain perception depict identical dynamical principles to the neural tissue in the brain.

Local Pain Dynamics during Constant Exhaustive Exercise.

The purpose of this study was to delineate the topological dynamics of pain and discomfort during constant exercise performed until volitional exhaustion. Eleven physical education students were tested while cycling and running at a "hard" intensity level (e.g., corresponding to Borg's RPE (6-20) = 15). During the tests, participants reported their discomfort and pain on a body map every 15s. "Time on task" for each participant was divided into five equal non-overlapping temporal windows within which their ratings were considered for analysis. The analyses revealed that the number of body locations with perceived pain and discomfort increased throughout the five temporal windows until reaching the mean (± SE) values of 4.2 ± 0.7 and 4.1 ± 0.6 in cycling and running, respectively. The dominant locations included the quadriceps and hamstrings during cycling and quadriceps and chest during running. In conclusion, pain seemed to spread throughout the body during constant cycling and running performed up to volitional exhaustion with differences between cycling and running in the upper body but not in the lower body dynamics.