The Effect of Stroke on Middle Cerebral Artery Blood Flow Velocity Dynamics During Exercise.

BACKGROUND AND PURPOSE: Previous work demonstrates that older adults have a lower response in the middle cerebral artery velocity (MCAv) to an acute bout of moderate-intensity exercise when compared with young adults. However, no information exists regarding MCAv response to exercise after stroke. We tested whether MCAv response to an acute bout of moderate-intensity exercise differed between participants 3 months after stroke and an age- and sex-matched control group of older adults (CON). A secondary objective was to compare MCAv response between the stroke- and non-stroke-affected MCAv. METHODS: Using transcranial Doppler ultrasound, we recorded MCAv during a 90-second baseline (BL) followed by a 6-minute moderate-intensity exercise bout using a recumbent stepper. Heart rate (HR), end-tidal CO2 (PETCO2), and beat-to-beat mean arterial blood pressure (MAP) were additional variables of interest. The MCAv response measures included BL, peak response amplitude (Amp), time delay (TD), and time constant (τ). RESULTS: The Amp was significantly lower in the stroke-affected MCAv compared with CON (P < 0.01) and in the nonaffected MCAv compared with CON (P = 0.03). No between-group differences were found between TD and τ. No significant differences were found during exercise for PETCO2 and MAP while HR was lower in participants with stroke (P < 0.01). Within the group of participants with stroke, no differences were found between the stroke-affected and non-stroke-affected sides for any measures. DISCUSSION AND CONCLUSIONS: Resolution of the dynamic response profile has the potential to increase our understanding of the cerebrovascular control mechanisms and test cerebrovascular response to physical therapy-driven interventions such as exercise.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A284).

Effects of Practical Blood Flow Restriction Training on Adolescent Lower-Body Strength.

Luebbers, PE, Witte, EV, and Oshel, JQ. Effects of practical blood flow restriction training on adolescent lower-body strength. J Strength Cond Res 33(10): 2674-2683, 2019-The purpose of this study was to examine the effects of a practical blood flow restriction (BFR) training program on lower-body strength of high school weightlifters. Twenty-five students were divided into 3 groups. For 6 weeks, each group completed the same resistance training program with the exception of the parallel back squat exercise (2 d·wk), which was different for each group. One group (HI) completed a traditional high-load (≥65% 1 repetition maximum [1RM]) back squat protocol with 3 sets of low repetitions (≤10). The LO group completed the squat exercise using a relatively light load (≤30% 1RM) for 1 set of 30 repetitions and 3 sets of 15 with 30 seconds of rest between sets. The LO + BFR group followed the same protocol as LO, but did so with blood flow restricted. One repetition maximum back squat tests were conducted before the start of the program and again on conclusion, the values of which were used as the dependent measure. A 3 × 2 (group × time) repeated-measures analysis of variance revealed a significant interaction (p = 0.043). Follow-up tests were conducted to explore the interaction. Paired-sample t-tests for each group indicated a significant increase in leg strength for the LO + BFR group (p = 0.005) but not for the HI (p = 0.142) or LO groups (p = 1.00). This suggests that a practical BFR training program may be effective in increasing 1RM squat performance of high school students.

A Novel Nonlinear System Identification for Cerebral Autoregulation in Human: Computer Simulation and Validation.

Cerebral autoregulation in healthy humans was studied using a novel methodology adapted from Bendat nonlinear analysis technique. A computer simulation of a high-pass filter in parallel with a cubic nonlinearity followed by a low-pass filter was analyzed. A linear system transfer function analysis showed an incorrect estimate of the gain, cut-off frequency, and phase of the high-pass filter. By contrast, using our nonlinear systems identification, yielded the correct gain, cut-off frequency, and phase of the linear system, and accurately quantified the nonlinear system and following low-pass filter. Adding the nonlinear and linear coherence function indicated a complete description of the system. Cerebral blood flow velocity and arterial pressure were measured in six data sets. Application of the linear and nonlinear systems identification techniques to the data showed a high-pass filter, like the linear transfer function, but the gain was smaller. The phase was similar between the two techniques. The linear coherence was low for frequencies below 0.1 Hz but improved by including a nonlinear term. The linear + nonlinear coherence was approximately 0.9 across the frequency bandwidth, indicating an improved description over the linear system analysis of the cerebral autoregulation system.

Exercise intensity and middle cerebral artery dynamics in humans.

Despite its necessity for understanding healthy brain aging, the influence of exercise intensity on cerebrovascular kinetics is currently unknown. We, therefore characterized middle cerebral artery blood flow velocity (MCAv) kinetics associated with two exercise intensities: low and moderate. We hypothesized that increasing exercise intensity would increase the MCAv amplitude response (Amp) and that age and estimated fitness (V̇O2max) would be related to Amp. Baseline (BL) values were collected for 90-seconds followed by a 6-minute exercise bout. Heart rate, end-tidal CO2, mean arterial pressure and MCAv were recorded throughout. MCAv kinetics were described by Amp, time delay (TD) and time constant (τ). Sixty-four adults completed the study. Amp was greater during moderate compared to low exercise intensity (p < 0.001) while no difference was observed in either TD (p = 0.65) or τ (p = 0.47). Amp was negatively associated with age (p < 0.01) and positively correlated with estimated V̇O2max (p < 0.01). Although Amp declines with age, maintaining higher V̇O2max may benefit the cerebrovascular response to exercise.