Cardiovascular response to anticipatory and reactionary postural perturbations in young adults.

NEW FINDINGS: What is the central question of this study? It has been suggested that the cardiovascular responses to a postural perturbation are centrally mediated and reflex mediated. We wanted to know the extent to which the cardiovascular responses to external perturbations could be executed in a feedforward manner, in anticipation of the perturbation. What is the main finding and its importance? We found no anticipatory component driving heart rate and systolic blood pressure responses, suggesting that reflexive mechanisms dominate cardiovascular regulation after a postural perturbation in young adults. ABSTRACT: Cardiovascular responses to postural perturbations have been reported, but whether the cardiovascular responses to external perturbations could be executed in anticipation of the perturbation is unknown. The purpose of this study was to determine the effect of anticipated and reactionary perturbations on heart rate (HR) and systolic blood pressure (SBP) responses in healthy young adults. A secondary aim was to determine whether perceived state anxiety scores were correlated with the change in HR response during postural perturbation. Twenty healthy young adults stood on a treadmill and experienced two perturbation conditions (anticipatory vs. reactionary), each with two intensity levels (Step vs. No Step). The HR and SBP were collected continuously. Two-way repeated-measures statistical non-parametric mapping tests were used to compare HR and SBP responses to the perturbations over time (from -3 to +8 s). The results indicated that HR was significantly elevated in the higher intensity perturbations [Step vs. No Step, at 0.56-1.32 s (P < 0.0001) and 1.92-3.44 s (P < 0.0001) post-perturbation], while there were no differences in HR between perturbation types (anticipatory vs. reactionary) or in SBP between perturbation types and intensity levels. The perceived state anxiety scores did not differ between perturbation types and intensity levels but were correlated with the change in HR post-perturbation (P = 0.013). We suggest that reflexive mechanisms dominate cardiovascular regulation after anticipatory and reactionary perturbations. The data highlight the cardiovascular mechanism(s) associated with perturbations that should be considered when assessing postural stability in populations with poor balance performance.

End-tidal carbon dioxide levels in patients with post-concussion syndrome during neurocognitive and physical tasks compared to a normative control group.

PRIMARY OBJECTIVE: Recent findings suggest breathing may negatively affect performance after concussion. The aim of the study was to examine group differences between individuals with and without post-concussion syndrome (PCS) in end-tidal carbon dioxide (ETCO2) and respiratory rate (RR) during neurocognitive and physical tasks. HYPOTHESIS: Individuals in the PCS group will have elevated ETCO2 and lower RR compared to the control group. METHODS: A quasi-experimental study was used in which a capnography unit collected ETCO2 and RR breathing data from 22 participants (control = 17; PCS = 5) during rest, the completion of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) battery and while slow and fast walking. Four repeated measures mixed factorial ANOVAs, with an alpha level set at p ≤ 0.05, were used to examine group and task differences. RESULTS: Both groups displayed similar breathing responses to cognitive and physical stress; however, PCS participants had significantly elevated ETCO2 throughout the study (during rest, the ImPACT and while walking) compared to the control. Conversely, no significant group differences were found in RR. CONCLUSION: Cerebral physiological alterations and deficits in the autonomic nervous system may cause abnormal ETCO2 in individuals after concussion. Future research evaluating breathing patterns in PCS may be warranted.

Cardiovascular response to postural perturbations of different intensities in healthy young adults.

The ability to regain control of balance is vital in limiting falls and injuries. Little is known regarding how the autonomic nervous system responds during recovery from balance perturbations of different intensities. The purpose of this study was to examine the cardiovascular response following a standing balance perturbation of varying intensities, quantify cardiac baroreflex sensitivity (cBRS) during standing perturbations, and to establish the stability of the cardiac baroreflex during quiet standing before and after balance disturbances. Twenty healthy participants experienced three different perturbation intensity conditions that each included 25 brief posteriorly-directed perturbations, 8-10 s apart. Three perturbation intensity conditions (low, medium, high) were given in random order. Physiological data were collected in quiet stance for 5 min before testing (Baseline) and again after the perturbation conditions (Recovery) to examine baroreflex stability. Beat-to-beat heart rate (HR) and systolic blood pressure (SBP) analysis post-perturbation indicated an immediate acceleration of the HR for 1-2 s, with elevated SBP 4-5 s post-perturbation. Heart rate changes were greatest in the medium (p = 0.035) and high (p = 0.012) intensities compared to low, while there were no intensity-dependent changes in SBP. The cBRS was not intensity-dependent (p = 0.402) but when perturbation conditions were combined, cBRS was elevated compared to Baseline (p = 0.046). The stability of baseline cBRS was excellent (ICC = 0.896) between quiet standing conditions. In summary, HR, but not SBP or cBRS were intensity-specific during postural perturbations. This was the first study to examine cardiovascular response and cBRS to postural perturbations.