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Cureus Apr 2024Background While the effects of exercise on the cardiovascular system are well documented, ultra-endurance sports involve distances beyond the scope of traditional...
Background While the effects of exercise on the cardiovascular system are well documented, ultra-endurance sports involve distances beyond the scope of traditional marathons and have grown in popularity at a staggering pace in recent years. While short-term high-intensity exercise stimulates sympathetic rises in heart rate (HR) and blood pressure (BP), the depletion of fluid and electrolyte reserves characteristic of ultra-endurance sports may contribute to decreases in overall BP after the race. If decompensation of the autonomic safety net occurs, orthostatic hypotension as a result of fluid loss during an event may cause fatigue, dizziness, syncope, or collapse. Methodology Subjects were recruited by emails sent to race participants and at pre-race meetings, and no participants were excluded from the study. We observed BP and HR changes in subjects before and after ultramarathon activity in both supine and standing positions over multiple races of variant length and terrain from 50 to 240 km from 2013 to 2018. Participants entered races in Florida, with a mean age of 43.8 and an average body mass index (BMI) of 21.2. In addition to pre-race and post-race measurements, positional post-race BPs and HRs were analyzed for orthostatic trends. Results Of those who participated, 140 completed the events and post-race HR and BP measurements were recorded. The mean systolic blood pressure (SBP) increase from pre-race to post-race standing was 21 mmHg, while the mean diastolic blood pressure (DBP) rise was 13 mmHg. While in a supine position, there was a 15 mmHg increase in SBP from pre-race to post-race, along with a 7 mmHg rise in diastolic pressure. Post-race supine to standing average BP change was insignificant. In the supine position, the mean HR increased by 20 beats per minute (bpm) after the race and by 27 bpm while standing. After the race, the average increase in HR supine to standing was 15 bpm. Conclusions The SBP changed much more notably than diastolic pressures likely due to the increase in stroke volume associated with the sympathetic response during exercise. HR values also climbed as a result of exercise stress in the setting of catecholamine release, and the combined influence contributed to increased cardiac output despite water and electrolyte loss during the event. Post-race, no trends of orthostatic hypotension were noted either with HR or BP when rising from a supine position. The significance of the contribution of fluid intake during the race to compensatory mechanisms under neural control requires further study.
PubMed: 38800277
DOI: 10.7759/cureus.58923 -
European Journal of Obstetrics,... May 2024Maternal mortality data and review are important indicators of the effectiveness of maternity healthcare systems and an impetus for action. Recently, a rising incidence...
Maternal mortality data and review are important indicators of the effectiveness of maternity healthcare systems and an impetus for action. Recently, a rising incidence of maternal mortality in high income countries has been reported. Various publications have raised concern about data collection methods at country level, as this usually relies mainly on national vital statistics. It is therefore essential that the collected data are complete and accurate and conform to international definitions and disease classification. Accurate data and review can only be truly available when an Enhanced Obstetric Surveillance System is in place. EBCOG calls for action by national societies to work closely with their respective ministries of health to ensure that high quality surveillance systems are in place.
PubMed: 38797618
DOI: 10.1016/j.ejogrb.2024.05.022 -
Sensors (Basel, Switzerland) May 2024This study examined the efficacy of an optimized DeepLabCut (DLC) model in motion capture, with a particular focus on the sit-to-stand (STS) movement, which is crucial...
This study examined the efficacy of an optimized DeepLabCut (DLC) model in motion capture, with a particular focus on the sit-to-stand (STS) movement, which is crucial for assessing the functional capacity in elderly and postoperative patients. This research uniquely compared the performance of this optimized DLC model, which was trained using 'filtered' estimates from the widely used OpenPose (OP) model, thereby emphasizing computational effectiveness, motion-tracking precision, and enhanced stability in data capture. Utilizing a combination of smartphone-captured videos and specifically curated datasets, our methodological approach included data preparation, keypoint annotation, and extensive model training, with an emphasis on the flow of the optimized model. The findings demonstrate the superiority of the optimized DLC model in various aspects. It exhibited not only higher computational efficiency, with reduced processing times, but also greater precision and consistency in motion tracking thanks to the stability brought about by the meticulous selection of the OP data. This precision is vital for developing accurate biomechanical models for clinical interventions. Moreover, this study revealed that the optimized DLC maintained higher average confidence levels across datasets, indicating more reliable and accurate detection capabilities compared with standalone OP. The clinical relevance of these findings is profound. The optimized DLC model's efficiency and enhanced point estimation stability make it an invaluable tool in rehabilitation monitoring and patient assessments, potentially streamlining clinical workflows. This study suggests future research directions, including integrating the optimized DLC model with virtual reality environments for enhanced patient engagement and leveraging its improved data quality for predictive analytics in healthcare. Overall, the optimized DLC model emerged as a transformative tool for biomechanical analysis and physical rehabilitation, promising to enhance the quality of patient care and healthcare delivery efficiency.
Topics: Humans; Neural Networks, Computer; Movement; Biomechanical Phenomena; Male; Female; Smartphone; Adult; Sitting Position; Standing Position; Motion Capture
PubMed: 38793876
DOI: 10.3390/s24103022 -
Sensors (Basel, Switzerland) May 2024Measuring postural control in an upright standing position is the standard method. However, this diagnostic method has floor or ceiling effects and its implementation is...
A Statistical and AI Analysis of the Frequency Spectrum in the Measurement of the Center of Pressure Track in the Seated Position in Healthy Subjects and Subjects with Low Back Pain.
Measuring postural control in an upright standing position is the standard method. However, this diagnostic method has floor or ceiling effects and its implementation is only possible to a limited extent. Assessing postural control directly on the trunk in a sitting position and consideration of the results in the spectrum in conjunction with an AI-supported evaluation could represent an alternative diagnostic method quantifying neuromuscular control. In a prospective cross-sectional study, 188 subjects aged between 18 and 60 years were recruited and divided into two groups: "LowBackPain" vs. "Healthy". Subsequently, measurements of postural control in a seated position were carried out for 60 s using a modified balance board. A spectrum per trail was calculated using the measured CoP tracks in the range from 0.01 to 10 Hz. Various algorithms for data classification and prediction of these classes were tested for the parameter combination with the highest proven static influence on the parameter pain. The best results were found in a frequency spectrum of 0.001 Hz and greater than 1 Hz. After transforming the track from the time domain to the image domain for representation as power density, the influence of pain was highly significant (effect size 0.9). The link between pain and gender ( = 0.015) and pain and height ( = 0.012) also demonstrated significant results. The assessment of postural control in a seated position allows differentiation between "LowBackPain" and "Healthy" subjects. Using the AI algorithm of neural networks, the data set can be correctly differentiated into "LowBackPain" and "Healthy" with a probability of 81%.
Topics: Humans; Male; Adult; Female; Sitting Position; Low Back Pain; Middle Aged; Young Adult; Algorithms; Postural Balance; Adolescent; Cross-Sectional Studies; Pressure; Prospective Studies; Artificial Intelligence; Healthy Volunteers; Posture
PubMed: 38793865
DOI: 10.3390/s24103011 -
Journal of Clinical Medicine May 2024: The relationship between heart rate and heart rate variability (HRV) indices has been repeatedly studied in adults but limited data are available on the relationship...
: The relationship between heart rate and heart rate variability (HRV) indices has been repeatedly studied in adults but limited data are available on the relationship in paediatric populations. : Continuous 12-lead electrocardiograms were recorded in 1016 healthy children and adolescents (534 females) aged 4 to 19 years during postural manoeuvres with rapid changes between 10-min positions of supine → sitting → standing → supine → standing → sitting → supine. In each position, the averaged RR interval was measured together with four HRV indices, namely the SDNN, RMSSD, quasi-normalised high-frequency components (qnHF), and the proportions of low- and high-frequency components (LF/HF). In each subject, the slope of the linear regression between the repeated HRV measurements and the corresponding RR interval averages was calculated. : The intra-subject regression slopes, including their confidence intervals, were related to the age and sex of the subjects. The SDNN/RR, RMSSD/RR, and qnHF/RR slopes were significantly steeper ( < 0.001) and the (LF/HF)/RR slopes were significantly shallower ( < 0.001) in younger children compared to older children and adolescents. : The study suggests that sympathetic and vagal influences on heart rate are present in both younger and older children. With advancing age, the sympatho-vagal balance gradually develops and allows the vagal control to suppress the sympathetic drive towards higher heart rates seen in younger age children.
PubMed: 38792438
DOI: 10.3390/jcm13102897 -
Journal of Clinical Medicine May 2024QRS fragmentation has not been linked with increased mortality in individuals without known cardiac disease. We aimed to investigate the physiological determinants of...
QRS fragmentation has not been linked with increased mortality in individuals without known cardiac disease. We aimed to investigate the physiological determinants of QRS fragmentation in individuals without cardiac disease. Study participants were 163 (54 athletes, 109 nonathletes) asymptomatic individuals with QRS fragmentation but without cardiac disease. QRS fragmentation was assessed in the supine position after deep inspiration or standing up and during exercise. The changes in QRS fragmentation were evaluated over a median follow-up period of 2.3 (0.8-4.9) years. The most common lead with QRS fragmentation was III (63.0% in athletes, 61.5% in nonathletes), immediately followed by V1 (50.0%) and aVF (42.6%) in athletes and aVF (55.0%) in nonathletes. QRS fragmentation in V1 was more frequent in athletes compared to nonathletes ( < 0.001). Among athletes, the presence of QRS fragmentation in V1 could be independently predicted by increased RVOTproxi (right ventricular outflow tract proximal diameter indexed to body surface area) ( < 0.001). Among individuals with QRS fragmentation in V1, deep inspiration resulted in disappearance of QRS fragmentation more frequently in nonathletes compared to athletes (100% vs. 20%, = 0.003). Deep inspiration resulted in disappearance of QRS fragmentation in aVF ( < 0.001). The presence of QRS fragmentation in II or aVF was associated with increased body mass index (BMI) ( = 0.003). Among athletes without QRS fragmentation in V1 at baseline, the appearance of QRS fragmentation in V1 at the end of follow-up was associated with greater training age ( = 0.034). Among individuals with QRS fragmentation in aVF at baseline, the disappearance of QRS fragmentation in aVF at the end of follow-up was associated with greater reduction in BMI ( = 0.008). The characteristic feature of QRS fragmentation in athletes was the presence of QRS fragmentation in V1, which was associated with RVOTproxi. The persistence of QRS fragmentation in V1 after deep inspiration could serve as a specific marker of exercise-training-related cardiac adaptation. The presence of QRS fragmentation in the leads of the frontal plane was influenced by BMI and respiration phase.
PubMed: 38792283
DOI: 10.3390/jcm13102741 -
Scientific Reports May 2024Heart rate is under constant autonomic influence but the development of the influence in children is not fully understood. Continuous electrocardiograms were obtained in...
Heart rate is under constant autonomic influence but the development of the influence in children is not fully understood. Continuous electrocardiograms were obtained in 1045 healthy school-age children (550 females) during postural provocations with body position changes between supine, sitting, standing, supine, standing, sitting and supine (in this order), 10 min in each position with position changes within 20 s. Heart rate was measured in each position and speed of heart rate changes between positions were assessed by regressions of rates versus timing of individual cardiac cycles. Supine heart rate was gradually decreasing with age: 82.32 ± 9.92, 74.33 ± 9.79, 67.43 ± 9.45 beats per minute (bpm) in tertile age groups < 11, 11-15, > 15 years, respectively (p < 0.0001), with no significant sex difference. Averaged speed of heart rate changes differed little between sexes and age groups but was significantly faster during rate deceleration than acceleration (e.g., supine ↔ standing: 2.99 ± 1.02 vs. 2.57 ± 0.68 bpm/s, p < 0.0001). The study suggests that in children, vagal heart rate control does not noticeably change between ages of approximately 6-19 years. The gradual resting heart rate decrease during childhood and adolescence is likely caused by lowering of cardiac sympathetic influence from sympathetic overdrive in small children to adult-like sympatho-vagal balance in older adolescents.
Topics: Humans; Heart Rate; Female; Child; Male; Adolescent; Electrocardiography; Posture; Autonomic Nervous System; Supine Position; Vagus Nerve
PubMed: 38789480
DOI: 10.1038/s41598-024-62000-7 -
Journal of Foot and Ankle Research Jun 2024Patellofemoral pain (PFP) is characterized by chronic pain in the anterior aspect of the knee during loading activities. Many studies investigating muscle morphology...
BACKGROUND
Patellofemoral pain (PFP) is characterized by chronic pain in the anterior aspect of the knee during loading activities. Many studies investigating muscle morphology changes for individuals with PFP focus on the proximal joints, however, few studies have investigated muscles of the foot and ankle complex. This study aimed to explore the differences in peroneal muscle size and activation between individuals with PFP and healthy controls using ultrasound imaging in weight-bearing.
METHODS
A case-control study in a university lab setting was conducted. Thirty individuals with PFP (age: 20.23 ± 3.30 years, mass: 74.70 ± 27.63 kgs, height: 161.32 ± 11.72 cm) and 30 healthy individuals (age: 20.33 ± 3.37 years, mass: 64.02 ± 11.00 kgs, height: 169.31 ± 9.30 cm) participated. Cross-sectional area (CSA) images of the peroneal muscles were taken in non-weight bearing and weight-bearing positions. The functional activation ratio from lying to single-leg standing (SLS) was calculated.
RESULTS
There was a statistically significant (p = 0.041) group (PFP, healthy) by position (non-weight-bearing, weight-bearing) interaction for the peroneal muscle CSA with a Cohen's d effect size of 0.2 in non-weight-bearing position and 0.7 in weight-bearing position. The functional activation ratio for the healthy group was significantly more (p = 0.01) than the PFP group.
CONCLUSION
Peroneal muscles were found to be smaller in size in those with PFP compared to the healthy subjects in the weight-bearing SLS position. This study found that those with PFP have lower activation of peroneal muscles in functional position.
Topics: Humans; Weight-Bearing; Case-Control Studies; Male; Female; Muscle, Skeletal; Young Adult; Patellofemoral Pain Syndrome; Ultrasonography; Adult; Adolescent; Foot; Posture
PubMed: 38773711
DOI: 10.1002/jfa2.12014 -
Fluids and Barriers of the CNS May 2024Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP... (Observational Study)
Observational Study
OBJECTIVE
Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP and intracranial pressure pulse wave amplitude (PWA) values in healthy individuals poses ethical challenges, and thus the current documentation remains scarce. This study explores ICP and PWA values for healthy adults without intracranial pathology expected to influence ICP.
METHODS
Adult patients (age > 18 years) undergoing surgery for an unruptured intracranial aneurysm without any other neurological co-morbidities were included. Patients had a telemetric ICP sensor inserted, and ICP was measured in four different positions: supine, lateral recumbent, standing upright, and 45-degree sitting, at day 1, 14, 30, and 90 following the surgery.
RESULTS
ICP in each position did not change with time after surgery. Median ICP was 6.7 mmHg and median PWA 2.1 mmHg in the supine position, while in the upright standing position median ICP was - 3.4 mmHg and median PWA was 1.9 mmHg. After standardization of the measurements from the transducer site to the external acoustic meatus, the median ICP was 8.3 mmHg in the supine position and 1.2 mmHg in the upright standing position.
CONCLUSION
Our study provides insights into normal ICP dynamics in healthy adults following a uncomplicated surgery for an unruptured aneurysm. These results suggest a slightly wider normal reference range for invasive intracranial pressure than previously suggested, and present the first normal values for PWA in different positions. Further studies are, however, essential to enhance our understanding of normal ICP. Trial registration The study was preregistered at www.
CLINICALTRIALS
gov (NCT03594136) (11 July 2018).
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Intracranial Aneurysm; Intracranial Pressure; Neurosurgical Procedures; Posture; Pulse Wave Analysis; Prospective Studies
PubMed: 38773608
DOI: 10.1186/s12987-024-00549-1 -
Journal of Bodywork and Movement... Apr 2024This study evaluated the activities of the Rectus Abdominis (RA) and Transversus Abdominis (TrA) muscles during abdominal bracing exercises (ABE) in different body...
AIMS
This study evaluated the activities of the Rectus Abdominis (RA) and Transversus Abdominis (TrA) muscles during abdominal bracing exercises (ABE) in different body positions.
METHODOLOGY
Electrical activities of both components of the RA and TrA muscles were assessed respectively in 25 obese females via surface electromyography during ABE in four (4) different body positions (crook lying, side lying, standing, and sitting). Each trial lasted for five (5) seconds with an hour rest period between trials.
RESULTS
Electrical activities of each of the right RA (p = 0.008) and TrA (p = 0.001) muscles significantly varied across the four trials. For the left components of the RA (p = 0.243) and TrA (p = 0.332) muscles, no significant differences were observed across trials. The highest muscular activities were recorded during the standing trial while the crook lying position resulted in the least muscular activities.
CONCLUSION
For the best results, abdominal bracing exercises should be performed in a standing position. The efficacy of adopting these body positions for long-term rehabilitation purposes should be investigated in future studies.
Topics: Humans; Female; Electromyography; Abdominal Muscles; Adult; Obesity; Posture; Young Adult; Rectus Abdominis; Exercise Therapy
PubMed: 38763559
DOI: 10.1016/j.jbmt.2024.01.008