2020-2021
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Browsing 2020-2021 by Author "Marshall, Erica M."
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Item Cold Water Facial Immersion to Reduce Orthostatic Intolerance(Florida Southern College, 2021-03-29) Rodriguez, Rebecca; Marshall, Erica M.During standing, passive effects of gravity result in venous pooling in the lower extremities. In healthy individuals, these effects are largely offset by actions of the baroreflex and subsequent sympathetic induced vasoconstriction. However, in those who experience orthostatic intolerance (OI), this response may be attenuated and lead to reductions in blood pressure (BP) and presyncope. Interestingly, highly trained aerobic athletes may be at risk of developing OI due to training induced reductions in sensitivity of the baroreflex. Interventions are necessary to mitigate symptoms of OI, but not interfere with exercise training in this population. In the literature, cold-water facial immersion is one intervention that may combat this paradox. Specifically, facial immersion in 0°C cold water, or an ice pack applied to the forehead and cheeks has been shown to increase vasoconstriction in the lower extremities, thus preventing large reductions in BP and symptoms of OI. Collectively, exercise professionals may use cold water facial immersion or ice pack application as part of the exercise prescription for highly trained aerobic individuals who experienced OI.Item Using the Head Up Tilt Test to Diagnose Orthostatic Intolerance(Florida Southern College, 2021-04-29) Rincon Garcia, Daniela; Marshall, Erica M.Approximately 500,000 individuals have orthostatic intolerance (OI). OI is defined as a reduction in systolic blood pressure (SBP), or diastolic blood pressure (DBP) by at least 20 and 10 mmHg, respectively within three minutes of standing. During standing, reductions in vasoconstriction contribute to venous pooling and then fainting. OI is a primary symptom in postural orthostatic tachycardia syndrome (POTS). In addition to OI, persons with POTS have reduced exercise capacity. POTS can be diagnosed using various autonomic tests, such as the head up tilt (HUT). The HUT is comprised of a 15-30 min rest in the supine position on a tilt table, followed by tilt to 60 degrees for 30-45 min. During this time, HR, SBP, DBP, and electrocardiogram measures are assessed. Collectively, diagnosis is crucial in order to improve symptoms, exercise tolerance and quality of life. Following diagnosis, appropriate interventions can be made. According to the literature, one of the most effective interventions for improving POTS is a progressive exercise program, which has been reported to be superior to use of pharmacologic agents. In summary, this presentation seeks to address OI in POTS patients, explore a modality for its’ diagnoses, and report exercise interventions to improve POTS.Item Using the Isometric Handgrip to Diagnose and Treat Future Hypertension(Florida Southern College, 2021-04-29) Eidenschink, Emily; Marshall, Erica M.Hypertension (HTN) is defined as a systolic blood pressure (SBP) ≥130mmHg and/or a diastolic blood pressure (DBP) ≥ 80mmHg. HTN is a known risk factor of cardiovascular disease (CVD), which is the leading cause of death in Americans. According to the American College of Sports Medicine, HTN may be predictable and is associated with an exaggerated blood pressure (BP) response. The isometric hand grip (IHG) test can be used to assess BP reactivity. During the IHG test, the subject performs a 30% maximal voluntary isometric contraction of the forearm muscles with a hand grip dynamometer for two minutes. BP reactivity is calculated as the difference between the highest BP during the IHG test and BP at rest. Although a universal standard is not defined, generally a rise in BP ≥ 22 mmHg is abnormal and the individual is considered a hyperreactor. Thus, the IHG test may be used to identify those at risk for developing HTN. In the literature, exercise training using the IHG has been demonstrated as an intervention to improve BP reactivity on the IHG test. In summary, the IHG is multipurpose tool that can be used by exercise professionals for potential diagnoses and treatment of future HTN.Item Using the Post-exercise Muscle Ischemia Test to Predict Hypertension(Florida Southern College, 2021-04-29) Diamond, Ryan; Marshall, Erica M.Hypertension increases risk cardiovascular disease and mortality and is defined as a systolic blood pressure (SBP) ≥ 130mmHg and/or a diastolic blood pressure (DBP) ≥ 80mmHg. Early detection and prevention are essential. The American College of Sports Medicine suggests that hypertension may be predicted by an exaggerated blood pressure (BP) response. Further, this abnormal BP response may be mediated by a heightened metaboreflex. The post-exercise muscle ischemia (PEMI) test can be used to assess BP reactivity due to actions of the metaboreflex. During the PEMI test, the subject performs two minutes of isometric hand grip exercise. Then, in the final seconds of exercise a BP cuff on the upper arm is inflated to suprastolic levels for three minutes. BP reactivity is calculated as the difference between the highest and lowest BP during the test and rest. If the individual has an increase in BP ≥ 22 mmHg they are considered a hyperreactor. Therefore, the PEMI test may be used by exercise and health professionals to identify hyperreactors, or those at risk for developing hypertension. Following this test, an intervention can then be initiated, such as exercise training, to improve BP reactivity and hypertensive risk.