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Proposal intensity adequacy of expiratory effort and heart rate behavior during the valsalva maneuver in preadolescents.

Paschoal MA, Donato Bde S, Neves FB - Arq. Bras. Cardiol. (2014)

Bottom Line: These procedures were repeated 30 days later, and the data collected in the sessions (E1, E2) were analyzed and compared in periods before, during (0-10 and 10-20 s), and after VM using nonparametric tests.The HR delta measured during 0-10 s and 10-20 s significantly increased as the expiratory effort increased, indicating an effective cardiac autonomic response during VM.Therefore, 60% of MEP may be the optimal expiratory resistance that should be used in clinical practice.

View Article: PubMed Central - PubMed

ABSTRACT

Background: When performing the Valsalva maneuver (VM), adults and preadolescents produce the same expiratory resistance values.

Objective: To analyze heart rate (HR) in preadolescents performing VM, and propose a new method for selecting expiratory resistance.

Method: The maximal expiratory pressure (MEP) was measured in 45 sedentary children aged 9-12 years who subsequently performed VM for 20 s using an expiratory pressure of 60%, 70%, or 80% of MEP. HR was measured before, during, and after VM. These procedures were repeated 30 days later, and the data collected in the sessions (E1, E2) were analyzed and compared in periods before, during (0-10 and 10-20 s), and after VM using nonparametric tests.

Results: All 45 participants adequately performed VM in E1 and E2 at 60% of MEP. However, only 38 (84.4%) and 25 (55.5%) of the participants performed the maneuver at 70% and 80% of MEP, respectively. The HR delta measured during 0-10 s and 10-20 s significantly increased as the expiratory effort increased, indicating an effective cardiac autonomic response during VM. However, our findings suggest the VM should not be performed at these intensities.

Conclusion: HR increased with all effort intensities tested during VM. However, 60% of MEP was the only level of expiratory resistance that all participants could use to perform VM. Therefore, 60% of MEP may be the optimal expiratory resistance that should be used in clinical practice.

Show MeSH
Overall medians of heart rate deltas (0–10 s and 10–20 s) recorded duringthe Valsalva maneuver performed with expiratory resistances of 60% (n =45), 70% (n = 38), and 80% (n = 25) of MEP. Data collected during thetwo moments were compared (E1 and E2). E1 is the first evaluation,whereas E2 is the second evaluation. There was a significant difference(p < 0.05) between HR values in the three situations (60%, 70%, and80% of MEP), however, there was no difference between moments E1 and E2regarding each employed intensity.
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f03: Overall medians of heart rate deltas (0–10 s and 10–20 s) recorded duringthe Valsalva maneuver performed with expiratory resistances of 60% (n =45), 70% (n = 38), and 80% (n = 25) of MEP. Data collected during thetwo moments were compared (E1 and E2). E1 is the first evaluation,whereas E2 is the second evaluation. There was a significant difference(p < 0.05) between HR values in the three situations (60%, 70%, and80% of MEP), however, there was no difference between moments E1 and E2regarding each employed intensity.

Mentions: Likewise, values for total delta (0-10 s and 10-20 s) were compared to determineHR increases between the beginning and end of the 20-s periods in stages E1 andE2, and with the same of expiratory effort intensities (Figure 3).


Proposal intensity adequacy of expiratory effort and heart rate behavior during the valsalva maneuver in preadolescents.

Paschoal MA, Donato Bde S, Neves FB - Arq. Bras. Cardiol. (2014)

Overall medians of heart rate deltas (0–10 s and 10–20 s) recorded duringthe Valsalva maneuver performed with expiratory resistances of 60% (n =45), 70% (n = 38), and 80% (n = 25) of MEP. Data collected during thetwo moments were compared (E1 and E2). E1 is the first evaluation,whereas E2 is the second evaluation. There was a significant difference(p < 0.05) between HR values in the three situations (60%, 70%, and80% of MEP), however, there was no difference between moments E1 and E2regarding each employed intensity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150666&req=5

f03: Overall medians of heart rate deltas (0–10 s and 10–20 s) recorded duringthe Valsalva maneuver performed with expiratory resistances of 60% (n =45), 70% (n = 38), and 80% (n = 25) of MEP. Data collected during thetwo moments were compared (E1 and E2). E1 is the first evaluation,whereas E2 is the second evaluation. There was a significant difference(p < 0.05) between HR values in the three situations (60%, 70%, and80% of MEP), however, there was no difference between moments E1 and E2regarding each employed intensity.
Mentions: Likewise, values for total delta (0-10 s and 10-20 s) were compared to determineHR increases between the beginning and end of the 20-s periods in stages E1 andE2, and with the same of expiratory effort intensities (Figure 3).

Bottom Line: These procedures were repeated 30 days later, and the data collected in the sessions (E1, E2) were analyzed and compared in periods before, during (0-10 and 10-20 s), and after VM using nonparametric tests.The HR delta measured during 0-10 s and 10-20 s significantly increased as the expiratory effort increased, indicating an effective cardiac autonomic response during VM.Therefore, 60% of MEP may be the optimal expiratory resistance that should be used in clinical practice.

View Article: PubMed Central - PubMed

ABSTRACT

Background: When performing the Valsalva maneuver (VM), adults and preadolescents produce the same expiratory resistance values.

Objective: To analyze heart rate (HR) in preadolescents performing VM, and propose a new method for selecting expiratory resistance.

Method: The maximal expiratory pressure (MEP) was measured in 45 sedentary children aged 9-12 years who subsequently performed VM for 20 s using an expiratory pressure of 60%, 70%, or 80% of MEP. HR was measured before, during, and after VM. These procedures were repeated 30 days later, and the data collected in the sessions (E1, E2) were analyzed and compared in periods before, during (0-10 and 10-20 s), and after VM using nonparametric tests.

Results: All 45 participants adequately performed VM in E1 and E2 at 60% of MEP. However, only 38 (84.4%) and 25 (55.5%) of the participants performed the maneuver at 70% and 80% of MEP, respectively. The HR delta measured during 0-10 s and 10-20 s significantly increased as the expiratory effort increased, indicating an effective cardiac autonomic response during VM. However, our findings suggest the VM should not be performed at these intensities.

Conclusion: HR increased with all effort intensities tested during VM. However, 60% of MEP was the only level of expiratory resistance that all participants could use to perform VM. Therefore, 60% of MEP may be the optimal expiratory resistance that should be used in clinical practice.

Show MeSH