Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 19:13:902903.
doi: 10.3389/fphys.2022.902903. eCollection 2022.

Acute effects of mixed circuit training on hemodynamic and cardiac autonomic control in chronic hemiparetic stroke patients: A randomized controlled crossover trial

Guilherme F Fonseca  1 , Adrian W Midgley  2 , Sandra A Billinger  3   4 , André C Michalski  1 , Victor A B Costa  1 , Walace Monteiro  1 , Paulo Farinatti  1 , Felipe A Cunha  1
Affiliations

Acute effects of mixed circuit training on hemodynamic and cardiac autonomic control in chronic hemiparetic stroke patients: A randomized controlled crossover trial

Guilherme F Fonseca et al. Front Physiol. .

Abstract

Objectives: To investigate whether a single bout of mixed circuit training (MCT) can elicit acute blood pressure (BP) reduction in chronic hemiparetic stroke patients, a phenomenon also known as post-exercise hypotension (PEH). Methods: Seven participants (58 ± 12 years) performed a non-exercise control session (CTL) and a single bout of MCT on separate days and in a randomized counterbalanced order. The MCT included 10 exercises with 3 sets of 15-repetition maximum per exercise, with each set interspersed with 45 s of walking. Systolic (SBP) and diastolic (DBP) blood pressure, mean arterial pressure (MAP), cardiac output (Q), systemic vascular resistance (SVR), baroreflex sensitivity (BRS), and heart rate variability (HRV) were assessed 10 min before and 40 min after CTL and MCT. BP and HRV were also measured during an ambulatory 24-h recovery period. Results: Compared to CTL, SBP (∆-22%), DBP (∆-28%), SVR (∆-43%), BRS (∆-63%), and parasympathetic activity (HF; high-frequency component: ∆-63%) were reduced during 40 min post-MCT (p < 0.05), while Q (∆35%), sympathetic activity (LF; low-frequency component: ∆139%) and sympathovagal balance (LF:HF ratio: ∆145%) were higher (p < 0.001). In the first 10 h of ambulatory assessment, SBP (∆-7%), MAP (∆-6%), and HF (∆-26%) remained lowered, and LF (∆11%) and LF:HF ratio (∆13%) remained elevated post-MCT vs. CTL (p < 0.05). Conclusion: A single bout of MCT elicited prolonged PEH in chronic hemiparetic stroke patients. This occurred concurrently with increased sympathovagal balance and lowered SVR, suggesting vasodilation capacity is a major determinant of PEH in these patients. This clinical trial was registered in the Brazilian Clinical Trials Registry (RBR-5dn5zd), available at https://ensaiosclinicos.gov.br/rg/RBR-5dn5zd. Clinical Trial Registration: https://ensaiosclinicos.gov.br/rg/RBR-5dn5zd, identifier RBR-5dn5zd.

Keywords: autonomic nervous system; blood pressure; circuit-based exercise; exercise; rehabilitation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart for the study. MCT, mixed circuit training; CTL, non-exercise control session.
FIGURE 2
FIGURE 2
Overview of the study design. CTL, non-exercise control session; MCT, mixed circuit training.
FIGURE 3
FIGURE 3
Mean ± SD AUCs for SBP (A), DBP (B), and MAP (C) during the first 40 min after the experimental trials. AUC, area under the curve; MCT, mixed circuit training; CTL, non-exercise control session; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure. *, Significant difference between CTL vs. MCT (p < 0.05).
FIGURE 4
FIGURE 4
Mean ± SD AUCs for HR (A), SV (B), Q (C), and SVR (D) during the first 40 min after the experimental trials. AUC, area under the curve; MCT, mixed circuit training; CTL, non-exercise control session; HR, heart rate; SV, stroke volume; Q, cardiac output; SVR, systemic vascular resistance. *, Significant difference between CTL vs. MCT (p < 0.05).
FIGURE 5
FIGURE 5
Mean ± SD AUCs for LF (A), HF (B), InLF:HF ratio (C), and BRS (D) during the first 40 min after the experimental trials. AUC, area under the curve; MCT, mixed circuit training; CTL, non-exercise control session; LF, low-frequency component; HF, high-frequency component; InLF:HF ratio, logarithmically transformed sympathovagal balance; BRS, baroreflex sensitivity. *, Significant difference between CTL vs. MCT (p < 0.001).
See this image and copyright information in PMC

References

    1. ACSM (2013). ACSM's guidelines for exercise testing and prescription. Baltimore: Lippincott Williams & Wilkins.
    1. Anunciação P. G., Farinatti P. T., Goessler K. F., Casonatto J., Polito M. D. (2016). Blood pressure and autonomic responses following isolated and combined aerobic and resistance exercise in hypertensive older women. Clin. Exp. Hypertens. 38 (8), 710–714. 10.1080/10641963.2016.1200601 - DOI - PubMed
    1. Berg K., Wood-Dauphinee S., Williams J. (1995). The balance scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand. J. Rehabil. Med. 27 (1), 27–36. - PubMed
    1. Billinger S. A., Arena R., Bernhardt J., Eng J. J., Franklin B. A., Johnson C. M., et al. (2014). Physical activity and exercise recommendations for stroke survivors: A statement for healthcare professionals from the American heart association/American stroke association. Stroke 45 (8), 2532–2553. 10.1161/STR.0000000000000022 - DOI - PubMed
    1. Brito L. C., Queiroz A. C., Forjaz C. L. (2014). Influence of population and exercise protocol characteristics on hemodynamic determinants of post-aerobic exercise hypotension. Braz J. Med. Biol. Res. 47 (8), 626–636. 10.1590/1414-431x20143832 - DOI - PMC - PubMed