The response to stress is hypertensive. Functional shifts under constant power loads. Types of response to physical activity
The dystonic type of reaction, as a rule, occurs after loads aimed at developing endurance, and is characterized by the fact that diastolic blood pressure can be heard to 0 (the “infinite tone” phenomenon).
When diastolic blood pressure returns to initial values in the 1-3 minutes of recovery, this type of reaction is regarded as a variant of the norm; if the “infinite tone phenomenon” persists for a longer time - as an unfavorable sign.
The hypertensive type of reaction is characterized by:
- inadequate increase in heart rate to the load;
- inadequate load increase in systolic blood pressure to 190-200 mm Hg. Art. (at the same time, diastolic pressure also increases slightly);
- slow recovery of both indicators.
The hypertensive type of reaction indicates a violation of regulatory mechanisms, causing a decrease in the efficiency of the functioning of the heart. It is observed in chronic overstrain of the central nervous system (neurocirculatory dystonia of the hypertensive type), chronic overstrain of the cardiovascular system (hypertensive variant), in pre- and hypertensive patients.
A reaction with a stepwise increase in maximum blood pressure is characterized by:
- a sharp increase in heart rate;
- an increase in systolic blood pressure that continues during the first 2-3 minutes of rest;
- slow recovery of heart rate and blood pressure.
This type of reaction is unfavorable. It reflects the inertia of regulatory systems and is recorded, as a rule, after high-speed loads.
The hypotonic type of reaction is characterized by:
- a sharp increase in heart rate inadequate to the load;
- absence of significant changes in blood pressure;
- slow recovery of heart rate.
The hypotonic type of reaction is the most unfavorable.
Flack straining test.
The subject is asked to take a deep breath, followed by imitation of exhalation to maintain a pressure in the manometer of 40 mmHg. Art. While straining “to failure”, the pulse is recorded at intervals of 5. The total time during which the subject is able to complete the test is also recorded.
Evaluation principles:
- excellent response - heart rate increases by 1-2 beats every 5 seconds in relation to the initial data. The duration of straining is 45-55 s. The increase in heart rate compared to the initial data continues for about a minute, then the heart rate stabilizes;
- good reaction - pulse acceleration is 3-4 beats in 5 s;
- satisfactory reaction - pulse acceleration is 5-7 beats in 5 s;
- unsatisfactory reaction - an even higher increase in heart rate. Satisfactory and unsatisfactory reactions to the test indicate changes in the regulation of cardiac activity.
Burger's straining test.
At rest, the subject's blood pressure is measured. Then he is asked to take 10 deep breaths in 20 seconds, at the end of which another blood pressure measurement is taken. After the 10th inhalation, the subject exhales into the mouthpiece, increasing the pressure in the manometer to 40-60 mmHg. Art., and maintains the range of this pressure for 20 s. Blood pressure is measured at the beginning of straining and after it ends. Evaluation principles:
- the normal type of reaction is that the maximum blood pressure remains almost unchanged throughout the entire period of straining;
- second type of reaction: blood pressure increases during straining and returns to the original values 20-30 s after its cessation;
- the third type of reaction (negative reaction to the test) is expressed in a significant drop in blood pressure during straining, which indicates a violation of the regulation of vascular tone, which can lead to a short-term loss of consciousness.
The assessment of the electrocardiogram during routine monitoring of athletes (12-16 hours after training or after a day of rest) is carried out primarily from the position of excluding a possible dystrophic variant of chronic physical overstrain of the heart.
T wave changes play a major role in diagnosis; segment changes
ST - auxiliary; changes in the U wave are optional.
When performing physical activity, unidirectional changes in blood pressure and pulse normally occur. Blood pressure responds to exercise by increasing maximum pressure as peripheral resistance decreases due to arteriolar dilation, allowing more blood to reach working muscles. Accordingly, pulse pressure increases, which indirectly indicates an increase in the stroke volume of the heart, and the pulse quickens. All these changes return to the original data within 3 to 5 minutes after cessation of exercise, and the faster this happens, the better the function of the cardiovascular system.
The different magnitudes of shifts in hemodynamic parameters and the duration of recovery to the initial values depend not only on the intensity of the functional test used, but also on the physical fitness of the subject.
The response of heart rate and blood pressure to physical activity in athletes can be different.
1 . Normotonic reaction. Well-trained athletes most often have a normotonic type of reaction to the test, which is expressed in the fact that under the influence of each load a pronounced increase in heart rate is noted to varying degrees. The heart rate in the first 10 seconds after the first load reaches approximately 100 beats/min, and after the second and third – 125 - 140 beats/min. With this type of reaction to all types of loads, systolic pressure increases and diastolic pressure decreases. These changes in response to 20 squats are small, but to a 15-second and 3-minute run they are quite pronounced. An important criterion for a normotonic reaction is the rapid restoration of pulse and blood pressure to resting levels: after the first load - on the 2nd minute, after the 2nd load - on the 3rd minute, after the 3rd load - on the 4th minute of the recovery period . Slow recovery of the above indicators may indicate insufficient training.
In addition to normotonic, there are four more types of reactions: hypotonic, hypertonic, reaction with a stepwise increase in systolic pressure and dystonic. These types of reactions are considered atypical.
2. Hypotonic reaction characterized by a significant increase in heart rate (up to 170–190 beats/min at the 2nd and 3rd loads) with a slight increase or even decrease in maximum pressure; the minimum pressure usually does not change, and, therefore, the pulse pressure, if increased, is insignificant. Recovery time is slow. This reaction indicates that the increase in circulatory function caused by physical activity is provided not by an increase in stroke volume, but by an increase in heart rate. Obviously, changes in heart rate do not correspond to changes in pulse pressure. This reaction is observed in athletes after illnesses (in the convalescence phase), in a state of overtraining, overexertion.
3. Hypertensive reaction consists of a significant increase in maximum pressure (up to 180 - 220 mm Hg), pulse rate and a slight increase in minimum pressure. Thus, pulse pressure increases slightly, which should not be regarded as an increase in stroke volume, since this reaction is based on an increase in peripheral resistance, i.e. spasm of arterioles instead of their dilation. Recovery time from this reaction is slower. This type of reaction is observed in people suffering from hypertension or prone to so-called pressor reactions, as a result of which the arterioles narrow instead of dilating. This reaction is often observed in athletes during physical overexertion.
4. Reaction with a stepwise increase in maximum (systolic) pressure manifests itself in a pronounced increase in heart rate, while the maximum pressure measured immediately after physical activity is lower than in the 2nd - 3rd minute of recovery. This reaction is usually observed after high-speed loads at a slow running speed. This reaction reveals the body’s inability to quickly enough provide the redistribution of blood that is required for muscle function. A stepwise reaction is observed in athletes when overworked and is usually accompanied by complaints of pain and heaviness in the legs after physical activity, fatigue, etc. This reaction may be a temporary phenomenon that disappears with appropriate changes in the training regimen.
5. Dystonic reaction characterized by the fact that with a significant increase in heart rate and a significant increase in maximum pressure, the minimum pressure reaches zero, or rather is not determined. This phenomenon is called the “infinite tone phenomenon.” This tone is a consequence of the sound of the walls of blood vessels, the tone of which changes under the influence of any factors. The phenomenon of endless tone is sometimes observed in people who have had an infectious disease when they are overworked.
Normally, this phenomenon occurs in adolescents and young men and less often in middle-aged people. It can be heard in healthy athletes after very hard or prolonged muscular work, as well as during overtraining or after drinking alcohol.
The question of whether this is a physiological tone or a consequence of pathology is decided individually in each specific case. If it persists after a normal functional test for no more than 1–2 minutes, then it can be considered physiological. Longer persistence of an endless tone requires medical supervision of the athlete to identify the causes of its occurrence.
The analysis of the recovery period after performing a functional test is of utmost importance. Without it, it is impossible to assess the functional state of the cardiovascular system. The faster the hemodynamic parameters are restored to their original values, the higher the functional state of the cardiovascular system of the subject. Therefore, in addition to assessing changes in heart rate and blood pressure immediately after physical activity, it is important to consider the duration of the recovery period.
Table 6 shows changes in pulse and blood pressure for different types of reaction of the cardiovascular system to S.P. Letunov’s test.
Table 6 - Changes in pulse and blood pressure with different types of reaction of the cardiovascular system to S.P. Letunov’s test
|
CV reactions |
State of hemodynamic parameters |
|||||
|
BP diast |
Recovery time |
|||||
|
Normotonic type of reaction |
||||||
|
After 1st load |
Increasing |
Rising |
Decreasing |
Rising | ||
|
After the 2nd load |
Increasing |
Rising adequately |
Decreasing |
Rising | ||
|
After the 3rd load |
Increasing |
Rising adequately |
Decreasing |
Rising | ||
|
Atypical types of reactions |
||||||
|
Hypotonic |
Sharply increases by 120-150% |
No significant changes |
No significant changes |
Sharply increased |
||
|
Hypertension- |
Increases sharply |
Increases sharply (up to 200-220) |
Does not change or increases |
Increases sharply (due to rise in blood pressure) |
Sharply increased |
|
|
With step rise |
Increases sharply |
Re-increases for 2-3 minutes |
No significant changes |
Rising (due to the rise in blood pressure) |
Increased |
|
|
Dystonic |
Increases moderately |
Increases moderately |
Reduces to 0 |
Not defined |
Blood pressure is one of the simplest hemodynamic indicators, which are widely used in the study of the cardiovascular system under medical supervision, both at rest and during exercise. Different magnitudes of blood pressure shifts also depend on the degree of preparation of the subject. During a medical examination, the degree of changes in blood pressure in the first minute after exercise is determined as a percentage of the initial value. Blood pressure at rest is taken as 100%, the difference in its values before and after the load is X. By drawing up the proportion, determine by what amount (%) the blood pressure increased. After 20 squats, the maximum blood pressure should not increase by more than 15-30%, and the minimum should decrease by more than than by 10-35%. The blood pressure level clearly reflects the degree of fatigue. Typically, as fatigue increases, blood pressure increases by 20 - 50 mmHg. In acute fatigue after greater physical exertion, the minimum pressure drops to zero (infinite tone phenomenon). In the process of diagnosing fatigue, various tests and tests are carried out. Average blood pressure is one of the important hemodynamic parameters. Mathematical method for calculating average pressure: average BP = BPdiast.+ BPpulse/2. Observations show that with physical fatigue, average blood pressure increases by 10 - 30 mmHg. Based on the nature of blood pressure recovery after short-term intense exercise (running in place for 15 seconds at maximum pace), 5 types of response to exercise are distinguished. The normotonic type of reaction is considered normal, other options are considered atypical. The hypotonic (asthenic) response to exercise consists of a slight increase or decrease in maximum blood pressure with an almost unchanged pulse pressure. This reaction to stress is considered unfavorable. Not only in people suffering from hypertension, but also in athletes with physical overstrain or overwork, a hypertensive reaction to stress is possible. It is characterized by a significant increase in maximum blood pressure (sometimes over 200 mm Hg). A hypertensive reaction also includes an increase in minimum blood pressure over 90 mm Hg. without significantly increasing the maximum. The basis of the hypertensive reaction is an increase in peripheral resistance. The recovery time for this reaction is slow. In older people and athletes, when overworked, the reaction of the cardiovascular system to high-speed load worsens. A stepwise increase in maximum blood pressure occurs due to the body’s inability to quickly enough ensure the redistribution of blood to the working muscles. In healthy athletes after very heavy muscular work, in persons who have had infectious diseases, a dystonic reaction to stress is normally possible in adolescents and young men. With a significant increase in heart rate and maximum pressure (up to 200 mm Hg), the minimum pressure determined by the Korotkoff auditory method reaches zero, that is, the phenomenon of infinite tone is determined. This phenomenon does not reflect the true level of minimum blood pressure, which is actually much higher. This tone is a consequence of the sound of the walls of blood vessels, the amplitude and frequency of vibrations of which changes under the influence of various factors. Hypertensive conditions are more common among athletes (11.07%) than among people who do not engage in sports (9.9%). The development of hypertension can be achieved by various hemodynamic mechanisms. Moreover, in the initial period of the disease, the role of increased CO in increasing blood pressure is more significant, while in later periods the role of peripheral resistance of the vascular network increases. The athlete is subject to a thorough clinical examination to determine whether this increased blood pressure is a manifestation of hyperreactivity of the vasomotor centers or hypertension. When a diagnosis of hypertension is made, sports should be prohibited and recreational physical education should be recommended. In athletes with hypotension due to overwork, initial dysfunction of the vasomotor centers occurs; this hypotension is a prepathological condition and it is necessary to take measures to prevent neurocirculatory hypotension (regulate the working day, reduce or completely remove training loads, increase the duration of night sleep, etc.) Physiological hypotension in athletes is not a manifestation of pathology. The decrease in blood pressure occurs not due to a violation of the contractile function of the myocardium, but due to excessive expansion of the precapillaries. Physiological hypotension is not an obstacle to playing sports. Hypotension that occurs due to overwork requires adequate rest. For patients with hypotension, health-improving physical education classes are recommended. Athletes with physiological hypotension of high fitness are characterized by a slowdown in the speed of blood flow, as a consequence of economization of metabolic processes. When monitoring blood pressure, you should pay attention to the limit values. Distinguish five types of reactions cardiovascular system under load: 1. With a good functional state of the cardiovascular system, normotonic reaction, which is characterized by an increase in heart rate by 30-50%, a clear increase in systolic blood pressure by 10-35 mm Hg. Art. and a slight decrease (by 4-10 mm Hg) in diastolic blood pressure, a recovery period of 2-3 minutes. The noted type of reaction indicates the adequacy of the body to physical activity. In addition to the normotonic reaction, atypical reactions may occur during functional tests. 2. Hypotonic or asthenic. With this reaction, there is a significant increase in heart rate (by more than 130%), a slight increase in systolic blood pressure and a slight decrease in diastolic blood pressure; the reaction is characterized by a slow restoration of pulse and pressure to initial values (up to 5-10 minutes). It is observed in functional diseases of the heart and lungs. In children with low physical fitness, such a reaction can be considered a variant of the norm. 3. Hypertensive reaction. It is characterized by a sharp increase in heart rate (more than 130%), a significant increase in systolic blood pressure (up to 200 mm Hg), and a moderate increase in diastolic blood pressure. The recovery period is significantly longer. A similar reaction occurs with arterial hypertension. 4. Dystonic. With this option, there is a significant increase in systolic blood pressure with a sharp simultaneous decrease in diastolic blood pressure, which often drops to zero, that is, the “infinite tone phenomenon” is obtained. The pulse increases sharply, and the recovery period is longer, up to 6-7 minutes. Such a reaction in schoolchildren may be associated with a state of overtraining, autonomic neuroses, or recent infectious diseases. In athletes, the rapid recovery of diastolic blood pressure within 1 minute is considered an indicator of high physical fitness. If the recovery of diastolic blood pressure takes up to 2-3 minutes, the student should be referred for examination to a cardiologist. 5. Stepped. With this type of reaction, systolic blood pressure in the 2-3rd minute of the recovery period is higher than in the 1st minute, diastolic blood pressure changes slightly, mainly downward against the background of a sharp increase in heart rate. This reaction is associated with the functional inferiority of the mechanisms regulating the activity of the cardiovascular system, indicating an insufficient adaptive ability of the cardiovascular system to physical activity. In case of atypical reactions of the cardiovascular system to physical activity, ECG studies and consultation with a cardiologist are necessary. Thus, when assessing the degree of adaptation of the cardiovascular system to physical activity, the following is noted: a) good. Observed in a normotonic type of reaction with a recovery period of up to 5 minutes; b) satisfactory - changes in pulse and blood pressure exceed the normative ones, but their parallelism remains, the recovery period is extended to 7 minutes; c) unsatisfactory – characterized by the manifestation of atypical reactions to physical activity (especially hypertonic and dystonic types). The recovery period is extended to 12 minutes. When assessing the response of the cardiovascular system to physical activity, leading importance should be given to the recovery period, analyzing the activity and nature of the recovery of pulse and blood pressure. When performing physical activity, unidirectional changes in blood pressure and pulse normally occur. Blood pressure responds to exercise by increasing maximum pressure as peripheral resistance decreases due to arteriolar dilation, allowing more blood to reach working muscles. Accordingly, pulse pressure increases, which indirectly indicates an increase in the stroke volume of the heart, and the pulse quickens. All these changes return to the original data within 3 to 5 minutes after cessation of exercise, and the faster this happens, the better the function of the cardiovascular system. The different magnitudes of shifts in hemodynamic parameters and the duration of recovery to the initial values depend not only on the intensity of the functional test used, but also on the physical fitness of the subject. The response of heart rate and blood pressure to physical activity in athletes can be different. 1 . Normotonic reaction. Well-trained athletes most often have a normotonic type of reaction to the test, which is expressed in the fact that under the influence of each load a pronounced increase in heart rate is noted to varying degrees. The heart rate in the first 10 seconds after the first load reaches approximately 100 beats/min, and after the second and third – 125 - 140 beats/min. With this type of reaction to all types of loads, systolic pressure increases and diastolic pressure decreases. These changes in response to 20 squats are small, but to a 15-second and 3-minute run they are quite pronounced. An important criterion for a normotonic reaction is the rapid restoration of pulse and blood pressure to resting levels: after the first load - on the 2nd minute, after the 2nd load - on the 3rd minute, after the 3rd load - on the 4th minute of the recovery period . Slow recovery of the above indicators may indicate insufficient training. In addition to normotonic, there are four more types of reactions: hypotonic, hypertonic, reaction with a stepwise increase in systolic pressure and dystonic. These types of reactions are considered atypical. 2. Hypotonic reaction characterized by a significant increase in heart rate (up to 170–190 beats/min at the 2nd and 3rd loads) with a slight increase or even decrease in maximum pressure; the minimum pressure usually does not change, and, therefore, the pulse pressure, if increased, is insignificant. Recovery time is slow. This reaction indicates that the increase in circulatory function caused by physical activity is provided not by an increase in stroke volume, but by an increase in heart rate. Obviously, changes in heart rate do not correspond to changes in pulse pressure. This reaction is observed in athletes after illnesses (in the convalescence phase), in a state of overtraining, overexertion. 3. Hypertensive reaction consists of a significant increase in maximum pressure (up to 180 - 220 mm Hg), pulse rate and a slight increase in minimum pressure. Thus, pulse pressure increases slightly, which should not be regarded as an increase in stroke volume, since this reaction is based on an increase in peripheral resistance, i.e. spasm of arterioles instead of their dilation. Recovery time from this reaction is slower. This type of reaction is observed in people suffering from hypertension or prone to so-called pressor reactions, as a result of which the arterioles narrow instead of dilating. This reaction is often observed in athletes during physical overexertion. 4. Reaction with a stepwise increase in maximum (systolic) pressure manifests itself in a pronounced increase in heart rate, while the maximum pressure measured immediately after physical activity is lower than in the 2nd - 3rd minute of recovery. This reaction is usually observed after high-speed loads at a slow running speed. This reaction reveals the body’s inability to quickly enough provide the redistribution of blood that is required for muscle function. A stepwise reaction is observed in athletes when overworked and is usually accompanied by complaints of pain and heaviness in the legs after physical activity, fatigue, etc. This reaction may be a temporary phenomenon that disappears with appropriate changes in the training regimen. 5. Dystonic reaction characterized by the fact that with a significant increase in heart rate and a significant increase in maximum pressure, the minimum pressure reaches zero, or rather is not determined. This phenomenon is called the “infinite tone phenomenon.” This tone is a consequence of the sound of the walls of blood vessels, the tone of which changes under the influence of any factors. The phenomenon of endless tone is sometimes observed in people who have had an infectious disease when they are overworked. Normally, this phenomenon occurs in adolescents and young men and less often in middle-aged people. It can be heard in healthy athletes after very hard or prolonged muscular work, as well as during overtraining or after drinking alcohol. The question of whether this is a physiological tone or a consequence of pathology is decided individually in each specific case. If it persists after a normal functional test for no more than 1–2 minutes, then it can be considered physiological. Longer persistence of an endless tone requires medical supervision of the athlete to identify the causes of its occurrence.  (No ratings yet)  Loading...Share with friends:
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