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The Effects of Gravity Inversion Procedures on Systemic Blood Pressure: Intra-ocular Pressure, and Central Retinal Arterial Pressure.

Authors:
  • Midwestern University, Chicago College of Osteopathic Medicine

Abstract

Gravity Inversion Boots (a device which clasps around the ankle joint and hooks onto a stationary horizontal bar allowing one to hang stationary in an inverted, head down position) is a popular method for traction and exercise now being used by an estimated one million people. Recent reports in the medical literature suggests that this device may be contraindicated in patients with hypertension, cardiovascular disease, and ocular problems. In an effort to document physiologic changes which occur in the inverted position, twenty healthy medical students were subjected to a 3-minute inactive period of inversion. Systemic blood pressure, pulse rates, central retinal arterial pressure, and intraocular pressures were measured and found to be significantly elevated in all subjects. We speculate that this device may be contraindicated in certain patient populations, specifically hypertensives. Caution is advised in relation to people with spinal instability, suspected abnormalities in hemostasis, or with intraocular hypertension.
... The finding is, however, inconsistent with that of LeMarr et al. 19 which reported a consistent increase in systolic blood pressure during a three-minute inversion. Also, contrary to the Klatz et al. 20 and Ballantyne, 21 studies, which showed an average increase of 20 mm Hg for systolic blood pressure during inversion, our findings revealed a lower increase of 7 mm Hg in systolic blood pressure at one minute into the HDCK position. ...
... Contrary to the finding of Klatz et al. 20 who found no increase in pulse rate during more than 90° headdown inversion among healthy young subjects, a significant increase in pulse rate was found at three minutes into inversion in the present study. The increase in heart rate response from the resting value, found in the present study, was very much expected because anxiety, albeit subtle, always occurs during unusual positions and can trigger a sympathetic pressure response. ...
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Background: Movement dysfunction may be expressed in terms of symptoms experienced in non-physiological postures, and head-down crooked kneeling (HDCK) is a posture frequently assumed by Muslims during prayer activities. The purpose of this study was to investigate the cardiovascular responses in the HDCK posture. Methods: Seventy healthy volunteers, comprising 35 males and 35 females, participated in the study. Cardiovascular parameters of blood pressure and pulse rate of the participants were measured in rested sitting position and then at one and three minutes into the HDCK posture. Two-way ANOVA was used to determine the differences between cardiovascular responses at rest and in the HDCK posture, and the Student t test was utilized to determine gender difference in cardiovascular responses at rest and at one and three minutes into the HDCK posture. Results: The study showed a significant decrease in systolic and diastolic blood pressures at one minute into the HDCK posture and an increase in pulse rate at one and three minutes into the HDCK posture, as compared to the resting values. Rate pressure product also rose at one minute into the HDCK posture, whereas pulse pressure increased at one and three minutes into the HDCK posture, as compared with the resting values. However, no significant change was observed in the mean arterial pressure values. Conclusion: The findings from this study suggest that no adverse cardiovascular event can be expected to occur for the normal duration of this posture during Muslim prayer activities.
... IOP increases on assuming a body position other than seated or upright. [1][2][3][4][5][6][7] A small variation can be detected when moving from the sitting to the recumbent position. [7][8][9][10] The increase in IOP is directly related to the inclination of the body toward the completely inverted position. ...
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Purpose: To measure changes in intraocular pressure (IOP) in association with yoga exercises with a head-down position. Methods: The single Center, prospective, observational study included 10 subjects with primary open-angle glaucoma and 10 normal individuals, who performed the yoga exercises of Adho Mukha Svanasana, Uttanasana, Halasana and Viparita Karani for two minutes each. IOP was measured by pneumatonometry at baseline and during and after the exercises. Results: All yoga poses were associated with a significant (P<0.01) rise in IOP within one minute after assuming the yoga position. The highest IOP increase (P<0.01) was measured in the Adho Mukha Svanasana position (IOP increase from 17±3.2 mmHg to 28±3.8 mmHg in glaucoma patients; from 17±2.8 mmHg to 29±3.9 mmHg in normal individuals), followed by the Uttanasana position (17±3.9 mmHg to 27±3.4 mmHg (glaucoma patients) and from 18±2.5 mmHg to 26±3.6 mmHg normal individuals)), the Halasana position (18±2.8 mmHg to 24±3.5 mmHg (glaucoma patients); 18±2.7 mmHg to 22±3.4 mmHg (normal individuals)), and finally the Viparita Kirani position (17±4 mmHg to 21±3.6 mmHg (glaucoma patients); 17±2.8 to 21±2.4 mmHg (normal individuals)). IOP dropped back to baseline values within two minutes after returning to a sitting position. Overall, IOP rise was not significantly different between glaucoma and normal subjects (P = 0.813), all though glaucoma eyes tended to have measurements 2 mm Hg higher on average. Conclusions: Yoga exercises with head-down positions were associated with a rapid rise in IOP in glaucoma and healthy eyes. IOP returned to baseline values within 2 minutes. Future studies are warranted addressing whether yoga exercise associated IOP changes are associated with similar changes in cerebrospinal fluid pressure and whether they increase the risk of glaucoma progression. Trial registration: ClinicalTrials.gov #NCT01915680.
... Few studies have documented the physiological changes associated with it. Studies have shown an increase in IOP when normal volunteers were transferred from a sitting to an inverted position 1 . There have been other reports of increased IOP associated with the dependent posture 2,3,4,5 . ...
Article
BACKGROUND: Intra Ocular Pressure (IOP) can be altered by changing body position. Very few studies are available in the Indian subjects. AIM: To study the effect of changes in the body position from upright posture to supine to head down tilt of - 60 0 . MATERIALS AND M ETHODS: The study group consisted of 60 subjects, 35 boys and 25 girls in the age group of 18 to 24 years, with no ocular pathology were chosen. Independent measurements of the IOP of each eye were obtained. Keelar Pulsair air impulse tonometer was used in all the subjects for IOP measurement. IOP was measured in the department of Ophthalmology, Teaching Hospital between 10AM to 12 Noon. STATISTICAL ANALYSIS : were done using Student’s paired ‘t’ test. RESULTS: The change of IOP (Increased) induced by the change of position between the means of IOP’s for the sitting and supine positions was 2.789±1.03 mm Hg of all subjects, 2.825±0.226 mm Hg in males and 2.739±0.089 mm Hg in females and between the supine and in clined - 60 ⁰ position was 4.971±0.914 mm Hg of all subjects, 4.703±0.816mm Hg in males and 5.346±1.098 mm Hg in females. CONCLUSION: It is apparent that, the IOP is significantly higher in the supine than in the sitting and in the inclined than in the supin e positions. The difference was statistically significant (P
...  La tracción eleva la presión sanguínea (Klatz, Goldman, Pinchuk, Nelson y Tarr, 1983).  Puede existir el riesgo de afectar la circulación intracraneal y puede llegar a romperse los capilares del ojo (Ploucher, 1982). ...
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1. Introducción 2. Importancia de los estiramientos en el deporte 3. Razón del estiramiento 4. Factores que mejoran o limitan los estiramientos 5. Principios metodológicos en los estiramientos 6. Clasificación tradicional de los estiramientos 7. Clasificación adicional de los estiramientos 8. Facilitación neuromuscular propioceptiva (FNP) 9. Manipulación 10. Tracción 11. Flexibilización, fortalecimiento y coordinación 12. Estiramientos con el fin de calentamiento 13. Estiramientos para después de una competición 14. Estiramientos y condición física general 15. Los estiramientos en un programa a largo plazo 16. Resumen de los estiramientos 17. Referencias bibliográficas 2 1. INTRODUCCIÓN Los estiramientos, enmarcados en el concepto de flexibilidad, han sido siempre un caballo de batalla en el campo escolar. Su aplicación, en la asignatu-ra de Educación Física, siempre ha sido, es y posiblemente será obligatoria, pues éstos son imprescindibles y previos para realizar cualquier tipo de actividad física. Por ello, su trabajo tanto teórico como práctico es uno de los más impor-tantes en el desarrollo de los contenidos que componen el marco de la Educa-ción Física, y que repercuten tanto a corto como a largo plazo en la salud. En esta modesta aproximación al estudio de los estiramientos establece-mos tres partes: una primera donde se detalla una serie de principios y razona-mientos metodológicos necesarios para el conocimiento de los estiramientos, en una segunda parte se describen unas clasificaciones de estiramientos y por últi-mo en la tercera parte se detallan algunos aspectos metodológicos de los esti-ramientos en la sesión de ejercicio físico.
... 714 Inverted posture raised the intraocular pressure from a pre-inversion average of 19 mm Hg to an average of 35 mm Hg after inversion for 3 minutes; this returned to normal within one minute after seated posture was resumed. 715 Glaucomatous patients experience a higher rise in pressure to 37.6mm Hg ± 5.0 after inversion for only 30 seconds. The inverted posture probably raises intraocular pressure by increasing episcleral venous pressure which is closely related to increased venous pressure in the orbit. ...
Article
Context: Inversion tables are used as treatment for back pain, but there is a lack of agreement on systemic effects of inversion. Objective: To assess intracranial pressure (ICP) and cerebral blood flow using ultrasonography during inversion table tilt. Methods: Optic nerve sheath diameter (ONSD), heart rate (HR), blood pressure, internal carotid artery (ICA) and middle cerebral artery (MCA) blood flow of participants were measured in 3 positions: supine before inversion, during inversion with head down, and supine post-inversion. ONSD was evaluated with ocular ultrasonography and blood flow (ICA and MCA) with Doppler ultrasonography. Results: The ONSD changed significantly between the supine position, at 3 min of inversion, and after returning to supine position (all P < .001). The post-inversion HR was less than pre-inversion (P = .03) and 3-min inversion HR (P = .003). There were significant changes in ICA and MCA flow caused by inversion, which affected blood flow velocity, resistance, and pulsatility index (all P ≤ .005). Conclusion: Inversion caused significant changes in ICP and blood flow. Thus, increased chance of complications may exist when using inversion as a therapeutic tool or during surgical procedures in patients with previous history of elevated ICP. These results demonstrate that inversion therapy should be used with caution.
Article
Twenty-three Optometry students with normal corneal condition were recruited. The intraocular pressure and central corneal curvature of the right eye were measured in a sitting and a 30 ° head-down posture. The mean (standard deviation) IOPs before and during posture change were 15.6 (2.4) mmHg and 22.1 (2.3) mmHg respectively. This 6.5 mmHg mean rise in IOP was found to be statistically significant which is similar to the results from previous studies. The mean changes in radius of corneal curvature and the orientation of the axis of the vertical principal meridian were 0.02 mm (SD 0.025 mm) and 2.4 ° (SD 10.4 °) respectively. No significant variation was demonstrated on these keratometric results due to the 30 ° head-down posture. The maximum change in radius of curvature was only 0.055 mm for one subject. Perhaps this amount of pressure rise was not sufficient enough to distort the corneal surface centrally. Another possibility could be an even distribution of the elevated pressure around the cornea, or the distribution of pressure is not even but could not be revealed by a conventional keratometer.
Article
We measured the central corneal thickness and the applanation intraocular pressure (IOP) on 45 Hong Kong Chinese. There was no obvious relationship between these two parameters, as different from other literatures. It could be due to either a limited number of subjects with a high IOP level (only six subjects with IOP ⪰ 22 mmHg), or Chinese has a thicker central cornea in general. The mean central cornea of our subjects was thicker (566 ± 36 μm) than some previous findings. Thirty subjects had their intraocular pressure further increased by adopting a 40 ° head-down posture. Their IOP and topographic corneal thickness were measured again. There was no significant change in the central corneal thickness even though the IOP was elevated by 11.7 mmHg. However the nasal cornea demonstrated a thinning effect (by some 18 μm) during the IOP elevation but it returned to the pre-inverted level after returning to a sitting posture for 5 min. Further investigation with more corneal regions being measured would be valuable to evaluate the in vivo effect of IOP elevation from glaucoma attack on corneal thickness.
Article
Rehabilitation of football players with low back pain caused by injury is a comprehensive process. Accurate diagnosis followed by early intervention is necessary. The rehabilitation plan can be divided into two phases: the pain-control phase, discussed in this article, and the training phase, to be discussed in part 2 in a coming issue. The pain-control phase may include a variety of passive modalities, flexion or extension exercises, lumbar mobilization, traction, and selective (precise localization with precise center) injections. The author stresses the importance of understanding the anatomy and biomechanics of the lumbar spine, referred pain and potential pain generators, the stages of the degenerative process, and lumbar spine injuries when planning a rehabilitation program.
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