Adj. Tenharkel et al., EFFECTS OF LEG MUSCLE PUMPING AND TENSING ON ORTHOSTATIC ARTERIAL-PRESSURE - A STUDY IN NORMAL SUBJECTS AND PATIENTS WITH AUTONOMIC FAILURE, Clinical science, 87(5), 1994, pp. 553-558
1. The effects of leg muscle pumping (tiptoeing) and tensing (leg-cros
sing) on orthostatic blood pressure were investigated in six healthy a
dult subjects (aged 28-34 years) and in seven patients with severe hyp
o-adrenergic orthostatic hypotension (aged 20-65 years). 2. Finger art
erial pressure was monitored. Relative changes in left ventricular str
oke volume were computed by a pulse contour method. 3. Tiptoeing incre
ased mean arterial pressure (7 +/- 5 mmHg) in the healthy subjects, bu
t not in the patients, whereas cardiac output increased in both groups
, although by more in the healthy adults than in the patients (35 +/-
10% versus 20 +/- 11%, P < 0.05). Systemic vascular resistance decreas
ed substantially in both groups while tiptoeing. Leg-crossing did not
affect arterial pressure in the healthy subjects, although stroke volu
me had increased. In contrast, in the patients an increase in cardiac
output (16 +/- 12%) and mean blood pressure (13 +/- 13 mmHg) was obser
ved. 4. Tiptoeing and leg-crossing have different effects on orthostat
ic blood pressure in healthy adult subjects and in patients with auton
omic failure. In normal humans, tiptoeing increases arterial pressure,
whereas leg-crossing has little effect. In the patients, in contrast,
tiptoeing has little effect, whereas leg-crossing increases arterial
pressure considerably. Patients with autonomic failure should be instr
ucted to apply leg-crossing to combat orthostatic dizziness.