title: Heart rate assessment during maximal static expiratory pressure and Valsalva maneuver in healthy young men.
abstract: BACKGROUND
  The measure of the maximal expiratory pressure (MEP) has some contraindications, as it is believed that the responses obtained in this measure are similar to the Valsalva maneuver (VM).
  
  
  OBJECTIVE
  The main purpose of this study was to evaluate the heart rate responses (HR) during the MEP and the VM measures in healthy young men into different postures aiming to identify whether and in which situation the MEP reproduces the responses obtained in the VM. Additionally we aim to estimate the workload realized during the maneuvers.
  
  
  METHODS
  Twelve healthy young men were evaluated, instructed and familiarized with the maneuvers. The VM was characterized by an expiratory effort (40 mmHg) against a manometer for 15 seconds. The MEP measure has been performed according to the American Thoracic Society. Both measures were performed at sitting and supine positions. ANOVA two-way with Holm-Sidak post-hoc test (p<0.05) was used to analyse the heart rate variation (∆HR); Valsalva index (VI); MEP index (MEPI), and the estimated workload of the maneuvers (Wtotal, Wisotime, Wtotal/∆HRtotal and Wisotime/∆HRisotime ).
  
  
  RESULTS
  The ∆HR during the maneuvers was not influenced by the supine and sitting positions. However, the ∆HR during the VM and VI were higher (supine: 47±9 bpm, 2.3±0.2; sitting: 41±10 bpm, 2.0±0.2, respectively) than ∆HR during the MEP and MEPI values (supine: 23±8 bpm, 1.5±0.2; sitting 24±8 bpm, 1.6±0.3, respectively) (p<0.001). The estimated workload of the maneuvers was statistically different (p<0.001) between the maneuvers, except to Wtotal/∆HR.
  
  
  CONCLUSIONS
  In the studied conditions the MEP does not reproduces the HR response observed in the VM in healthy young men.
authors.affiliation: Laboratório de Fisioterapia Cardiovascular, Núcleo de Pesquisa em Exercício Físico, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, SP, Brasil.
authors.forename: Vinicius
authors.initials: V
authors.lastname: Minatel
authors.forename: Marlus
authors.initials: M
authors.lastname: Karsten
authors.forename: Laura M T
authors.initials: LM
authors.lastname: Neves
authors.forename: Thomas
authors.initials: T
authors.lastname: Beltrame
authors.forename: Audrey
authors.initials: A
authors.lastname: Borghi-Silva
authors.forename: Aparecida M
authors.initials: AM
authors.lastname: Catai
mesh_terms: D000328:Adult; D006339:Heart Rate; D006801:Humans; D008297:Male; D011187:Posture; D015656:Respiratory Mechanics; D014636:Valsalva Maneuver; D055815:Young Adult