Key result
Valsalva maneuver increases carotid pulsatility index ~6%, while abdominal bracing lowers peripheral oxygen saturation.
Why the study?
Blood flow is critical for tissue oxygenation, and this study aimed to examine the impact of distinct mechanisms for increasing intra-cavity pressure via abdominal bracing versus the Valsalva maneuver on central and peripheral hemodynamics.
Do abdominal bracing and the Valsalva maneuver differentially affect central and peripheral hemodynamics in healthy adults?
RCT (n=30)
Randomized order
Do abdominal bracing and the Valsalva maneuver differentially affect central and peripheral hemodynamics in healthy adults?
Abdominal bracing and the Valsalva maneuver elicit distinct central and peripheral hemodynamic responses, which may have implications for clinical and exercise settings.
VM and AB produce distinct central-peripheral hemodynamic profiles; extends RCT comparison to guide maneuver selection in exercise and clinical settings.
Background and Objectives: Blood flow is critical for tissue oxygenation, and alterations in cerebrovascular and peripheral circulation have important health implications. This study aimed to examine the impact of distinct mechanisms for increasing intra-cavity pressure through the abdominal bracing (AB) and Valsalva maneuver (VM) on central and peripheral hemodynamics. Materials and Methods: A randomized crossover design was used, and thirty healthy young adults (age 21.9 ± 1.5 years; BMI 20.9 ± 1.8 kg/m2) performed AB and VM in a randomized order. All participants provided written informed consent, and the study protocol was approved by the Clinical Research Information Service (KCT0009742; registered on 30 August 2024). Hemodynamic responses were measured before and after each intervention, including heart rate, blood pressure, pulse wave velocity, carotid artery diameter, pulsatility index, resistive index, peripheral oxygen saturation, and cerebral oxygenation. Repeated-measures analysis of variance and paired t-tests were conducted on the datasets. Results: Both the VM and AB significantly increased heart rate (p < 0.001) and systolic blood pressure (VM: p = 0.015; AB: p < 0.001). Cerebral oxygen saturation decreased significantly (VM: p < 0.05; AB: p < 0.05), whereas oxyhemoglobin increased during both interventions, suggesting higher cerebral oxygen demand. The VM specifically increased the carotid pulsatility index (pre = 1.76 ± 0.28; post2 = 1.87 ± 0.33; p = 0.008), reflecting elevated central vascular resistance. In contrast, AB decreased peripheral oxygen saturation (pre = 98.43 ± 0.71; post1 = 97.49 ± 1.76; p < 0.001) and increased peripheral (heart–finger) pulse wave velocity (Lt: p = 0.026; Rt: p = 0.010), indicating greater stimulation of peripheral circulation. Conclusions: Distinct mechanisms that elevate intra-cavity pressure differentially influence central and peripheral hemodynamics. These findings suggest that intra-cavity pressure can selectively modulate hemodynamic responses, with potential applications in both clinical and exercise settings.
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Yu et al. (2025) conducted an RCT in Healthy (n=30). Abdominal bracing vs. Valsalva maneuver was evaluated on Central and peripheral hemodynamics (including heart rate, blood pressure, pulse wave velocity, and oxygen saturation). The Valsalva maneuver increased carotid pulsatility index (1.76 to 1.87; p=0.008), whereas abdominal bracing decreased peripheral oxygen saturation (98.43% to 97.49%; p<0.001).
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