Vol.1 No.

4 2012

Scientific Research Journal of India

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Comparison of the Effect of Isometric Exercise of Upper Limb on Vitals between Young Males and Females
Pranjal Parmar. BPT*

Abstract: Background and objective: studies on gender difference in cardiovascular responses to isometric exercises have been numerous and confliction the objective of this study was to determine if cardiovascular response to upper extremities isometric exercises differ between apparently healthy male and female subjects. Method: 60 young adults age between 18 to 22 years were included in study. These consisted of 30 males and 30 females. The baseline cardiovascular parameters (HR, SBP, DBP & MAP) were recorded. After two sets of three isometric upper limbs for 3 minutes these parameters recorded at the end of exercise and after recovery. Results:An increase in HR ,SBP , DBP&MAP was seen in both groups after exercise .the result showed group B had more increase in HR,SBP,DBP and MAP as compared to group A and significant rise in MAP &SBP in group B. Conclusion: Isometric exercise of upper limb can lead to increase in SBP, DBP, MAP &HR among apparently healthy males & females. It is more proannounced in males as compared to females. SBP &MAP increased in both but more in males as compared to females.

Keywords: Isometric Exercises, Cardiovascular Measures

INTRODUCTION Exercise, a common physiological stress, can elicit cardiovascular abnormalities not present at rest and can be used to determine the adequacy of cardiac function.1 The isometric contractions are

seen in various exercises like pushing or lifting heavy load where net displacement of load is not, but the rising tension can be felt in contracting muscles.3 It imposes greater pressure than volume load on left http://www.srji.co.cc

ventricle in relation to the body ability to supply oxygen.4 The metabolic demands of the exercising muscles increases, depending upon intensity of exercises and are met with various changes in circulatory and respiratory system.13 The effect of isometric exercises on vitals in between males and females may vary with substantial anatomical, physiological and morphological differences that exist between men and women which may affect their exercise capacity and influence magnitude of response to exercise.5 The average isometric strength estimate is generally 30% greater in men than in women in different muscle group. Gender difference in cardiovascular response to static exercise is believed to be due to differences in sympathetic

During exercise it is mainly adrenaline that produces changes in the heartbeat. Adrenaline is a hormone which causes the heart rate to quicker. 2. Breathing quickens and deepens: You breathe quicker so as to get more oxygen into the lungs. An efficient heart can then transport this to the working muscles. Training can be of great benefit to the Respiratory System. The capacity of the lungs is increased, which allows more oxygen to be taken in per breath. 3. Temperature rises: When we exercise, our muscles are working and they generate heat, so our body temperature rises. Body temperature is regulated by heat radiating from the skin and water evaporating by sweating. When we shiver, our muscles are working to produce heat in order to raise our body temperature. 4. Start to sweat: As we have just seen, some of our energy is turned into heat. The body will tolerate a small rise in temperature, but very soon we begin to sweat. If the conditions are hot, we sweat more and produce less urine. We also lose salt as well as body heat and water. We have to replace the salt so that the body stays the same, otherwise we will get cramp. 5. Muscles begin to ache: As we now know, in order to work, muscles need energy. Energy comes from

parasympathetic or adrenal interactions at cardiac level. The larger the muscle group that is involved in isometric tension the greater the cardiovascular response.6 Response To Exercise:7 When you exercise or take part in a strenuous sport you will notice several changes taking place in your body: a. Your heart beats stronger and faster b. Your breathing quickens and deepens c. Your body temperature increases d. You start to sweat e. Your muscles begin to ache 1. Heart beats stronger and faster:

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food, which is mainly converted to glucose. To work more efficiently muscles also need plenty of oxygen. Glucose and oxygen are brought to the muscles in the blood. Wastes such as carbon dioxide are carried away in the blood. This process of getting energy is called respiration. Glucose + Oxygen = Energy + CO2 + Water When muscles do extra work more Glucose and Oxygen are needed, so more blood must flow to the muscles.

Vitals response to exercise has been used as major criteria in exercise prescription for both patient and healthy population. Thus for prescribing isometric exercise, repetitions and frequency it would be helpful and prevent the adverse effect on vitals. The study would also be helpful in prescribing exercises for those with cardiovascular compromise. It would help to determine the safety limits of the exercise.

Eventually it becomes impossible to get enough oxygen to the muscles, so they use a different method of getting energy. Glucose is still used, but now there is a waste product called lactic acid, which makes muscle ache, & muscles.

OBJECTIVES: 1. To analyze if there is any change in vitals as a result of isometric exercises of upper limb 2. To compare the response of upper limb isometric exercises in young male and female.

Acute

Cardiovascular

Response

to METHODOLOGY Research Design: An quasi-Experimental (comparative) study. Sample Size: 60 normal individuals. Sample Population: 60 young adults between 18 to 22 yrs. Group A: 30 normal individuals (females) Group B: 30 normal individuals(males) Type of Sampling: Convenient sampling with random assignment. Duration of Study: one month. Study Set Up:

Exercise: As exercise intensity increases, heart rate, stroke volume, and cardiac output increase to get more blood to the tissues. More blood forced out of the heart during exercise allows for more oxygen and nutrients to get to the muscles and for waste to be removed more quickly. Blood flow distribution changes from rest to exercise as blood is redirected to the muscles and systems that need it.

Physiotherapy OPD of a tertiary care hospital.

CLINCAL SIGNIFICANCE

Inclusion Criteria:

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No previous history of known cardiovascular condition. Normal values of vitals at rest. No neurological defecit in upper limb. Sex both male and female. Willingnessof patient.

intervention

was

explained

to

the

individuals and their written consent was taken from them. 60 individuals were assigned into two groups, group A and group B, 30 patients in each group. Procedure details of group A and group B: Pre-measures: Heart rate and blood pressure was measured using an electronic sphygmomanometer in standing position. Reading was noted. Individual position: standing position. Therapist position: on the individual side in stride standing position. Procedure: Participants in upstanding position performed 3 upper extremities isometric exercises i.e. 2 sets of each exercise for each 30 second each thus total duration of exercise for 3 minutes. 1. The exercise are pushing against the wall with outstretched arms and were instructed to exert maximal tension on wall.8 2. Hands clasped together and brought to manubrosternal level to chest while shoulders are 60 70 degree abducted and participants were instructed to maximally generate tension by pressing opposite was hands against each other.8 3. Both palms on wall with participants standing ahead arms extended and were

Exclusion Criteria: Fracture of upper limb bones. Cervical fracture. Neurogenic deficit. Congenital anomalies. Previous exercise training Any disability limiting to upper limb exercise. Psychiatric patients. Non-willing patients. vertebrae or scapula

Outcome Measures: Heart rate of patient at rest, immediately post exercise and 3 minutes after exercise Blood pressure i.e. systolic and diastolic blood pressure at rest, immediately postexercise and 3 minutes after exercise. Mean arterial pressure

calculated from the above data.

PROCEDURE 60 individuals were selected according to the inclusion and exclusion criteria. The need of the study and treatment

asked to push the wall without coming behind and keeping elbow straight.8 Participants were instructed to avoid valsalva maneuver by not holding breath

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Thereafter participants were asked to rest for 10 minutes before leaving. Postmeasures: Heart rate and blood pressure was measured immediately after exercise and 3 minutes after exercise. All patients s were comfortable after the treatment session.

MEAN AGE OF POPULATION

20.25 20.2 20.15 20.1 MEAN AGE OF POPULATION

DATA ANALYSIS AND RESULT The data collected was entered in excel sheet and statistical analysis was done using SPSS software. Heart rate and blood pressure are objective data hence can be considered for statistical analysis. This isan interval data hence pre and post parmeters was statistically analysed using paired t-test, and difference in paramate test, paramaters Post exercise -5.46072 -10.1411 10.1411 1.64e-05 3.14e 3.14e-09 Rest Recovery

The above graph shows mean age of group A and group B.

Group A (females) Group B (males)

Table 2 Rest Post exercise 117.8 123.28 123.6 134.58

Recovery 120.45 128.95

Value Group A Group B

Table 3 P value

Significance Difference is significant. Difference is significant.

Value -10.0176 P 2.19e-11 value between two groups was statistically analysed using unpaired t- test. -

-1.6912 3.47e 3.47e10 -1.3678 3.17e 3.17e12 Table 4

Table No.1 Mean age (yrs)of study group )of Group A B Number 30 30 Age (yrs) 20.23 20.16 Table 2 shows mean of systolic blood pressure at rest in group A is 117.8 and group B IS 123.6 ,post exercise in group A is 123.28 and group B is 134.58 and recovery in group A is 120.45and group B is 128.95.

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Table 3 shows p value by paired t test in group A and group B and difference is statically significant. Table 4 shows p value by unpaired t test in group A and group B at rest, post exercise and recovery and difference is statically significant.

0.3SYSTOLIC BLOOD PRESSURE - RECOVERY 0.25 0.2 0.15 Female 0.1 Male 0.05 0 108101214161820222426283032 1 1 1 1 1 1 1 1 1 1 1 1 128

The above graph shows distribution of

150 100 50 0 REST POST EXERCISE RECOVERY

SYSTOLIC BLOOD PRESSURE

systolic blood pressure in males and females at rest, post exercise and recovery. Diastolic Blood Pressure Table 5 Rest Post exercise 75.6 84.25 80 96.50 Recovery 80.20 83.60

The graph shows mean of males and females of systolic blood pressure at rest , post exercise and recovery. . 0.2 SYSTOLIC BLOOD PRESSURE - REST
0.15 0.1 0.05 0 102106110114118122126130 Female Male

Group A (Females) Group B (Males)

Group A Group B

0.15SYSTOLIC BLOOD PRESSURE - POST EXERCISE 0.1 Female 0.05 Male 0 108112116120124128132136140

Value P value

Table 6 P value Significance 3.95e- Difference is 15 significant. -1.236 3.21e- Difference is 08 significant. Table 7 Rest Post Recovery exercise -5.78263 -14.6703 -4.4098 14.6703 1.1e-06 3.14e-09 1.58e-07 09 Value -1.345

Table 5 shows mean of diastolic blood pressure at rest in group A is 75.6 and group B is 80, at post exercise in group A is 84.25 and in group B is 96.50 and at recovery in group A is 80.20 and group B is 83.60.

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Table 6 shows p value by paired t test in group A and group B and difference is statistically significant. Table 7 shows p value by unpaired t test at rest, post exercise and recovery in group A and group B and difference is statistically significant

The above graph shows distribution of diastollic blood pressure between males and females at rest, post exercise and recovery.

Mean Arterial Pressure Table 8 Rest Post exercise 89.66 97.26 94.53 109.19 Recovery 93.61 98.71

DIASTOLIC BLOOD PRESSURE

120 100 80 60 40 20 0

FEMALES

Group A (Females) Group B (Males)

MALES

Group A Group B

Table 9 P value 5.78e10 -1.784 4.08e12 Table 10 Value -1.327 Rest Post exercise -9.57881 1.91e-11

Significance Difference is significant Difference is significant. Recovery -7.17096 2.06e-09

The above graph shows mean of males and females of diastolic blood pressure at rest, post exercise and recovery. Value P value

-7.001 1.16e09

0.2 0.1 0

DIASTOLIC BLOOD PRESSURE - REST

Female Male 68 70 72 74 76 78 80 82 84 86 88

Table 8 shows mean of mean arterial pressure at rest in group A is 89.66 and in group B is 94.53,at post exercise in group A is 97.26and in group B is 109.19 and at recovery in group A is 93.61 and group B

0.2 0.1 0

DIASTOLIC BLOOD PRESSURE - POST EXERCISE

is 98.71. Table 9 shows p value by paired t test in group A and group B difference is statistically significant.

Female Male 74767880828486889092949698 00 1 102

0.2 DIASTOLIC BLOOD PRESSURE - RECOVERY 0.1 0 70 72 74 76 78 80 82 84 86 88 90 92 Female Male

Table 10 shows p value by unpaired t test at rest, post exercise and recovery in group A and group and difference is statistically significant.

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The above graph shows distribution of

MEAN ARTERIAL PRESSURE
120 100 80 60 40 20 0

mean arterial pressure between males and females at rest, post exercise and recovery.

Heart Rate
FEMALES MALES

Group A (Females) Group B (Males) The above graph shows mean of mean arterial pressure at rest, post exercise and recovery between group A and group B. Group B
MEAN ARTERIAL PRESSURE -REST 0.2
0.15 0.1 0.05 0 80 90 100 Female Male

Table 11 Rest Post exercise 72.6 80.40 74.4 82.95

Recovery 76.40 78.65

Table 12 Group A Value 0.00615 P value Significance 0.015E- Difference 04 is significant 0.00322 0.14E- Difference 05 is significant Table 13 Rest Post Recovery exercise 0.00123 0.00808 0.00055 0.012e0.080e- 0.055e-06 06 05

Value P value

Table 11 shows mean of heart rate at rest

0.1 MEAN ARTERIAL PRESSURE - POST EXERCISE 0.05 0 86 90 94 9800104108112116 88 92 96 1 102106110114118 0.2 MEAN ARTERIAL PRESSURE - RECOVERY 0.15 0.1 0.05 0 82 84 86 88 90 92 94 96 98 100102104106 Female Male Female Male

in group A is 72.6 and in group B is 74.4, at post exercise in group A is 80.40 and in group B is 82.95 and at recovery in group A is 76.40 and in group B is 78.65. Table 12 shows p value by paired t test in group A and group B and difference is statistically significant. Table 13 shows p value by unpaired t test at rest, post exercise and recovery in group A and group B and difference is statistically significant.

Vol.1 No.4 2012 Heart Rate

100 80 60 40 20 0

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45

The above graph shows distribution of heart rate between males and females at rest, post exercise and recovery.
FEMALES MALES

DISCUSSION The study investigated the gender

difference in cardiovascular response to The above graph shows mean of heart rate in males and females at rest, post exercise and recovery. upper extremities isometric exercise

among apparently young healthy subjects. 60 participants were included in the study. They were divided into two groups, group

0.2 0.15 0.1 0.05 0 65

HEART RATE - REST

A and group B. Group A included female gender and group B included male gender.
Female Male

BP, HR and MAP were taken as outcome measure. These measures were taken pior, immediately after test and 3 minutes after

70

75

80

study. The data collected was statistically analysed. The result showed group B had more increase in HR,SBP ,DBP AND

0.15 0.1

HEART RATE - RECOVERY

MAP as compared to group A and there was significant rise in MAP and SBP in
Female

group B. The average isometric strength estimate is generally about thirty percent greater in men than in women in different

0.05 0 68 78 88

Male

muscle groups . Upon initiating isometric tension, increases in heart rate, systolic

0.15 0.1

HEART RATE - POST EXERCISE

blood

pressure,

and

diastolic

blood

pressure occur. Mitchell and associates

Female 0.05 0 72 82 92 Male

and

Seals

et

al

suggested

that

cardiovascular responses to isometric exercise are greater when larger muscle groups are involved. While heart rate responses to sustained submaximal static contractions tend not to be significantly http://www.srji.co.cc

different before, during, or after exercise, blood pressure responses to this exercise are significantly elevated before, during, and after exercise Gender differences in cardiovascular responses to static exercise are believed to be due to differences in sympathetic-parasympathetic or adrenal interactions at the cardiac level. The finding of this study revealed that there was no significant gender difference in vitals of participants at baseline which was statistically significant. The data collected reveals that post exercise heart rate, systolic blood pressure ,diastolic blood pressure and mean arterial pressure were higher than pre exercise values and was statistically significant in both groups ie group A and group B. When values of recovery i.e. 3 minutes after exercise when compared it was almost same in both groups but when compared to values at rest it was much greater than recovery values. The result between the two was calculated using unpaired t test. Therefore upper extremities isometric exercise had

These result indicate that more blood is pumped by left ventricle into aorta in response to upper extremities isometric exercise among males than females; while myocardial oxygen uptake & measure of oxygen consumption of heart muscles of female participants in response to upper extremities isometric exercises is higher than that of males. The tissues working hard during exercise and also after the completion of exercise require more oxygen than normal to pay off this oxygen debt incurred during the exercise. These results in increase in blood supply to active muscles to supply this extra amount of blood. At rest, muscles receive approximately 20% of total blood flow but during exercise blood flow to muscles increase to 80 -85% . Generally ,longer the duration of exercise greater the role the cardiovascular system plays in metabolism and performance during exercise bout.eg an 1T00 meter walk (little or no cardiovascular

involvement) versus a marathon(maximal involvement).9 It has reported that release of adrenaline and lactic acid into the blood result increase in a heart rate. The isometric exercises does not increase the oxygen demand to the extend raised by isotonic exercise thus DBP does not rise much in isometric exercise The isometric exercise results in pressure overload on

significant effect on heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood blood pressure. When values of group A and group B at post exercise were compared it was seen that male participants (group B) had higher post exercise MAP and SBP had level than females (group A) (p<0.05)

Vol.1 No.4 2012 heart. The myocardial

Scientific Research Journal of India oxygen extremities isometric

47 exercise in

consumption (mvo2) also increase due to exercise . Higher ventricular contraction is evoked among males leading to increase in systolic blood pressure. This indicates that the males have higher myocardial oxygen demand during

normotensive subjects. By Cembada and Gender differences in cardiovascular response to isometric in seated and supine positions by Don Melrose. The proposed mechanisms attempting to explain gender differences in cardiovascular responses to isometric exercise have been numerous and conflicting. Sanchez et al. found differences in adrenergic patterns between genders in response to isometric exercise and support the study. Ettinger and associates demonstrated attenuated

isometric exercise predisposing them to greater risk of ischemia if developing cardiovascular risk, factor compromising the coronary blood flow.10 It has been seen males have higher plasma levels of all three catecholoamines out of which plasma levels of epinephrine are higher as compared to females .this results in increase in MAP immediately at of exercise. The findings supports the results of previous investigators than upon initiation isometric tension increase heart rate, systolic blood pressure and diastolic blood pressure occur.12 The result of

increases in blood pressure and muscle sympathetic nerve activity compared with men. In data also derived from static exercise as well as temperature and psychological stressors, Jones et al found that gender did not influence sympathetic neural reactivity to stressors such as isometric handgrip exercise Changes in posture often experienced during exercise or sporting activities have also been shown to elicit various

investigations have been reported at best inconsistent and do not follow definite pattern.12 However during the recovery period the vitals were decreased as compared to immediately post exercise in both genders. However the vitals were not the same as they were at rest prior to commmencent of exercise. The result of study is supported by the articles Gender difference to in upper

circulatory adaptations. Sagiv et al. and Borst et al. both noted changes in cardiovascular regulation as a result of postural changes. Relatively fewer studies have investigated the cardiovascular

adaptations to exercise performed when posture does not change during the time course of the positions. A further study can be made:

cardiovascular

response

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Comparison of vitals for larger muscles groups to smaller muscles group in upper limb isometric exercises.

pressure ,diastolic blood pressure ,mean arterial pressure and heart rate among apparently healthly males and females. 2. This was more preannounced in males than females .Systolic blood pressure (SBP) and Mean arterial pressure (MAP) increased in both but more males as compared to females

Comparison of vitals in isometric exercise for upper limb versus lower limb.

The result can be used as It can be used for prescription of exercise in those with

LIMITATION 1. The participants in study were young and elderly or middle aged participants were not included in these study. 2. All the subjects who were included in the study were students. 3. The participants nutritional status or

cardiovascular crompromise and elderly patients. It can be used to determine the safety regimen. limits during exercise

CONCLUSION The above study gives following

BMI were not considered while selection. 4. The occupation or lifestyle of

conclusion: 1. Isometric exercises of upper limb can lead to increase in systolic blood

participants was not considered. 5. The muscle mass or bulk of upper limb was not considered.

REFERENCES: 1. Journal of Exercise Physiology Online. Volume 8, number 5, august 2005. 2. Therapeutic Exercise, Carolyn 5. Effect of exercise .stending

lenderg 2004 6. Gender cardiovascular difference response in to

Kisner & Lynn Allen Collby.Pg No 168,5th Edition 3. Sports Fitness Advisor, Fleck

isometric exercise.gatzke 2005 7. Circulation, amercian heart

association,2007pg no 3 &4 8. Clinical Orthopaedic

st&kramerwj(2004). 4. Husketh Mount, pg no 92-96,lord street,merseyside, england.

rehabilitation ,2nd editions brent brotzman,pg no 138-142

Vol.1 No.4 2012 9. Cardiovascular system

Scientific Research Journal of India and isometric exercise

49 of upper

exercise physiology,aulter &amer suleman 10. International journal of biomedical reserach,srinath galag & ravipati sarath volume 2,november 2011 11. Gender cardiovascular difference response in to

limbs,howden et clf 2006. 12. Gender cardiovascular difference response in to

isometric exercise,gatzke 13. The essential guide to building muscles by phil daviee.

CORRESPONDENCE:
* Consultant Physiotherapist, Bhagwan Mahaveer Medical Centre, M.G. Road, Goregaon (W), Mumbai. Email: pranjalparmar38@yahoo.in

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