Knee-high compression socks minimize head-up tilt-induced cerebral and cardiovascular responses following dynamic exercise

Scand J Med Sci Sports. 2018 Jul;28(7):1766-1774. doi: 10.1111/sms.13084. Epub 2018 Apr 16.

Abstract

In healthy individuals during a non-exercised state, knee-high compression socks (CS) may reduce the magnitude of lower limb venous pooling during orthostasis but are not effective at minimizing the incidence of pre-syncopal symptoms. However, exaggerated reductions in cerebral blood flow velocity (CBV) and cardiac stroke volume (SV) occur during passive head-up tilt (HUT) testing following dynamic exercise. It is unknown if CS can minimize post-exercise HUT-induced decrements in CBV and SV in this population. To test the hypothesis that CS will attenuate the reductions in SV and CBV during 60° HUT following 60 minutes of moderate-intensity (60% VO2 peak) cycling exercise. Ten healthy volunteers (22.6 ± 2.1 years, 24.1 ± 2.5 kg/m2 ) completed pre- and post-exercise 15-minute HUT tests during randomized CS and Control (no CS) conditions. Changes in blood pressure (finger plethysmography), SV (Modelflow® method), and CBV (Transcranial Doppler) were measured during HUT and preceding supine rest periods. Pre-exercise HUT-induced similar (all, P > .47) reductions in SV (Control; -23.1 ± 11.5%, CS; -20.5 ± 10.9%) and CBV (Control; -18.1 ± 6.3%, CS; -15.3 ± 9.0%). However, larger post-exercise decreases in SV and CBV during HUT were observed in the Control versus CS condition. Specifically, CS attenuated the drop in SV (Control: -32.9 ± 5.6%, CS: -24.3 ± 11.6%; P = .01) and CBV (Control: -25.1 ± 5.8%, CS: -17.6 ± 7.8%; P = .02) during the post-exercise HUT test. These results indicate that CS attenuated HUT-induced reductions in SV and CBV following moderate-intensity cycling exercise and suggest that CS may be an effective countermeasure to reduce the incidence of post-exercise syncope in vulnerable populations.

Keywords: dynamic exercise; orthostasis; transcranial doppler; venous compression.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Pressure
  • Cerebrovascular Circulation*
  • Cross-Over Studies
  • Exercise / physiology*
  • Female
  • Heart Rate
  • Humans
  • Male
  • Oxygen Consumption
  • Stockings, Compression*
  • Stroke Volume*
  • Syncope / prevention & control*
  • Tilt-Table Test
  • Young Adult