Postural Balance – ABC CARDIOL

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Editorial

Is There an Association Between Timed Up and Go Test Performance Results and Directly Measured Peak Oxygen Consumption in Patients with Heart Disease?

Functional capacity, the ability to perform daily activities independently, is commonly assessed using standardized tests like the 6-minute walk test, Timed Up and Go Test (TUGT), and one-minute sit-to-stand test. However, the gold standard for evaluating functional or cardiorespiratory capacity is cardiopulmonary exercise testing (CPET), which measures peak oxygen consumption (VO₂peak). CPET involves gradually increasing exercise intensity until exhaustion or symptom onset.

Numerous studies consistently demonstrate a strong inverse association between VO₂peak and cardiovascular events, cardiovascular mortality, and all-cause mortality,^, underscoring the pivotal role of functional capacity in the context of cardiovascular diseases. Moreover, in heart failure, regardless of ejection fraction status, poor performance on the 6-minute walk test has been linked to elevated risks of all-cause mortality and heart failure.

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Original Article

Cardiac and Musculoskeletal Responses to the Effects of Passive and Active Tilt Test in Healthy Subjects

Rogerio Ferreira Liporaci et al. Marcelo Camargo Saad Julio César Crescêncio Fabiana Marques … Debora Bevilaqua-Grossi Lourenço Gallo-Júnior

Abstract

Background:

Maintenance of orthostatism requires the interaction of autonomic and muscle responses for an efficient postural control, to minimize body motion and facilitate venous return in a common type of syncope called neurocardiogenic syncope (NCS). Muscle activity in standing position may be registered by surface electromyography, and body sway confirmed by displacement of the center of pressure (COP) on a force platform. These peripheral variables reflect the role of muscles in the maintenance of orthostatism during the active tilt test, which, compared with muscle activity during the passive test (head-up tilt test), enables the analyses of electromyographic activity of these muscles that may anticipate the clinical effects of CNS during these tests.

Objective:

to evaluate and compare the effects of a standardized protocol of active and passive tests for CNS diagnosis associated with the effects of Valsalva maneuver (VM).

Methods:

twenty-thee clinically stable female volunteers were recruited to undergo both tests. EMG electrodes were placed on muscles involved in postural maintenance. During the active test, subjects stood on a force platform. In addition to electromyography and the platform, heart rate was recorded during all tests. Three VMs were performed during the tests.

Results:

progressive peripheral changes were observed along both tests, more evidently during the active test.

Conclusion:

the active test detected changes in muscle and cardiovascular responses, which were exacerbated by the VM.