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General characteristics of methods for studying the state of the cardiovascular system
In determining the state of health in the first place is the study and assessment of the state of the cardiovascular system, since it is the main link that determines and limits the delivery of oxygen to the working organs, and in addition, the cardiovascular system of modern man is extremely vulnerable. The data of a study conducted at rest cannot fully reflect the functional state and functional capabilities of the cardiovascular system, since functional insufficiency of an organ or organ system is more manifested under load conditions than at rest. Therefore, a complete assessment of the state of adaptation of the cardiovascular system, determining the degree of human health and its functional capabilities is possible only with the involvement of various functional tests or stress tests.
Functional test - a special type of test of the reaction of the human body as a whole or its individual systems and organs to a specific functional load. When performing stress tests, those pathological reactions and processes are found that indicate a limitation of the reserves of compensation and adaptation, instability and incompleteness of adaptive reactions, premorbid state (pre-illness) or the presence of latent forms of diseases. Physical activity during the performance of functional tests involves large muscle groups in the work, while it should be performed uniformly at the same pace, without hampering breathing. The performance of functional tests is reflected in the tone of blood vessels, blood pressure, heart rate and other indicators of the circulatory system.
To study the state of the cardiovascular system, its adaptability to physical activity, a Martine test is performed. Assessment of the state of the cardiovascular system and its adaptability to physical activity is carried out by analyzing the percentage increase in heart rate, changes in blood pressure (compared with indicators before exercise) and taking into account the recovery time of heart rate and blood pressure after the test. As a rule, when performing a Martine test, heart rate increases by no more than 50-70% of the resting level. The state of the cardiovascular system is assessed as good with an increase in heart rate up to 25% of the initial level; satisfactory - with an increase in heart rate of 50-75% under the influence of a functional test; and unsatisfactory if the heart rate increases by more than 75% compared with the state of relative rest. The adaptability of the cardiovascular system to physical activity is assessed as unsatisfactory if the heart rate is not restored within 3 minutes. Recovery of blood pressure normally lasts 3-4 minutes, while systolic pressure increases by 25-30 mm RT. Art., and the diastolic remains unchanged or decreases insignificantly (by 5-10 mm Hg. Art.).
The determination of the Ruffier-Dickson and Harvard step test indices makes it possible to assess the effect of the state of the cardiovascular system on the physical performance of the body. Due to the high intensity of the load, IGST is used only for the examination of healthy people. It is calculated based on the time of climbing the step and the pulse values after work. Step height and climbing time are selected depending on the gender and age of the subject. For adult men, youths and adolescents 12-18 years, the height of the step should be 50 cm, the time of climbing the step - 5 minutes for men and 4 minutes for 12-18-year-olds and adolescents. The height of the steps for women is 43 cm, the ascent time is 5 minutes. For girls and adolescents 12-18 years, the step height when performing the test should be 40 cm, and the climb time is 4 minutes. The rate of ascent should be constant, equal to 30 cycles per minute. Each cycle consists of four steps. The tempo is set by the metronome, which is set at 120 beats / min. If the subject during the ascent due to fatigue begins to lag behind the set pace, then after 15-20 seconds, after the remark made to him, the test is stopped and the actual time in seconds is recorded. The highest IGST values - up to 172 - were noted among extra-class athletes training for endurance.
To characterize the functional usefulness of the reflex mechanisms of hemodynamics, an orthostatic test is used.
An orthostatic test allows you to identify the mechanisms of regulation of peripheral circulation during the transition from horizontal to vertical. The main factor of the orthostatic test is the Earth’s gravitational field, creating a 1 g load on the body with a head-foot action vector. When the body position changes from horizontal to vertical, redistribution of blood occurs, which, obeying the law of gravity, rushes down, while the blood supply to the human brain deteriorates. This causes the inclusion of reflexes that regulate blood circulation, to ensure normal blood circulation of organs, especially the brain. In a vertical position, the location of the main great vessels coincides with the direction of gravity, which leads to the appearance of hydrostatic forces, which to some extent impede blood circulation. Orthostatic stability of the body, i.e. human tolerance of an orthostatic test is assessed by the body’s response to the transition from horizontal to vertical. When assessing the tolerance of an orthostatic sample, one feels well-being, the nature of the sensations (vegetative reactions) of the subject, changes in heart rate, systolic, diastolic and pulse pressure in response to the transition of the body from horizontal to vertical. Pulse pressure is the difference between the values of systolic and diastolic pressure. It is necessary to open the valves of the aorta and pulmonary trunk during ventricular systole. Normally, the pulse pressure is 35-55 mm Hg. Art. The higher the level of health and fitness of the cardiovascular system, the less pronounced and shorter the orthostatic reaction.
There are good, satisfactory and poor orthostatic stability. With good orthostatic stability, the subject does not complain of discomfort, the pulse accelerates by 20 beats / min, the pulse blood pressure decreases by 10 mm RT. Art.
Satisfactory orthostatic stability is accompanied by unpleasant sensations, an acceleration of the pulse by 30-40 beats / min, a decrease in pulse pressure by 20 mm RT. Art. compared with the horizontal position of the body.
With poor orthostatic stability, the subject complains of poor general condition, dizziness, and nausea. The face and visible mucous membranes turn pale, which indicates hemodynamic insufficiency of the brain. The pulse accelerates by 40-60 beats / min or more, the pulse pressure decreases by 30 mm RT. Art. and more.
The degree of adaptation is one of the most important criteria for assessing health. Adaptation of the body can manifest itself at different levels. At the vegetative level, adaptation is assessed by indicators of the circulatory and respiratory systems, since they are among the first to be included in the processes of adaptation of the body to changing environmental conditions. The set of functional indicators of the cardiovascular system is used as an indicator of the adaptive reactions of the whole organism, an indicator of the risk of developing diseases. The adaptive capabilities of an organism are the reserve of its functional reserves, which, when diverged, support the interaction between the organism and the environment. The following levels of adaptation are distinguished:
- “satisfactory adaptation” with sufficient adaptive capabilities of the body;
- “adaptation voltage”, when adaptation is realized due to higher than normal normative voltage of regulatory systems;
- “unsatisfactory adaptation”, i.e. premorbid with a decrease in functional reserves;
- “failure to adapt” with a decrease in the functional capabilities of the body is already a condition in which a clinical diagnosis is made.
To assess the level of adaptation, the value of the adaptation indicator (AP) is determined, the calculation of which is carried out according to the method of R.M.Baevsky in the modification of A.B.Bersenyeva et al. (1987). The results of this test allow us to identify the functionality of the circulatory system.
In order to study the functional reserves of the cardio-respiratory system of the body, the Skibinskaya index (IS) is determined.
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General characteristics of methods for studying the state of the cardiovascular system
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