Relationship of conditioning and step test performance to arterial blood pressure

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RELATIONSHIP OF CONDITIONING AND STEP TEST PERFORMANCE TO ARTERIAL BLOOD PRESSURE

A Thesis Presented to the Faculty of the Department of Physical Education University of Southern California

In Partial Fulfillment of the Requirements for the Degree Master of Arts

by James A, Browne June 1950

UMI Number: EP62869

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T his thesis, w ritte n by si d - — r v \

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under the guidance of h.i.. S t . . F a c u lty C o m m ittee, and app ro ved by a l l its members, has been presented to and accepted by the C o u n cil on G ra duate Study and Research in p a r t ia l f u l f i l l ­ ment of the requirements f o r the degree of

.........

l y r i s t ........

H.J.Deuel,Jr. Deari L ^ - S l.Q

Faculty Committee

Chairman

TABLE OF CONTENTS CHAPTER I.

PAGE

THE P R O B L E M ............................... Introduction

• • • • . ......... • • • • •

Purpose of the study

1

..................

1

Importance of the s t u d y ..................

2

Limitations of the study

................

2

....................

3

Definitions of terms

Systolic blood pressure

• • ............

Diastolic blood pressure

........

Master and Harvard Step Test

REVIEW OF THE. LITERATURE

...

. • •

. . . . . .

Organization of remaining chapters II*

1

• • . .

* .........

4 4 -4 5 6

Studies indicating a decrease in blood pressure due to training

..............

6

Studies indicating an increase in blood pressure due to training

• • • • » . • •

9

Studies indicating no change in blood pressure due to training III.

..........

9

THE PERSONNEL, MATERIALS AND METHODS, PROCEDURE AND TRAINING PROGRAM USED IN THE EXPERIMENT

IS

Personnel

.........

IS

Subjects

.........• • • • • ...........

IS

Examiners

................

. . . . . . .

IS

• • • • • • • •

IS

Materials and methods used

iii

CHAPTER

PAGE Blood pressure

......................

13

Master Step Test

• • • ............ • • •

13

Harvard Step Test

.............

13

....................

14

Training p r o g r a m .................. • • • •

14

Procedure

I?.

• • • • .

ANALYSIS OF THE RESULTS Master Step Test

........... •*

Diastolic blood pressure

...

Harvard Step Test

18 18

..........

Systolic blood pressure

Pulse pressure

........

. . • • • • . • • . . . • .............. . • • •

18 33 33 34

Systolic blood pressure

• • • • . • • •

34

Diastolic blood pressure

••

..........

35

Pulse pressure

..............

35

Discussion V.

...........

. . . . .

........ • • • • ...........

36

.........

28

• • • • •

28

SUMMARY AND CONCLUSIONS Summary Conclusions

BIBLIOGRAPHY

................. ..............................

29 31

LIST OF TABLES TABLE I, II. III.

PAGE Weight lifting exercises - Set I Weight lifting exercises - Set II

..............16 ........... 17

Differences recorded in blood pressuresfor the Master Step Test before and after conditioning

IV.

..............................

19

Differences recorded in blood pressuresfor the Harvard Step Test before and after conditioning

................

20

LIST OF FIGURES FIGURE I*

PAGE Blood pressure means before and after training of the Master Step T e s t .................

II.

21

Blood pressure means before and after training of the Harvard Step Test

• • • • • • • • •

22

CHAPTER I THE PROBLEM I.

INTRODUCTION

The effect of physical conditioning on arterial blood pressure has long been a controversial subject.

Some authors

have stated that conditioning will lower the blood pressure, while others have contended that conditioning raises the blood pressure*

This variation in results may be due to the condi­

tioning methods employed in each experiment or to the kinds of exercise measures used* Previous studies on the effect of training on blood pressure have used a conditioning program of either light re­ petitious work in which a steady state was possible or a pro­ gram in which maximum muscular contraction was required and heavy work was performed. This study has attempted to combine the two previously described types of conditioning programs and to analyse the resultant effect on arterial blood pressure. II.

PURPOSE OF THE STUDY

The purpose of this study was to investigate the effect of physical conditioning on arterial blood pressure in healthy male adults.

The blood pressure measurements considered were

systolic, diastolic, and pulse pressures at rest and one min­ ute, four minutes, and nine minutes after completion of the

z Harvard Step Test and the Master Step Test*

The condition­

ing program included progressive weight training, track and treadmill running* III. IMPORTANCE OF THE STUDY Scientific knowledge of the effect of training and exercise on the various systems of the body, including the cardiovascular system, constitutes a portion of the scienti­ fic basis of physical education.

Changes in arterial blood

pressures have been considered significant as measures of changes in the functional efficiency of the individual. Further determinations of the effect of training on blood pressure may be of value in leading to the establish­ ment of valid physiological tests by which individuals may be classified qualitatively with reference to their physical condition and ability to participate in strenuous activity. This study also contributes to the general knowledge of the physiology of exercise. IV. LIMITATIONS OF THE STUDY It was beyond the scope of this study to regulate the dietary intake, sleep, and living habits of the subjects due to the varying circumstances encountered among the university students used in this experiment. The training of each subject was controlled to the ex­ tent of requiring a set amount of work and exercise each week.

3 Some performed only those exercises which were required while others participated in additional physical activities, thus attaining a higher degree of physical conditioning, which may or may not have affected the results. Each exercise of the weight training program was standardized on the basis of a one-hundred and sixty pound man.

It was done in this manner to facilitate the adminis­

tration of the training program since it would have required considerable extra time for each subject to adjust each weight to his own standard. To eliminate as much as possible the effect of diurnal variations in blood pressure^ the majority of the subjects were tested at approximately the same time of day after the training period as they were prior to the training period* because of rescheduling complications several subjects were unable to comply with this.

The diurnal variations in the

blood pressure of these subjects may or may not have been significant, V.

DEFINITIONS OF TERMS

In a study of this type it is advisable to determine and define the various technical terms used to avoid misin­

1 James H, McCurdy and Leonard A, Larson, The Physio­ logy of Exercise (Philadelphia: Lea and Febiger, 1939), p. 80*

4 terpretations of methods, procedures, and results.

It is

also important to show specifically how these terms were utilized in this study. Systolic blood pressure.

Is that pressure which is

exerted upon the arterial walls during systole, i.e., during the contraction of the left ventricle and blood is forced into the aorta. The systolic blood pressure was recorded at the first sound heard by the examiner, which is caused by the passing of the blood into the brachial artery. Diastolic blood pressure.

9

Is that pressure which is

placed upon the arteries during diastole, i.e., the contrac­ tion of the auricles. In measuring blood pressure by the auscultatory method there are five different phases which are noted.

The onset

of the fourth phase of blood pressure sounds was recorded as the diastolic pressure.3 Master and Harvard Step Tests. These two tests were used as the standard exercises to determine the effect of conditioning on arterial blood pressure. in detail in Chapter III.

2 McCurdy, o£. cit.. p. 69. -3 JjQo . cit •

They are described

5 VI.

ORGANIZATION OF REMAINING CHAPTERS

The first chapter has included the purpose, importance and limitations of the study, and the definitions of terms. The second chapter deals with the review of related litera­ ture.

Chapter III discusses the various methods and proce­

dures used in the experiment.

The fourth chapter discusses

the results obtained from the study.

The final chapter

summarizes the findings and presents conclusions.

6 CHAPTER II REVIEW OF THE LITERATURE Many studies and experiments have been conducted concerning blood pressure.

The majority have been centered

on blood pressure response to differences in work load and are therefore not directly related to this study. Reviewing the literature since 1900 in regard to the effect of training on arterial blood pressure indicates that there is some disagreement as to its effect. I. STUDIES INDICATING A DECREASE IN BLOOD PRESSURE DUE TO TRAINING The most recent study was conducted by Cogswell^, in *

which seven subjects from a Civilian Public Service experi­ ment were used.

The subjects maintained the same dietary

intake, sleep and living habits during the training period; July 1, 1945 to October 1, 1945. The Harvard Step Test (one hundred and twenty beats per minute for five minutes) served as the training exercise as well as the control exercise to determine blood pressure response to training.

^ R. C. Cogswell, C. R. Henderson, and G. H. Berryman, ,fSome Observations of the Effects of Training on Pulse Rate, Blood Pressure and Endurance in Humans, Using the Step Test (Harvard), Treadmill and Electrodynamic Brake Bicycle Ergometer,” American Journal of Physiology. 146:422, June, 1946. 1

7 The results indicated that the resting and post exercise systolic blood pressures tended to decrease with training, as did the resting and one minute post exercise diastolic pressure*

No trends were observed in the two or

three minute post exercise diastolic blood pressures* In an experiment conducted by Langston5 at Spring­ field College in 1938, ten varsity swimming team contestants were tested at the beginning and end of the training season* The results indicated that the training period reduced the blood pressures an appreciable amount* sure was reduced from

to -i— 74 pressure was reduced from to 93 pressure was, therefore, reduced 92

Sitting blood pres­

mm* Eg and standing blood A§i mm* Hg*

Sitting pulse 90 from 48 to 40 mm* Hg and

standing pulse pressure from 45 to 31 mm* Hg* Even though the results indicated that training lowered the blood pressures, Cureton interpreted the results as meaning that the blood pressures were higher than average before training, and as the cardiovascular systems adjusted to the work the blood pressure reduced* A six week physical training program combined with

5 W. J. Langston, ”A. Study of the Training Procedures Used in Competitive Swimming,” Unpublished Project in Aqua­ tic Methods Course, Springfield College, Springfield, Mass*, 1938; taken from T. K* Cureton, et.al., Physical ffitness and Guidance (St. Louis? The C* V. Mbsby Company, 1947), p. 222 •

8 artificial ultraviolet radiation reduced the resting blood pressures in an experiment conducted by Allen and Cureton*

6

The control group participated in the training program which was conducted three times weekly.

The experimental

group was exposed to ultraviolet rays three times weekly, gradually increasing from thirty seconds to one minute and thirty seconds over the six weeks period, and also took the same training program as the control group* According to Cureton and Allen the experiment yielded the following results.

In the ultraviolet experimental

group there was a reduction in lying blood pres stare from blood pressure from mm* Hg* to

108

to

In the control group there was a change from

1 PA

62 in the lying blood pressure and in standing blood

pressure from

to

mm* % •

TJ

Steinhaus ,in reviewing the literature on blood pres­ sure stated that Herxheimer®, Swig9, and Akermamr*-8, in con­

6 H* M* Allen and T. K* Cureton, "Effects of Ultra­ violet Radiation on Physical Fitness,11 Archives of Physical Medicine. 26:6453, October, 1945* 7 A* H,Steinhaus, "Chronic Effects of Exercise,” Physiological Review. 13:117, 1933* 8 H* Herxheimer, Zeitschrift fair Klinisohe Medizin. 98:484, 1924* (Quoted by S'teinhaus, loo* cit77 1925*

9 W. Ewig, Minchen Medizin Wochensohrift. 72:1955, (Quoted by Steinhaus. locT cit*)

10 R* Ackermann, Zeitschrift fiir Klinische Medizin. 106:244, 1927* (Quoted by Steinhaus, lbc* cit*)

9 ducting individual studies on blood pressure changes due to training have found that the resting systolic blood pressure is reduced considerably* Herxheimer found that a decrease in blood pressure does not occur during strenuous training, but that it does decrease as the training becomes more moderate# In eighty-eight per cent of Ackermann's subjects a decrease of diastolic pressure was noted. II. STUDIES INDICATING AN INCREASE IN BLOOD PRESSURE DUE TO TRAINING BarachU in comparing the average resting systolic blood pressure of marathon runners prior to their race, found the blood pressure higher than for corresponding ages, eighteen to twenty-five, of non-competitive indivi­ duals.

It must be pointed out, however, that the blood

pressure of the marathon contestants may have been higher than usual due to the excitement of the approaching contest. III. STUDIES INDICATING NO CHANGE IN BLOOD PRESSURE DUE TO TRAINING The results of a study conducted by Gimmill^2 on

^ J. H. Barach, "Physiological and Pathological Effects of Severe Exertion," Archives of Internal Medicine. 5:404, 1913. 0. Gemmill, W. Booth, and B. Pocock, Muscular Training: I. "The Physiological Effect of Daily Repetition of the Same Amount of Light Muscular Work," American journal of Physiology. 92:253, Peb. 1930.

10 physiological effect of light muscular training, indicated that no significant changes occur in blood pressure due to training*

In this experiment only three subjects were used*

The training consisted of riding a stationary bicycle one half hour each day for several weeks, keeping time to a metronome and maintaining a constant load throughout the working period* For three consecutive years, 1914, 1915, and 1916, Dawson-*-3 experimented with different training procedures in an effort to determine the effect of physical training and practice on blood pressure* The training procedures and periods were as follows: In 1914, three mile run each day, with absolutely no emphasis on speed, the training period was three months in duration; 1915, gymnastics which lasted for one month and a half; and in 1916, the training consisted of playing tennis and daily workouts on a bicycle ergometer, this period continuing for three and a half months* Dawson interpreted the results of his study to be that the effect of training on resting blood pressure is neither striking nor constant*

His observation concerning

Percy m . Dawson, "Effect of Physical Training and Practice on Pulse Rate and Blood Pressures During Activity and During Rest, with a note on Uertain Acute Infections and on the Distress Resulting from Exercise," American journal of Physiology. 50:444, 1920*

11 pulse pressure was that it tended to increase from three to six mm., due to training. Bramwell and Ellis14, in comparing the resting systo­ lic, diastolic, and pulse pressures of 202 Olympic athletes, found them to be within the ranges common to people of similiar ages, thus indicating that training has little effect on resting blood pressure.

0. Bramwell and E. Ellis, "Clinical observations on Olympic Athletes," Arbeitsphysiol. 2:51, 1929; taken from Edward o. sehneider and Peter v. Karpovich, Physiology of Muscular Activity (Philadelphia and London: W. B. Saunders company, 1948), p. 197.

12 CHAPTER III THE PERSONNEL, MATERIALS AND METHODS, PROCEDURE AND TRAINING PROGRAM USED IN THE EXPERIMENT I. PERSONNEL Subjects.

in this study thirty-four male, adult

students of the University of Southern California were used as subjects.

The majority were physical education majors

and a few were members of varsity athletic teams.

The sub­

jects ranged from twenty to twenty-eight years of age, most of them falling between the ages of twenty-three and twentysix. Examiners. The blood pressures were taken by four competent graduate students of the University. II. MATERIALS AND METHODS IBID Blood Pressure. The blood pressure was determined by the auscultatory method using a Baumanometer, 300 model, sphymomanometer.

A binaural stethoscope was used to deter­

mine the pulsations of the artery. Master Step Test. The Master Step Test represented light muscular work. Qppenheimer in 1929.*^

This test was developed by Master and It consisted of mounting steps, each

Thomas K. Cureton and et.al., Physical Fitness Appraisal and Guidance (St. Louis: The O. v• Mosby Company* 1947), p. 37.

nine inches high, two steps up and two steps down.

The

number of steps to be completed by each subject in ninety seconds was determined by a standardized table according to age and weight.

This ranged from forty-five and one-third

to sixty-six and two-thirds steps.

This standardized num­

ber was in turn transferred to a metronome which set the pace the subject was required to maintain.

The test contin­

ued for three minutes. Harvard Step Test. The Harvard Step Test, developed in the Harvard Fatigue Laboratory during World War represented heavy muscular work. This test consisted of mounting one twenty inch step. It was required that both feet be resting on the twenty inch platform before the subject was allowed to step to the floor again.

This test was performed at a rate of one-hundred and

twenty beats per minute by every subject and was five minutes in duration.

Each subject was required to maintain a reason­

ably erect posture when both feet were on the step. Exaggerated arm swinging was not allowed since this would aid the subject in lifting his body weight.

Optimum

swinging which facilitated balance was permitted. The metronome was also used in this test to set the pace for the subject.

16

P« 174.

14

III* PROCEDURE Each subject sat quietly for a minimum of five min­ utes before the resting blood pressure was taken.

When

this was completed the individual began the Master Step Test, as previously described.

Upon completing the test,

the subject again sat down and the blood pressure was taken in the first, fourth and ninth minutes of recovery. Immediately after finishing the above procedure, the subject performed the Harvard Step Test, after which blood pressures were again taken in the first, fourth and ninth minutes of recovery. IT. TRAINING PROGRAM For six and a half weeks each subject participated in a training program of weight lifting and running three times each week. The weight lifting exercises were taken from two articles written by Morehouse and Rasch.**-7 All subjects used the same amount of weight and per­ formed the same number of repetitions in each of the weight exercises.

Each weight increased five pounds per week

throughout the complete training period. The number of repetitions per exercise varied.

All

^ Laurence E. Morehouse and Philip J. Rasch, "Weight Training," Scholastic Coach, 17:12-14, Dec. 1947 and 17:13-16, Feb. 1948.

15 arm exercises were six repetitions the first workout of each week and increased three repetitions for each of the two succeeding workouts of the week.

All leg exercises were ten

repetitions the first workout and increased five repetitions for each of the two succeeding workouts. The weight training exercises were divided into two sets, utilizing a total of twenty different exercises.

The

specific exercises, amount of weight and repetitions done are shown in Tables I and II. The exercises in Set I were performed for three weeks, three times weekly.

In addition to the exercises the subjects

either ran five four hundred and forty yard laps or performed the Harvard Step Test. The exercises In Set II were performed three times . weekly for three and one half weeks.

In addition the sub­

jects ran for five minutes on a treadmill which was set at a grade of eight and seven tenths degrees and a speed of seven miles per hour.

16 TABLE I WEIGHT LIFTING EXERCISES - SIT I 1st.wk

"SnH'.wK " 3rd .wk

Repetitions*

Weight

Weight

Press

6-9-12

40#

45#

50#

Press behind neck

6-9-12

30#

35#

40#

Curl

6-9-12

30#

35#

40#

Push back

6-9-12

10#

15#

20#

Reverse curl

6-9-12

20#

25#

30#

Supine press

6-9-12

50#

55#

60#

Rowing motion to chest

6-9-12

40#

45#

50#

Straight arm pull over

6-9-12

25#

30#

35#

Straight leg dead lift

6-9-12

80#

85#

90#

Rise on toes

10-15-20

40#

45#

50#

Leg raise

10-15-20

Iron Boot

5#

10#

Straddle lift

10-15-20

80#

Name of exercise

* This table is to be read as follows:

85#

Weight

.. .

90#

Six repetitions

were performed the first workout of the week, nine repetitions the second workout and twelve repetitions the third workout of the week.

The weight used for each exercise was increased by

five pounds each week.

17 TABLE II WEIGHT LIFTING EXERCISES - SET II

Name of exercise

Repetitions*

4th *wk

5th.wk

6th *wk

Weight

Weight

Weight

Press

6-9-12

55#

60#

•65#

Side Press

6-9-12

15#

20#

25#

One arm rebound press

6-9-12

15#

20#

25#

Lateral Raise

6-9-12

10#

15#

Gurl

6-9-12

45#

50#

55#

Reverse curl

6-9-12

35#

40#

45#

Straight leg dead lift

6-9-12

90#

95#

100#

Wrestlers bridge

6-9-12

25#

30#

35#

Zottman curl

6-9-12

10#

15#

2#

Rowing motion to abdomen

6-9-12

55#

60#

65#

Bent arm pull over

6-9-12

10#

15#

20#

Supine press

6-9-12

65#

70#

75#

High pull up

6-9-12

30#

35#

40#

10-15-20

80#

85#

90#

Deep knee bend

* Tills table is to be read as follows:

Six repetitions

were performed the first workout of the week, nine repetitions the second workout and twleve repetitions the third workout of the week*

The weight used for each exercise was increased by

five pounds each week*

18 CHAPTER I\T ANALYSIS OF THE RESULTS The resting, one minute, four minute and nine minute recovery blood pressures and pulse pressures for the Master and Harvard Step Test of each subject prior to training was compared with the same measures taken following six weeks of training.

By use of Fisher*s ntn formula, the statisti­

cal significance of the obtained differences was determined. The mean blood pressures, differences, the obtained value for Mt** and the level of confidence for the significant dif­ ferences are shown in Tables III and IF.

Graphic represen­

tation of these values is made in Figures 1 and £• I.

MASTER STEP TEST

Systolic blood pressure. The decrease in the resting systolic blood pressure following six weeks of systematic conditioning averaged 7.88 mm.

This change was statistically

significant at the one percent level of confidence. It appears reasonable to conclude, therefore, that the conditioning program described in this study tended to lower the resting systolic blood pressure. On the other hand the changes in systolic blood pres­ sure during recovery from the mild exertion of the Master Test were not significant.

There was an average decrease of

5 mm. in the one and four minute recovery blood pressures and an average decrease of 4 mm. in the nine minute recovery

19 TABLE III DIFFERENCES RECORDED IN BLOOD PRESSURES FOR THE MASTER STEP TEST BEFORE AND AFTER CONDITIONING

Means in mm. Hg Before After rraining Training

Differ­ ences in nijitt mm. Hg

Level of confidence

Systolic Resting blood pressure

118

111

-7.88

2.5

One minute recovery

125

119

-5.06

1.7

Four minute recovery

119

113

-5.53

2.0

Nine minute recovery

115

112

-4.41

1.8

Resting blood pressure

81

75

-5.35

2.7

1%

One minute recovery

81

77

-4.47

2.4

■256

Four minute recovery

81

76

-5.06

2.7

1%

Nine minute recovery

81

75

-5.65

2.8

1%

Resting pulse pressure

38

36

-2.26

1.1

Not significant

One minute recovery

44

43

-2.26

0.4

Not significant

Four minute recovery

38

37

-0.59

0.0

Not significant

Nine minute recovery

32

36

+3.94

0.9

Not significant

1% Mot significant 5% Not significant

Diastolic

Pulse Pressure

20

TABLE IV DIFFERENCES RECORDED IN BLOOD PRESSURE FOR THE HARVARD STEP TEST BEFORE AND AFTER CONDITIONING

Means in mm. Hg Before After Training Training

Differ­ ences in «T” mm. Eg

Level of Confidence

Systolic Not significant

One minute recovery

165

160

—4 .88

1.3

Four minute recovery

140

131

-8.06

2.5

1%

Nine minute recovery

122

114

-7.53

3.1

1$

One minute recovery

79

69

-9.65

2.8

i$>

Four minute recovery

77

73

-3.12

1.4

Nine minute recovery

81

77

-4.76

3.0

One minute recovery

86

91

-*-4.76

1.0

Not significant

Four minute recovery

63

58

-5.12

1.7

Not significant

Nine minute recovery

41

38

-3.06

1.6

Not significant

Diastolic

Not significant

Pulse Pressure

m

TO

m

yo m.

^pe&B133?