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J Phys Fitness Sports Med, 5 (3): 235-238 (2016)
DOI: 10.7600/jpfsm.5.235
JPFSM: Short Review Article
Hisayoshi Ogata
Department of Lifelong Sports for Health, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan
Abstract
Passive walking-like leg movement in the standing posture (PWM) has been used
to activate neural mechanisms responsible for generating gait movement and to prevent disuse
syndrome including muscle atrophy, bone mass loss and joint contracture as a rehabilitation
tool for individuals with gait disturbance. However, circulatory responses to PWM have not
been fully determined, despite the potential risk of orthostatic intolerance from standing posture.
Quiet standing (QS) causes a decrease in blood volume in the ventricles due to the pooling
of blood in the lower extremities and subsequent decrease in stroke volume. On the other hand,
cardiac contractility and heart rate increase to maintain cardiac output due to enhancement of
sympathetic nerve activity. The enhancement of cardiac activity is linked to vasovagal responses
characterized by bradycardia and the drop in arterial blood pressure and symptoms such as
pallor, lightheadedness, hyperventilation and blurred vision, especially in young individuals. In
addition, QS can cause orthostatic hypotension due to loss of sympathetic control of the heart
and vasculature in individuals with cervical spinal cord injury. Vasovagal response and orthostatic
hypotension may lead to syncope. However, PWM has been shown to induce a decrease
in cardiac activity compared to that during QS in young individuals and a large increase in arterial
blood pressure in individuals with cervical spinal cord injury, suggesting that PWM reduces
the risks of vasovagal responses and orthostatic hypotension and, consequently, syncope. The
efficacy and safety of PWM suggests that PWM is a useful tool for rehabilitation in individuals
with gait disturbance.
Keywords
gait, orthostatic intolerance, rehabilitation, standing
