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Cited by 140Cardiovascular Syncope and Autonomic DisordersHeart Rate Variability and Autonomic ControlBalance, Gait, and Falls Prevention

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Physical manoeuvres that reduce postural hypotension in autonomic failure

Wieling, W., van Lieshout, J. J., van Leeuwen, A. M.·1993·Clinical Autonomic Research
DOI 10.1007/bf01819146
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Abstract

A young female with autonomic failure is described. She successfully reduced the symptoms of orthostatic hypotension by application of physical manoeuvres like leg-crossing, bending forward and placing a foot on a chair. The beneficial effects of these manoeuvres can be explained by a small (10-15 mmHg) increase in mean arterial pressure to a level just sufficient to maintain adequate cerebral blood flow. The underlying common mechanism appears to be an increase of thoracic blood volume by translocation of blood from the vascular beds below the diaphragm to the chest. Instruction in these physical manoeuvres should be part of the management programme to reduce the disabilities arising from postural hypotension in patients with autonomic failure.

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  • Wieling et al. (1993) suggested that small changes in blood pressure through increased venous return from the legs may be sufficient to prevent syncope by increasing cerebral blood flow minimally above the threshold necessary.

    “Wieling et al. (1993) suggested that small changes in BP through increased venous return of blood flow from the legs may be sufficient to prevent syncope by increasing CBF minimally above the threshold necessary.”

    From The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm (2010) · cites this paper as Wieling et al. (1993)

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Research works printed but not linked: 46

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Metadata

Authors
Wieling, W., van Lieshout, J. J., & van Leeuwen, A. M.
Affiliations
Amsterdam UMC Location University of Amsterdam (NL)
ORCID
Wieling, W.
Venue
Clinical Autonomic Research
Publisher
Springer Science and Business Media LLC
Published
1993-02
Volume
3
Issue
1
Pages
57-65
ISSN
  • 0959-9851 (ISSN-L)
  • 1619-1560
DOI
10.1007/bf01819146
OpenAlex
W2014179488
Cited by
140
References
0
Citations by year
2026: 1 · 2025: 1 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 2 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 9 · 2013: 5 · 2012: 6
FWCI
1.87
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Clinical Autonomic Research (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Keywords
autonomic failure, orthostatic hypotension, leg crossing, forward bending, cerebral blood flow, mean arterial pressure
MeSH terms
Adult, Autonomic Nervous System Diseases, Bicycling, Blood Pressure, Cerebrovascular Circulation, Female, Humans, Hypotension, Orthostatic, Leg, Norepinephrine, Posture, Regional Blood Flow, Exercise

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