EFFECTS OF HEAD DOWN TILT TRAINING ON CAROTID BLOOD FLOW, PSYCHOLOGICAL STRESS AND ANXIETY SENSITIVITY IN THE ELDERLY
Authors: Guo Zhangjie , Liu Peng , Yang Hongmei , Bao Yaling , zhou Yuhua , Sun Mingyun , Qu Hang 
Published: July 2022

Abstract

Background
At present, population aging has become an important social problem in the world, which is closely related to the economic development of various countries. For the elderly, exercise is an important means of disease prevention and rehabilitation. “Head down tilt training” has attracted a lot of interest. From the perspective of preventive medicine, there is still a lack of systematic research on the impact of head down training on human function. The purpose of this study was to investigate the changes of carotid blood flow and the characteristics of psychological stress in the elderly after HDDT. We hypothesized that HDDT can increase carotid blood flow and reduce psychological stress. At the same time, whether head down tilt training has an impact on the psychological anxiety of the elderly has also become an important research question.

Participants and Methods
40 retired teacher volunteers were recruited. Carotid hemodynamics was measured by Phillips color Doppler cv850 color ultrasound. The blood flow characteristics of four different postures were studied. This paper also uses the multidimensional health locus of control scale wallston, &amp; dvellis, 1978 (multidimensional health locus of control scales) MHLC scale to evaluate the views on health from the perspective of psychological locus of control in three areas: Levenson's internality, the influence of powerful others and the role of opportunities. MHLC has two parallel versions, each of which is divided into three parts with six entries in each part, all of which are self-rated scales. The scores of each subscale range from 6 to 36. The sample sources of MHLC include healthy people such as students, secretaries, nurses, doctors, etc., as well as people with health problems such as diabetes, hypertension and patients undergoing hemodialysis or chemotherapy. The norm data are in IHLC m-26 (SD = 5), CHLC M = 15 (SD-6), PHLC M = 20 (SD = 5.5). Internal consistency study showed that IHLC Cronbach a = 0.61-0.80, CHLC) 0.55-0.83, phlc 0.83 56-0.75, the correlation of each component between the two parallel versions is ihlc0.75 respectively 48-0.77, CHLC0. 38-0.65, PHLC0. 46-0.53. The three subscales of test-retest reliability after an interval of 4 to 6 months were ihlco 66 CHLC0. 73, PHLC0. 71.

Results
There was no significant difference in gender in the same part (P &gt; 0.05), and there was no significant difference in blood flow in different parts of the same artery (P &gt; 0.05). In both men and women, the blood flow of left common carotid artery, right common carotid artery, right internal carotid artery and right vertebral artery showed head downward tilt of - 90 ° &lt; head downward tilt of - 30 ° &lt; head upward tilt &lt; supine position. For the blood flow of the left internal carotid artery, it is head downward tilt - 90 ° &lt; head upward tilt &lt; supine &lt; head downward tilt N-30 °. This study communicated with the subjects before and after the experiment. The subjects generally responded that after hdtt, the psychological pressure in life slowed down and the sleep quality improved. At the same time, in the influence of head down tilt training on anxiety, directional emotional response plays an intermediary role and psychological elasticity plays a regulatory role. Head down tilt training mediates anxiety through directional emotional response, which is regulated by psychological elasticity. The more head down tilt training, the less influence of adjusting life events and coping styles on anxiety; On the contrary, the less head down tilt training, the greater the impact of adjusting life events through coping style on anxiety.

Conclusion
The total blood flow of the carotid artery decreases in the same position as that in the supine and supine position. The changes of carotid blood flow were related to body position, but not to gender. The change of body position has a certain effect on cerebral blood flow, but the overall change is small in the normal range. HDDT is safer as a way of fitness. This study also found that the psychological pressure in the life of the elderly slowed down and the sleep quality improved. Finally, strengthen the cognitive education of the elderly on head down tilt training, carry out targeted education for elderly nursing professionals, and guide them to carry out corresponding head down tilt training according to their own situation. Regularly hold professional training sharing, experience introduction and other activities, establish a successful model of positive emotion, clarify the specific objectives of the activities, form strong psychological motivation, stimulate internal potential and help realize positive behavior. Strengthen professional guidance and make the motivation of winning the bid behavioral. The concentration of nursing staff is high and the degree of nursing specialization is high. Organize experts and scholars to form a professional nursing guidance team, give full play to the professional project role of experts and scholars in their respective fields, and more effectively solve the key problems of the project.

Acknowledgement
This study was supported by the Social Sciences Key Research Project Foundation of Anhui Provincial Department of education (SK2018A0981), Provincial Ideological and Political Demonstration Course “Research Methods of Sports Science” (2020szsfkc0561), the Key Project of Anhui University Excellent Young Talent Support Program (gxyqZD2019113), the Key project of N S F of Anhui Provincial Department of education (KJ2017A364).