An Investigation of Heart Rate Recovery Responses to Repeated Active Stand Protocols

Study Overview
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Brief Summary
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Study background: Impaired heart rate recovery following active stand is associated with morbidity and mortality. Evidence for the repeatability of this measure is limited. This study seeks to determine the repeatability of the active stand procedure in eliciting heart rate recovery in healthy adults of all ages. Research aims: The aims of this study are to determine the repeatability of heart rate recovery in response to the active stand procedure among different age groups. Study design: This will be a repeatability study with between group comparison. Study setting: This study will take place in the Clinical Research Facility in St James's Hospital. Participants: Participants will be recruited from the staff and student population of Trinity College Dublin and St James's Hospital, from the Trinity Retirement Association and from the community in the St. James's Hospital catchment area. Participants will be healthy adults (over 18 years old). They will be invited to participate via an email and poster campaign. Participation will be fully voluntary. Participants who meet inclusion criteria will be selected. Informed, explicit voluntary consent will be obtained from each participant. Data collection and processing: Data collection and processing will be carried out by the Research Physiotherapist. A clinical visit for the participant will be arranged at a time most convenient for them. Participants will conduct the active stand assessment on three occasions.

Official Title
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An Investigation of Heart Rate Recovery Responses to Repeated Active Stand Protocols

Conditions
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Heart Rate Response, Orthostasis

Intervention / Treatment
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* Diagnostic Test: Active Stand


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy adults aged ≥18 (considering 18 is the age of legal consent). Fluent in English. Free of intellectual disability or cognitive impairment that would impair or impede the ability to give informed, explicit consent. Free of all exclusion criteria below. Exclusion Criteria: Unstable or un-managed cardiac/respiratory/metabolic conditions (i.e. condition must be diagnosed and being managed as per medical input to be classified as stable and managed). Neuro- musculoskeletal disorders. Acute musculoskeletal injury or impairment (including acute pain). Malignancy. Mental illness. Chronic infectious disease (Hep C/ HIV/ AIDS). Acute systemic infection or illness. Taking medication that affects cardiovascular function. Exclusion for any other reason deemed appropriate by the research team.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Active Stand|The participant is asked to lie down for 10 mins without moving or speaking. A heart rate monitor is attached while the participant is lying down. They are then asked to stand up as quickly as possible and to remain standing unassisted for 3 minutes. The participant will be asked to describe any symptoms at 1 and 3 minutes after standing. Blood pressure and heart rate will be monitored constantly throughout the test.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Baseline Heart Rate | R-R interval is recorded by portable ECG throughout assessment | 60 seconds prior to standing assessment | 
| Maximum heart rate | R-R interval is recorded by portable ECG throughout assessment | Within 3 minutes of standing assessment | 
| Minimum heart rate | R-R interval is recorded by portable ECG throughout assessment | Within 3 minutes of standing assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Demographic data | gender, age, relevant past medical history | Day 1 | 
| Height | Centimeters | Day 1 | 
| Weight | Kilograms | Day 1 | 
| Body Mass Index | Kg/m^2 | Day 1 | 
| Body Fat Percentage | Percentage | Day 1 | 
| Blood Pressure | Blood Pressure | At baseline | 
| Vascular Stiffness | Pulse Wave Analysis conducted using the Mobil-O-Graph 24-hour Pulse Wave Analysis (PWA) system. | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Heart rate response, Active Stand