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Publication date: 01.09.2021

DOI: 10.51871/2588-0500_2021_05_03_5

UDC 612.172.2

**FEATURES OF CHANGES IN SOME INDICATORS OF HEMODYNAMICS OF PARACHUTE DIVERS IN EXTREME CONDITIONS**

V.I. Pustovojt

FSBI SRC FMBC named after A.I. Burnazyan FMBA of Russia, Moscow, Russia

**Key words**: athletes, functional state, blood pressure, parachute divers, extreme sports.

**Annotation **The study was conducted to determine the main indicators that characterize the level of functional state in conditions of severe psychological and physiological stress, which leads to decreasing adaptation of parachute divers. Volumetric compression oscillometry method was the main method of examination, which parameters were subjected to mathematical and statistical analysis. The significant (p<0,01) indicators (pulse rate, diastolic and mean blood pressure) closely correlating (r>0,70; p<0,01) with the level of functional state of the athlete's organism were determined as a result of the study. The obtained data up potential to classify the functional state criteria for the parachute divers with a gradation at eight levels while developing a function.

**Introduction.** Today parachuting becomes more and more popular and a number of competitions increases. Therefore, it is very important direction in sports medicine to establish in time exact level of functional state (LFS) and adaptation resources of parachute divers in intensive training period or in competitions season period.

All parachute divers have an extremely high psychological and physiological stress. As the result, functional state and adaptation level decrease. These changes lead to negative outcome such as dysimmunity and decrement of sport performance. To establish these problems, it is necessary to obtain method that will be able to identify changes in organism in a short time and then basing on this knowledge, we can take necessary medical steps to correct this condition. That is why methods of functional state testing in athletes engaging extreme sports, especially parachute divers, become more and more interesting field of knowledge.

There are many methods that are used for LFS testing but they unfortunately do not take into consideration psychophysiological characteristics of parachute divers, so they cannot estimate objectively LFS of athletes’ organism [1-4].

We have chosen the volumetric compression oscillometry method (VCOM) as a basis to establish parachute divers’ LFS. This method is much more better than the usage of traditional functional tests.

The purpose of the research was to find out base attributes, which characterize parachute divers’ LFS in extreme conditions when testing with VCOM.

Objectives of the research:

- To find out features of cardiovascular correlates, which characterize the variation of organism LFS;
- To establish correlation between VCOM and LFS parameters of parachute divers’ organism;
- To develop classification criteria of parachute divers’ LFS, based on main parameters of VCOM.

**Methods and organization. **Materials were collected in period from 2018 to 2020 in the “Aerograd Kolomna” club. The participants were 30 athletes (parachute divers), with a mean age of 30,5±0,4 years. The main purpose of the research was to find out some parameters of cardiovascular system, which characterize organism’s LFS. The research design was accepted by the decision № 10/2 (18.10.2018) of the Ethics Committee of FSBI SRC FMBC named after A.I. Burnazyan FMBA of Russia, and it corresponds with the Declaration of Helsinki.

To standardize examined parameters and increase the measure of reliability, we excluded parachute divers with cardiac index higher than 3,5 l/min/m^{2 }and lower than 2,75 l/min/m^{2 }(hyperkinetic and hypokinetic types of blood circulation) [3, 5, 6].

The volumetric compression oscillometry method (VCOM) is based on registration of participants’ level of the blood pressure by original measurement system of the volumetric arterial oscillograms with hardware and software complex CAP CGosv-“Globus” [7]. It consists of pulse waves of a large vessel registered when pressure in the blood pressure cuff is grown (compression).

This method allows us to estimate the following: level of the blood pressure, parameters of cardiac activity, arterial wall elasticity and vessel patency. All of these points give us enough information to continue analyzing general hemodynamic function of parachute divers’ organism. These parameters have an exceptional value in evaluating functional state of the cardiovascular system in conditions of the norm and its deviation.

One measurement with this device demonstrates us next parameters: pulse frequency (heart rate, PF, HR), systolic blood pressure (sBP), diastolic blood pressure (dBP), pulse pressure (PP), true systolic pressure (tSP), mean blood pressure (mBP), cardiac index (CI), cardiac output (CO), systolic volume (SV), stroke volume index (SVI), arterial stroke pressure (ASP), rate of pressure rise – dp/dt (RPR), power drain parameters to move 1 liter of blood, linear velocity of blood flow (LVBF), left ventricle power constriction (LVPC), volumetric flow rate (VFR), pulse-wave velocity (PWV), arterial compliance (AC), peripheral resistance (PR), specific peripheral resistance (sPR), functional state (FS) [3, 5, 6, 7].

All received information was managed with math-and-stats methods by standard programs with using PC. In combination with the table editor Excel for Windows 2016, we used special software package Knime 4.1.2, which maintains all common statistical methods [8]. To model correlation between LFS and intensity of training, we used a number of statistic methods: binnings, statistical description (arithmetic mean value, standard deviation, standard error of mean, visual representation of data, relative number of distribution); Spearman rank correlation with estimating meaningfulness based on Student’s t-test for checking correlation between volumetric compression oscillometry parameters, heart rate variability and levels of functional state of athletes’ organism. The method selection was based on objectives that we worked on.

To increase diagnostic accuracy of establishing LFS of parachute divers’ organism we also use the heart rate variability method (the HRV method) with the hardware and software complex “Varicard 2.57”, which is wildly used in elite sports [2-3].

All conclusions that we have mentioned in the current research are based on all-around and objective materials which we have got by now methods: the volumetric compression oscillometry method and the HRV method.

**Results and discussion. **The integral estimation of organism’s functional state with 8-score scale significantly (p<0,01) changes, when parachute divers’ training intensity and duration increases.

The groups corresponded to the optimal functional state: (A) – excellent and (B) – very good adaptation level. Athletes of these groups had no use for functional state correction. The groups corresponded to the permissible functional state: (C) – good and (D) – satisfying condition. It means that there were pre-nosological changes, which result is insignificant physical capability reduction, to restore it athletes needed lowering intensity of training process for two days. Athletes, who had signs of premorbid changes and 2-times physical capability reduction in comparison to with the optimal group, were classified in following groups: (E) – unsatisfying and (F) – very bad functional state. There were changes in training and contest season period for these groups of parachute divers; also, these athletes were given nonobligatory recommendations to correct their functional state. The group (G) corresponded as extreme level. Athletes of this group were banned from any sporting activities for a period up to the moment of full functional state recovery, also metabolic correction was obligatory. The last group (H) consists of parachute divers, who have signs of critical LFS. These athletes were banned from further training camp.

As the result of math-and-stats basic VCOM parameters processing, a correlation was found between some VCOM parameters: if the LFS of parachute divers decreases, then there is significant (p<0,05) increase dBP, vBP, PF, SV, SVI, VFR, power drain parameters to move 1 liter of blood, PR, sPR) and decrease (AC) of some signs. This data was used to plot Spearman rank correlation with estimating meaningfulness based on Student’s t-test for checking correlation between main parameters of the VCOM and functional state with dividing in accordance with the 8-score scale (Fig. 1).

Fig. 1. Rank correlation and interrelation determination between main VCOM parameters and parachute divers’ LFS

Note: IIHRV – integral indicator of the HRV; IIVCOM – integral indicator of the VCOM.

Rows: the bottom line corresponds to the 8-score classification scale of the parachute divers’ LFS.

Columns: the last column at the right corresponds to the 8-score classification scale of the parachute divers’ LFS.

The data of Spearman rank correlation illustrated us intergroup differences in the dependence of LFS with some signs of VCOM, and we could determine three main, the most significant (p<0,01) signs, which had strong positive and negative (dBP, mBP, PF) correlation (r>0,70; r>-0,70), eight signs that had medium positive (tSP, PR, sPR, power drain parameters to move 1 liter of blood) and negative (SV, SVI, VFR, AC) correlation (0,50<r<0,69; -0,69<r<-0,50; p<0,01).

Correlation analysis of the obtained data by the HRV method with VCOM (when dividing the LFS on 8 levels) indicated a strong positive (PF- r>0,70; p<0,01), negative (SVI- r>-0,70; p<0,01) and also medium positive (SV, VFR, AC) correlation with integral parameters of HRV.

The final results of integral estimation of athletes’ LFS had strong negative correlation (r>-0,70; p<0,01) with HRV and functional state, which we obtained with hardware and software complex CAP CGosv-“Globus”.

The analysis of variance (ANOVA) established significant (p<0,05) changes in the main VCOM parameters depending on level of functional state. This pattern is presented in the second and subsequent figures in the form of average values with a gradation of eight levels.

Groups (A) and (B) correspond to the optimal LFS of the athletes’ organism (Fig. 2-5), these parachute divers were in top shape and their health significantly (p<0,05) differ from the other levels.

The second and third figures demonstrate the average values of diastolic and mean blood pressure, where extreme (G) and critical (H) LFS corresponded to clinical signs of overwork (breathlessness, fatigue, poor recovery of heart rate after exercise, low physical capability, anxiety dream, rapid onset of fatigue, decreased appetite and weight loss). As the result of the significant reducing of collaterals, these groups are characterized with high dBP values from 86,93±1,5 to 96,3±4,8 mm of Hg and mBP values increased to pathologic level of 108,5±5,4 mm of Hg. Athletes of these groups had the highest true systolic pressure (128,6±7,5 mm of Hg; p<0,05). These changes and increasing energy expenditure, which cardiac muscle uses to sanguimotion in closed vessel system, ran simultaneously, and values of 15,3±0,9 W corresponded to the critical condition and 13,3±0,8 W – to the extreme LFS. First of all, it is associated with meaningful growing up of vascular tone and accelerated passage of the increased blood flow if the initial section of the arterial bed due to its propulsive movement, which consumes most part of the kinetic energy of heart contractions because the function of the arterial walls decreased.

Fig. 2. The graph of the average values of diastolic blood pressure, characterizing LFS

Fig. 3. The graph of the average values of mean blood pressure characterizing LFS

When the health condition got worse, a significant (p<0,05) decrease of the AC values was recorded (Fig. 4) and an inversely proportional increase in pulse pressure from 55,1±4,4 in (A) to 95,6±8,5 in (H) groups, which was a consequence of the disturbance the mechanisms of cardiovascular system regulation, confirmed by performing typical physical activity, in conditions of the functional state of the organism’s decrease. According to the previously mentioned result, we have registered the bias of correlation between HR and power working capacity turned to the worse (the dependence deviance to the left) and athletes returned to the previous level after full recovery.

Fig. 4. The graph of values of the arterial compliance characterizing LFS

The increase of the peripheral resistance (Fig. 5) was in inverse proportion to the decrease of LVS of parachute divers’ organism. Thus, the parameters of PR, which characterize the premorbid, extreme and critical condition, in groups (F), (G) and (H) were higher than the average population normal value (1269,3±94,4 for (F), 1373,3±107,2 for (G) and 1485,5±117,3 for (H) sm/s).

Fig. 5. The graph of the average values of peripheral resistance characterizing LFS

With a high level of intergroup significance (p<0,05) in the study of the cardiovascular system, the indicators of the functional state of the body of parachutists were calculated with hardware and software complex CAP CGosv-“Globus” (Fig. 6), which demonstrated that the average values of 0,862±0,054 с.u. corresponded to the excellent (A) LFS of athletes, and the critical (H) – 0,46±0,08 c.u.

Fig. 6. The graph of the average meanings of the functional state estimating with hardware and software complex CAP CGosv-“Globus”, characterizing LFS using 8-score scale

The math-and-stats data analysis established that the LFS dynamic changing has strong both positive and negative correlation (r>0,70; r>-0,70; p<0,001) with the functional incoordination of the cardiovascular system. This was borne out by the morning examination, which depended on recovery of athletes’ organism after intensive training. When there was a significant (p<0,05) deterioration of the LFS, an increase (dBP, mBP, pulse, SV, SVI, VFR, PR, sPR) and significant decrease (PP, AC, FS) of some signs were recorded that demonstrated the development of the non-optimal adaptation variant of the cardiovascular system to intensive physical training or organism’s response on exogenous factors [1, 5].

There have been registered changing circulation type to hyperkinetic, which is characterized as non-economic power drain to move 1 liter of blood, when the adaptation mechanisms failured and the condition was critical.

To determine the LFS, statistically significant (p<0,05) were increase of diastolic blood pressure, mean blood pressure, pulse frequently and decrease of arterial compliance when there was the physical performance decrement.

The extreme and critical LFS was characterized with non-optimal variant of the cardiovascular system regulation. There was an increment of cardiac output due to increment of HR, not to systolic volume (Fig. 7, 8). The significant decrement of the functional resources of the heart muscle in 3-4 times is usual for these groups.

Fig. 7. The histogram of HR parameter depending on LFS of the organism. The critical and extreme LFS correspond to 1 and 2 groups of x-axis of a plot

Fig. 8. The histogram of systolic volume parameter depending on the LFS of the organism. The critical and extreme LFS correspond to 1 and 2 groups of x-axis of a plot

First of all, when there was a change in parachute divers’ LFS, the vegetative nervous system became hyperreactive, which we approved with the HRV method. The level bias to critical way made sympathicoadrenal system active and if there was not any correction in time, then there was nervous and hormone exhaustion, which was confirmed by the hyperreactivity of the parasympathetic over sympathetic nervous regulation.

The analysis of variance (ANOVA) established a significant relationship (p<0,05) between the HRV diagnostic method and the VCOM in parachute divers which significantly increases the accuracy of the final diagnosis (Fig. 9).

Fig. 9. The graph of the average values of the integral parameters of the HRV method and the VCOM based on 8-score scale

The 8-score scale usage allowed us to establish LFS of parachute divers with a high degree of accuracy (p<0,01).

**Conclusion**

- The dynamic examination of parachute divers with the VCOM let us to determine significant (p<0,05) signs of the LFS estimation using such simple parameters like dBP, mBP, PF, SV, SVI, VFR, power drain parameters to move 1 liter of blood, PR, sPR, PP, AC, FS.
- The obtained results make it possible to conclude that there is close positive correlation (dBP, mBP, pulse) between some VCOM parameters and signs of the parachute divers’ LFS change.
- Classification criteria have been developed. It allows us to distribute, with a high level of intergroup reliability, a parachutist athlete into one of the eight LFS groups, based on the analysis of significant (p<0,01) VCOM parameters (dAP, mAD and Pulse).

**Conflict of interest:** the authors declare no conflict of interest.

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**Information about the authors: Vasilij Igorevich Pustovojt – **Candidate of Medical Sciences, Senior Researcher of the Laboratory of Big Data and Precision Sports Medicine of the FSBI “State Research Center of the Russian Federation – Federal Medical Biophysical Center named after A.I. Burnazyan” of the FMBA of Russia, Moscow, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..