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juergfeldmann

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 #16 
ryinc, yes  I  saw  that  too. Was hoping nobody  would ask  as I  have no  explanation on that. What  we  can do , we  can go  and look at closer  what the  up and down in SmO2  connect  to with tHb. Will be fun to see, whether there is  a decent  acceptable indication.
juergfeldmann

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 #17 
Ryinc.
I went back  for some closer looks  at  the  section. . 1. We  are still not sure, whether the middle load  was  to  pressure socks  load. There are  some indication but  with one single  tryout  and  minimal  trends  I would  go back and to some 50 - 100 more of this.  Perhaps  Sebo  or you get a  sponsor ship  from a  compression garment  company  to  do that   over a  lot  more  trials. So I  went back  to  our own trials  with  socks  and pants and I  could not find  one similar   reaction.

BUT
 All the  test we did  where in most likely much lower intensities. Sebo may coincidentally  loaded and intensity  where  we may be close  to one or the otehr limiter on that  day  at this intensity. So  HR  if  available  would be a big step  forward  here. So below  what we  can see

smo2  thb  dleta  aall three.jpg

Y
ou can easy see  what  ryinc means  first  and third load  have this  wave  form regular pattern in SmO2  for  sure but as well in tHb

Now  if we go closer  to  them  see below




thb smo2 pattern sine  wave.jpg




A
nd if we  go  even closer
. A  surprising regular  30 +-  second  pattern, with an amplitude  which would  expect  to have a  abduction pattern  which  Sebo not  did  at all.
Now  in  clients  with unstable  BP  when   we create  an orthostatic  challenge  we see that  pattern as a  body reaction to  try  to real but than BP  collapses  so  they vasoconstriction  to maintain  but than  BP   no problem so  they try  again to relax. This  as a sign of a limited  CO  in that situation.. To stabilize  this feeling  they than  either have to  do   lower leg  muscle pump  for   compression outflow increase  or  they get  compression  support !!!!
So  was Sebo in that intensity just borderline CO limited  and  the  socks  avoided  the battle  for BP.? So lets go and take  2  simple waves to look closer

thb smo2 pattern sine  wave closer.jpg 
I take  2  and look  way . 1.I take  one 30 second  wave  where tHb  and SmO2  go identical, so  down at the same time and up. If  it is  an activity  we  will see that.
 Than I  take  one wave  by 700 . Why . looks  like   some  slightly timing off and looks like we  would see in an occlusion  situation.

bias  super close   up and donw  delta.jpg 


You can see the up  SmO2  motion is  here in O2Hb increase  and O2Hb increases  as  sign of blood  inflow  (tHb  up )  and we have more  O2  in  the  blood.
So  dilatation  relaxation  but as well  some what higher demand  to maintain BP. Lets see  the  700 wave  which is  slightly off   between tHb  and SmO2  and looks like an occlusion  picture in many cases.

bias  super close   up and donw  delta occl question BP.jpg   Hmm  absolute   minimal HHb increase basically  nothing  and that would take part  when we have a  vasoconstriction to maintain BP  as  the  outflow pressure is minimal as the constriction is not  muscular  but in the arterioles  to  reduce flow and increase .
 Ryinc  if  you have a PH.D  you can  publish  that  as   you do not need   a lot  of  examples. As a  forum reader we need  another  50 - 100   cases  where we see that  and  again the question isi whether  the intensity  Sebo   bike was just perfect  for this feedback.BP. If  that is the case  it would show  that at a specific  critical intensity  the pressure could in fact support a better performance

ryinc

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 #18 
Haha Juerg i only have a midwife certificate issued by you so i dont think that is enough to publish.
ryinc

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 #19 
Sebo can you confirm which interval is the correct answer
sebo2000

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 #20 

Drum roll…..,[biggrin]

I had compression socks in interval # 2 . First 15min no compression socks, then compression socks on, then # 3 I removed them.

Virtual Moxy KungFu Master Award goes to Ryan!!!!

 

First of all I want to thank Juerg for not telling me, what I probably would hear on 99% of the internet forums: “What are you doing, you are not doing it right…, he is truly open minded scientist”

 

Here is why:

My experiment could be compared to following:

My wife asks me what the temperature inside the house is, I look at the thermometer outside, and try to guess temperature inside the house based on reading from thermometer outside the window”

 Juerg doesn't say a word, just mentions it, he lets the "kids" play and even participate himself and does really good analysis. Thanks for not killing the fun and allowing us to learn.


I honestly have to admit I didn’t have a clue how those socks should really work, until Craigs comment:

 â€œThey are meant to assist in venous return. Given that the moxy is not on the calf how can we tell if this is so? More HHB should be shifted to the quadriceps”

 

This comment made me really thinking [idea], sock www site said their product helps with “venous insufficiency”…

 

I will be fully honest, and explain my initial wrong thinking below, I was actually wrong twice, until l saw Craigs comment about venous return, then Juerg chart confirming it.

 

1. Before wearing the socks, I have asked myself what would I expect to see? [confused]  My wrong impression was: Socks will compress my lower leg, this will push all blood out of the lower leg to my body, increasing tHb and SmO2. I was convinced I will see the difference on my VL and possibly Deltoid since that seemed like a lot of blood volume, I was not really thinking what could happen to my lower limbs left without circulation and O2 for 15 min…[smile]

 

I jumped on the bike and did quite a lot of respiratory manipulations (bad idea) I wanted to have fresh legs (again wrong, if you test compression socks you probably want to have tired legs and see if socks work[smile] I didn’t think about my resp and CO at all.

I’m on the bike doing interval # 1, intensity was picked to stay in balance for 45 min (on VL), I wanted to have as flat Smo2 line as possible for all 3 intervals when looking at VL, and slightly increasing on Deltoid.

 

After about 6 minutes when my Deltoid Smo2 started to go up and down, I knew I pushed too much with my respiratory manipulations, normally my SMO2 on Deltoid increases (nice flat line), now it is erratic, does not go down in trend, but it seems I lower my O2 extraction ability by a notch.

 

I’m pedaling and thinking: this is actually good, when I put the socks on, I should see my erratic Deltoid SmO2 go flat or even increase. Great, accidentally I have created perfect O2 scenario, so I thought.

 

2. I stopped, put the socks on for interval #2 (It is PITA to put them on…) I jumped on the bike, and after few minutes almost screaming: wow they work, my Smo2 on deltoid is SOLID. Then I started to look at my VL SMO2 and realized line is solid, BUT slowly very slowly going down…I completely didn’t understood that. (as true scientists I pretended it didn't happen [biggrin]) If my Deltoid Smo2 (systemic) is not moving up/down, why my VL Smo2 goes down!!!, are my legs working harder? No, I could not explain that at all. (can not be explained, it must be fiction [smile]

 

3. While removing my socks, I was expecting my Smo2 and tHb to drop, I was thinking: if I could see my “jumpy” Smo2 in interval #1 now it will be amplified by quite a lot. Surprise: I’m looking at my Deltoid and Smo2 is stable the same way as it was in # 2, that threw me off, after about 7 min smo2 started erratic movement again. I could not come up with the reason, why the delay was so long.

 

 

After the ride, my second incorrect conclusion was:

 

“Moxy on VL does not show much, due to constant load the demand and utilization on VL is “the same” balanced, small differences we see in smo2 dropping cannot be explained….[smile]

 

The real proof about those socks working; can be observed by looking at  Deltoid SMO2, during second interval systemic SMo2 was less erratic indicating more oxygenated blood in deltoid.

 

And then I noticed Craig’s post about Venous return and realized dropping SMo2 in # 2 and clearly visible increased trend of HHB could indicate more Venous blood in VL that was pushed from my calf, this is at list in line with how compression socks should work.

Juerg biased 2 chart also showed tHb increase while Smo2 was going down. (thats multiple confirms)

 

At that time I realized I should really have moxy on my calf and look at HHb and O2Hb, those socks are so tight there is no way I could stick moxy in it, and I realized my experiment is flawed. I’m looking for signs in wrong places…

 

Having said that: increasing HHB trend on VL is a “good sign socks work”, I could confirm it by having second moxy on my hamstring instead of Deltoid, and repeat the same exercise 5 more times on different days, if I would observe the same HHB uptrend I could have much stronger evidence of venous blood shifting up.

 

Calf is not used that much in normal pedal stroke, it is just there to stabilize the knee, I could think about some pedal stroke manipulation to increase calf workload and observe if HHB increases even more during those manipulations.

 

Intensity as Juerg said, should be lowered, this would much easier show potential changes.

 

Attempt of explanation of more stable Smo2 in Interval #2 :

 

Since I did respiratory manipulations before this experiment, and I could clearly see the negative results in less stable smo2 in # 1, What happened is; when I stopped to put the socks on, I “topped out” my O2, I rested/recovered and fully loaded with oxygen. The same trend was visible in # 3 for first 7 minutes even without the sock.(removal was quicker= less recovery time). I'm in balanced zones but with overloaded respiratory.

 

Final conclusions:

 

  1. This was fun, thanks everyone for commenting. I’m still not sure if HHB uptrend in # 2 means venous blood increase in VL was caused by the compression sock.
  2. If HHB blood increases in VL due to compression socks, then I would not recommend them for road cyclists\criterium races, they could be probably better for runners… For road cyclists with dominant VL it would be more beneficial to wear way longer compression socks, as long as possible, to have more O2HB in VL and less HHB, maybe even covering Gluts, but that would mean I would need to wear stockings...[crazy], I’m not sure how my wife and cycling friends would react to that ..[smile]
  3. We would need to somehow check, how increased compression affect pressure and O2 exchange at the cell\tissue level, it could be negatively affecting it after a while. Initially higher pressure difference allows on better O2-CO2 exchange, but once cell pressure changes due to external force (does it after 2-3 hours?) we could be dealing with less arterial pressure difference and no CO2 extraction by hemoglobin…This could end up badly….
  4. If time permits I will do 2 more tests: A. Moxy on VL and hamstring, at lower power, and B: static tests off the bike while standing and slowly working my calf, eg (5 min while doing some calf raise exercise every 5 seconds…protocol to be developed any comments welcome.

Some charts I’m referring in this long write-up:

VL HHB main indicator of venous blood going up:


VL HHB.JPG 


VL SMo2 going down in # 2


VLSMo2.JPG 



Deltoid SMo2, recovered trend i n# 2 and recovered trend in first 7min of # 3 caused by putting on and removing socks.


DeltoidSMo2.JPG 







juergfeldmann

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 #21 

We may have a  question  for a pipe fitter ( piping  question )

Having said that: increasing HHB trend on VL is a “good sign socks work”, I could confirm it by having second moxy on my hamstring instead of Deltoid, and repeat the same exercise 5 more times on different days, if I would observe the same HHB uptrend I could have much stronger evidence of venous blood shifting up.

  1. This was fun, thanks everyone for commenting. I’m still not sure if HHB uptrend in # 2 means venous blood increase in VL was caused by the compression sock.
Or in other terms
 You have  different   levels in your  house  and different   bath rooms. Each of them  will feed into a main pipe  as well as  input  will come over  a main pipe.
 So the  question in MOXY  on VL  is, whether  the  readings we have  from NIRS  will be able to read  the main pipe  feedback  from the  calf.

Let's look at the idea in a picture.

circulation  exchnage.jpg 
 NIRS  will try to pick up depending in  optode  distance  the  O2  trend ( changes  from Hb  and MB in the  very  tiny little  piping  system In the red pipes  the    blood  could  go  bot  direction with pressure or it  can be pooled  Arterial occlusion.
 In the blue  once  we normally have only one direction ( outflow )  or no  movement if it is pooled. A  back  flow  towards red is  unlikely  with exception for some damage  valve problems. So  once  O2 is taken  form O2Hb (  and sometimes  Mb . The HHb   and empty  Mb will  be there. The  HHb  will move towards  the main piping system  and than moves  back up to the  pumping station. Below  the  idea of  the man pipping.
 Question. Is  it possible  that HHb  or  venous blood  from the  calf  could make  all its  way back  to the  small venous  system in the wash room at  the VL  so a back  flow  of blood  to  that   washroom. ? Or  could it be  that  the venous blood  from the  calf   may have  little  or no influence in the reading   of the  O2Hb and HHb  ( Mb ) color  change in the VL ?





stocktrek-images-medical-illustration-of-arteries-veins-and-lymphatic-system-in-human-legs.jpg

sebo2000

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Posts: 229
 #22 
hmmm Most likley  HHb  or  venous blood  from the  calf  will not make  all its  way back  to the  small venous  system in the washroom at  the VL [smile])))


venous blood  from the  calf   may have  little  or no influence in the reading   of the  O2Hb and HHb  ( Mb ) color  change in the VL .

BUT my moxy was fixed right where that big blue vain is on the pic below. Maybe, just maybe we picked up some HHB noise...[smile]

But on the serious note, there must be other explanation for increasing HHb in second interval.




bobbyjobling

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Posts: 215
 #23 
Compression socks could increase the venous system blood pressure by reducing the total available venous volume within the body? And therefore the mean blood pressure value within any muscle is slightly elevated. I don't think we get a back flow from calf to VL is just that the PB of the return circuit system is elevated.

Increasing venous blood pressure helps with SV too
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