Resistance exercise, the Valsalva Maneuver, and cerebrovascular transmural pressure

Purpose: To examine the acute effects of resistance exercise (RE) performed without a Valsalva maneuver (VM) versus a VM performed alone on systolic pressure, intracranial pressure (ICP), and cerebrovascular transmural pressure (CVTMP) (i.e., the important pressure that stresses the cerebral arterial and aneurysmal walls and calculated as systolic pressure minus ICP). Methods: The subjects for this study consisted of seven (mean +/- SD, Age: 39 +/- 14 yr) fully alert, cooperative, and clinically stable individuals who recently underwent various neurosurgical operations. Heart rate, systolic pressure, ICP, and CVTMP were obtained at rest, during a VM, and during submaximal (8.0 +/- 3.0 kg performed for 18 +/- 10 repetitions) unilateral bicep curl RE. Results: The VM resulted in a significantly greater increase in ICP (VM: 31 +/- 14 mm Hg vs RE: 16 +/- 7 mm Hg, P < 0.05) with a concomitant decrease in CVTMP (VM: 106 +/- 22 mm Hg vs RE: 132 +/- 14 turn Hg, P < 0.05) compared with unilateral bicep curl RE. Conclusions: Unilateral bicep curl RE results in a greater increase in CVTMP compared to a VM performed alone.