The idea of ​​using a change in body position in space as an input to study the functional state of the body has been implemented in practice functional diagnostics for a long time. This test gives important information primarily in those sports in which changes in body position in space are elements of sports activity (artistic gymnastics, rhythmic gymnastics, acrobatics, trampolining, diving, high jumping and pole vaulting, etc.). In all these sports, orthostatic stability is a necessary condition sports performance. Usually, under the influence of systematic training, orthostatic stability increases.

Orthostatic reactions of the athlete’s body are associated with the fact that when the body position changes (from horizontal to vertical), a significant amount of blood is deposited in its lower half. As a result, the venous return of blood to the heart deteriorates, and therefore the stroke volume of blood decreases (by 20-30%). Compensation for this adverse effect is carried out primarily through increased heart rate. Besides, important role belongs to changes vascular tone.

Thus, the development of various reactions of the body associated with changes in the position of the body in space is based on mechanisms similar to those described when considering the straining test.

The degree of decrease in venous return of blood to the heart with a change in body position depends on the tone of the large veins. If it is reduced, then the decrease in venous return can be so significant that when standing up due to sharp deterioration blood supply to the brain, fainting may develop. Low tone of large veins may cause the development fainting and at long stay in a vertical position - orthostatic collapse.

In athletes, orthostatic instability associated with decreased venous tone develops relatively rarely. However, during so-called passive orthostatic tests, it can sometimes be detected. Therefore, it is advisable to use orthostatic tests to assess the functional state of the body of athletes.

Typically, during an orthostatic test, the transition from a horizontal to a vertical position is performed by the subject actively, by standing up. The reaction to standing up is studied based on recording heart rate and blood pressure. These indicators are measured repeatedly in a horizontal position of the body, and then for 10 minutes in a vertical position.

A natural reaction to an orthostatic test is an increase in heart rate (in well-trained athletes it is relatively small - from 5 to 15 beats/min; in young athletes the reaction may be more pronounced). Due to this, the minute volume of blood flow is slightly reduced. Systolic blood pressure remains unchanged or even decreases slightly (by 2-6 mm Hg), diastolic blood pressure naturally increases (by 10-15%) in relation to its value in a horizontal position. If during a 10-minute study systolic blood pressure approaches the initial values, then diastolic blood pressure remains elevated.

When performing an active orthostatic test, the reaction cardiovascular system to a certain extent associated with muscle tension during 10 minutes of standing. To reduce the influence of this factor, a modified orthostatic test is performed (Yu. M. Stoida): the subject stands not just in a veotic position, but at a distance of one foot from the wall, leaning his back against it; a cushion with a diameter of 12 cm is placed under the sacrum; the subject is in a state of significant relaxation; The angle of inclination of the body relative to the horizontal plane is approximately 75-80°. Such a test gives results very close to those obtained with a passive orthostatic test (Table 29).

Table 29. Changes in heart rate and blood pressure in athletes under orthostatic influences

Orthostatic stability is most accurately determined on the so-called rotary table, the lid of which is rotated 90° in the vertical plane, due to which the body of the subject, lying on the lid and fixed to it with belts, is transferred from a horizontal position to a vertical one (the legs rest against the footrest).

With normal orthostatic stability, the reaction to a passive test is more pronounced than to an active one. Signs of orthostatic instability are sharp drop Blood pressure and a significant increase in heart rate.

The assessment of the orthostatic test, based on heart rate data, continues to be refined and improved. The fact is that such a seemingly reliable indicator, which is the increase in heart rate in a vertical position relative to heart rate in a horizontal position, provides inaccurate data for some athletes. This is especially true for individuals with bradycardia in a horizontal body position: their heart rate can increase by 30-35 beats/min without any signs of orthostatic instability. In this regard, in the laboratory of sports cardiology of GCOLIFK, the test is assessed based on the real heart rate in an upright position of the body. If during 10 minutes of the study the heart rate does not exceed 89 beats/min, the reaction is considered normal; A heart rate of 90-95 beats/min indicates a decrease in orthostatic stability; if the heart rate exceeds 95 beats/min, resistance to changes in body position in space is low. Athletes with low stability may develop orthostatic collapse. This approach to assessing orthostatic reactions is based on the so-called invariance principle (V.L. Karpman), the essence of which is that, under the influence of one or another disturbing influence, the functioning indicators vegetative systems organisms do not depend (or depend to a small extent) on the initial indicators and are determined exclusively by the current needs of the organism.

The response to an orthostatic test improves under the influence of sports training. This applies both to individuals in whose sports activities changing body position is a mandatory element, and to representatives of other sports (for example, runners).

When studying gymnasts, data from an orthostatic test can be used to assess functional readiness. The higher the gymnasts’ training, the better results orthostatic test.

B. Methods of standards, correlation, indices.

Standards methods. Anthropometric standards are a system of objective average data about physical development person, including height, body weight, volumes.

Correlation method– the most objective, because the connection (correlation) of indicators is taken into account. As a result of statistical processing, the correlation coefficient is determined, which is used to construct nomograms.

Index methods. Index – the value of the ratio of several anthropometric characteristics. For example, the Quetelet weight-height index (see above). Broca-Bugsche index. Body weight to height ratio:

For heights up to 165 cm, you need to subtract 100 units.

With a height of 166-175 cm - subtract 105 units.

With a height of 176-185 cm or more - subtract 110 units.

20th century Functional tests

The functional state of the body is the level of development and manifestation of the basic human life support systems.

1.Cooper test: 12 minute run. Method for determining physical performance. (See table above).

2.Ruffier's test. Determination of cardiac muscle recovery after physical activity. The lower the heart rate, the more powerful the heart muscle.

Ruffier index = 4 x (P1 + P2 + P3) – 200 / 10

Less than 0 - athletic heart

1 – 5 - excellent

5 – 10 - good

10–15 - satisfactory (heart failure medium degree)

15–20 - bad (severe heart failure)

3.Respiration rate(BH). Determination of the functioning of the respiratory system.

14-18 breaths per minute - assessment - “normal”.

Ratio of heart rate to RR at rest 4: 1 – 5: 1 – rating “normal”

Normal blood pressure is 110/70 mm Hg. Art. BP – 120/70

4.Serkin test. Determination of the performance and fitness of the heart muscle. 3 phases. 5 minutes of rest before starting the test.

1. Hold your breath while sitting while inhaling. Record the result and compare it with the table.

2. Perform 20 squats in 30 seconds and repeat holding your breath while inhaling while standing, write down the result and compare it with the table.

3. 1 minute rest while standing and holding your breath while sitting, record the result and compare it with the table.

Evaluation of results: determine which contingent you belong to?

6. Stange test. Test for resistance to oxygen starvation.

Sitting, after 5 minutes calm state, after a deep breath, hold your breath, closing your nostrils.

Time is estimated in seconds:

1. Less than 30 seconds is unsatisfactory

2. 30 sec satisfactory

3. 30 – 60 sec is good

4.Over 60 sec excellent

7. Genchi test (Buteyko) (holding your breath after a calm exhalation)

1. Less than 20 seconds is unsatisfactory

2.20 – 30 sec satisfactory

3. 30 – 45 sec is good

4. more than 45 seconds excellent

8.Mobility(flexibility) of the spine

Bend forward while standing on a bench, legs together, do not bend your knees. Measure the result in cm from the edge of the bench to your fingertips.

20 cm excellent

10 cm is good

0 -5 cm is satisfactory

less than 0 cm unsatisfactory

9. Romberg test. Coordination function indicator nervous systems s. The Romberg test is carried out in four modes with a gradual decrease in the support area. 1st – legs on the same line, arms forward, fingers apart, eyes closed. Observation of finger tremor. 2.Standing on one leg, the other foot touches the knee of the supporting leg. The 3rd supporting leg is on the floor, the other is raised forward 45 degrees, the 4th is standing on a support, the leg is raised forward.

Stability of the pose for more than 15 seconds is good, less than 15 seconds is bad.

10. Tapping test– indicator of functional state motor sphere and the strength of the nervous system (identification of the maximum frequency of hand movements).

Divide a sheet of paper into 4 rectangles 6 x 10.

Place dots with a pen or pencil for 10 seconds in one rectangle, then a break of 20 seconds, 10 seconds in the 2nd rectangle, etc.

Maximum quantity– 79 points in one rectangle. A decrease in the number of points indicates insufficient functional stability of the neuromuscular system.

Divide the sheet into 4 parts and place dots in each part for 5 seconds, moving on command without pause to another square. The average is 30-35 dots in each square.

11. Yarotsky’s test. Determines the sensitivity threshold of the vestibular analyzer.

Perform rotational circles with your head at a fast pace to the right or left, closing your eyes, until you lose balance, and record the beginning of the time to maintain balance during the test.

For those who do not engage in sports, loss of balance occurs within 28 seconds, for those who train, within 40–80 seconds.

Sensitivity threshold vestibular apparatus, mainly depends on heredity, but under the influence of training it can be increased.

A decrease in balance time indicates the onset of fatigue.

12. To assess the speed of movements You can use the coin test. One hand holding a coin is located 40 cm vertically above the other. The exercise is performed 10 times, if the coin is caught, then speed is well developed.

13. Test with a ruler. Performed from a standing position. The strongest hand with straightened fingers is extended forward with the edge of the palm down. The assistant places a 40 cm ruler parallel to the palm of the person being examined at a distance of 1-2 cm. The zero mark is at the level of the lower edge of the palm. After the “attention” command, the assistant must release the ruler within 5 seconds. The subject's task is to clench his fingers as quickly as possible and hold back the falling ruler. 3 attempts. A result of 13 cm for men and 15 cm for women is considered a good indicator.

Orthostatic tests provide important information in those sports that are characterized by a change in body position in space (gymnastics, acrobatics, diving, pole vaulting, freestyle, etc.) In all these sports, orthostatic stability is a necessary condition sports performance. Usually, under the influence of systematic training, orthostatic stability increases, and this applies to all athletes, and not just representatives of those sports in which changes in body position are a mandatory element.

Orthostatic reactions of the athlete’s body are associated with the fact that when the body moves from a horizontal to a vertical position, a significant amount of blood is deposited in its lower half. As a result, the venous return of blood to the heart worsens and, consequently, blood emission decreases (by 20-30%). Compensation for this adverse effect is carried out mainly by increasing heart rate. Changes in vascular tone also play an important role. If it is reduced, then the decrease in venous return can be so significant that when moving to a vertical position, a fainting state may develop due to a sharp deterioration in blood supply to the brain.

In athletes, orthostatic instability associated with decreased venous tone develops extremely rarely. However, during a passive orthostatic test it can be detected. Therefore, the use of orthostatic tests to assess the functional state of the body of athletes is considered appropriate.

Simple orthostatic test characterizes the excitability of the sympathetic division of the autonomic nervous system. Its essence lies in the analysis of changes in heart rate in response to changes in body position during the transition from horizontal to vertical. Pulse indicators are determined in the supine position and after the first minute of being in an upright position. The evaluation of the results is presented in Table 3.

Table 3 – Evaluation of the results of the 1st minute of the orthostatic test

(Makarova G.A., 2003)

With normal excitability of the sympathetic department of the autonomic nervous system, the pulse increases by 12 - 18 beats/min, with increased excitability - more than 18 beats/min.

Active orthostatic test according to Schellong: the subject performs the transition from a horizontal to a vertical position actively, standing up. The reaction to standing up is studied based on changes in heart rate and blood pressure(HELL). These indicators are measured in a lying position, and then for 10 minutes in a standing position.

A natural reaction to an orthostatic test is an increase in heart rate. Due to this, the minute volume of blood flow is slightly reduced. In well-trained athletes, the heart rate increases by 5–15 beats/min. In less trained individuals, this reaction may be less pronounced. Systolic blood pressure remains unchanged or decreases slightly (by 2-6 mm Hg). Diastolic blood pressure increases by 10–15% relative to its value in a horizontal position. During the 10-minute study, systolic pressure returns to the original data, and diastolic pressure remains elevated.

Modified orthostatic test according to Yu.M. Stoyde When conducting an active orthostatic test, the reaction of the cardiovascular system is to a certain extent related to muscle tension during 10 minutes of standing. To reduce the influence of this factor, the usual vertical position of the body is changed. The subject stands at a distance of one foot from the wall, leaning his back against it; a cushion with a diameter of 12 cm is placed under the sacrum. This allows the subject to be in a state of significant relaxation (the angle of inclination of the body in relation to the horizontal plane is approximately 75-80°). The results of this test are close to those obtained with a passive orthostatic test.

Passive orthostatic test allows you to most accurately determine orthostatic stability. Changing body position occurs using a turntable. The subject is fixed with straps to the table top, which rotates 90° in the vertical plane. Due to this, the position of the body in space changes. The pulse response to a passive test is more pronounced than to an active one.

With normal orthostatic stability during a 10-minute study, the pulse rate does not exceed 89 beats/min. A pulse equal to 90 -95 beats/min indicates a decrease in orthostatic stability. A pulse exceeding 95 beats/min is a sign of low orthostatic stability, which can lead to orthostatic collapse.

In highly qualified athletes, orthostatic stability can be assessed as good, satisfactory and unsatisfactory:

1) good - pulse by 10 minutes of orthostatic position increases by no more than 20 beats/min in men and 25 beats/min in women (compared to the pulse value in a lying position), stabilization of pulse indicators ends no later than the 3rd minute of orthostatic position positions in men and 4 minutes in women, pulse pressure decreases by no more than 35%, well-being is good.

2) satisfactory - the pulse increases by the 10th minute of a vertical position to 30 beats/min in men and 40 beats/min in women. The transition process for the pulse ends no later than the 5th minute in men and the 7th minute in women. Pulse pressure decreases by 36-60%, health is good.

3) unsatisfactory - characterized by a high increase in heart rate by the 10th minute of the orthostatic position: more than 30 beats/min in men and 40 beats/min in women. Pulse pressure decreases by more than 50%. Feeling unwell: dizziness and pallor appear.

Kerdo Vegetative Index (VI) is one of the simplest indicators of the functional state of the autonomic nervous system, in particular, the ratio of the excitability of its sympathetic and parasympathetic divisions.

The Kerdo index is calculated based on the values ​​of pulse and diastolic pressure using the formula:

VI = (1 – blood pressure d / Pulse) x 100

The assessment of the vegetative index is presented in Table 4.

Table 4 – Kerdo index assessment

Evaluation of the Kerdo Vegetative Index
from + 16 to +30	sympathicotonia
	pronounced sympathicotonia
from -16 to -30	parasympathicotonia
	pronounced parasympathicotonia
from -15 to + 15	balance of sympathetic and parasympathetic influences

Orthostatic test

Parameter name	Meaning
Article topic:	Orthostatic test
Rubric (thematic category)	Sport

The idea of ​​using a change in body position in space as an input to study the functional state of the body has been implemented in the practice of functional diagnostics for a long time. This test provides important information primarily in those sports in which changes in body position in space are elements of sports activity (artistic gymnastics, rhythmic gymnastics, acrobatics, trampolining, diving, high jumping and pole vaulting, etc.). d.). In all these sports, orthostatic stability is a necessary condition for athletic performance. Usually, under the influence of systematic training, orthostatic stability increases.

Orthostatic reactions of the athlete’s body are associated with the fact that when the body position changes (from horizontal to vertical), a significant amount of blood is deposited in its lower half. As a result, the venous return of blood to the heart deteriorates, and therefore the stroke volume of blood decreases (by 20-30%). Compensation for this adverse effect is carried out primarily due to increased heart rate. At the same time, changes in vascular tone also play an important role.

However, the development of various reactions of the body associated with changes in the position of the body in space is based on mechanisms similar to those described when considering the straining test.

The degree of decrease in venous return of blood to the heart with a change in body position depends on the tone of the large veins. If it is reduced, then the decrease in venous return should be so significant that when standing up, due to a sharp deterioration in the blood supply to the brain, a fainting state may develop. Low tone of large veins should be the cause of the development of fainting and, with prolonged exposure to an upright position, orthostatic collapse.

In athletes, orthostatic instability associated with decreased venous tone develops relatively rarely. However, during so-called passive orthostatic tests, it can sometimes be detected. For this reason, it is advisable to use orthostatic tests to assess the functional state of the body of athletes.

Typically, during an orthostatic test, the transition from a horizontal to a vertical position is performed by the subject actively, by standing up. The reaction to standing up is studied based on recording heart rate and blood pressure. These indicators are measured repeatedly in a horizontal position of the body, and then for 10 minutes in a vertical position.

A natural reaction to an orthostatic test is an increase in heart rate (in well-trained athletes it is relatively small - from 5 to 15 beats/min; in young athletes the reaction should be more pronounced). Due to this, the minute volume of blood flow is slightly reduced. Systolic blood pressure remains unchanged or even decreases slightly (by 2-6 mm Hg), diastolic blood pressure naturally increases (by 10-15%) in relation to its value in a horizontal position. If during a 10-minute study systolic blood pressure approaches the initial values, then diastolic blood pressure remains elevated.

When conducting an active orthostatic test, the reaction of the cardiovascular system is to a certain extent associated with muscle tension during 10 minutes of standing. To reduce the influence of this factor, a modified orthostatic test is performed (Yu. M. Stoida): the subject stands not just in a veotic position, but at a distance of one foot from the wall, leaning his back against it; a cushion with a diameter of 12 cm is placed under the sacrum; the subject is in a state of significant relaxation; The angle of inclination of the body relative to the horizontal plane is approximately 75-80°. Such a test gives results very close to those obtained with a passive orthostatic test (Table 29).

Table 29. Changes in heart rate and blood pressure in athletes under orthostatic influences

Indicators	Modified active orthotest	Passive orthotest
	Vertical body position (3rd min)	Difference	Horizontal body position	Vertical body position (3rd min)	Difference	Vertical body position (10th min)
Heart rate, beats/min			+ 19			+ 17
Blood pressure, mmHg Art.:
maximum			- 2			- 2
minimum			+ 10			+ 9
average			+ 4			+ 4

Orthostatic stability is most accurately determined on the so-called rotary table, the lid of which is rotated 90° in the vertical plane, due to which the body of the subject, lying on the lid and fixed to it with belts, is transferred from a horizontal position to a vertical one (the legs rest against the footrest).

With normal orthostatic stability, the reaction to a passive test is more pronounced than to an active one. Signs of orthostatic instability are a sharp drop in blood pressure and a significant increase in heart rate.

The assessment of the orthostatic test, based on heart rate data, continues to be refined and improved. The fact is that such a seemingly reliable indicator, which is the increase in heart rate in a vertical position relative to heart rate in a horizontal position, provides inaccurate data for some athletes. This is especially true for individuals with bradycardia in a horizontal body position: their heart rate can increase by 30-35 beats/min without any signs of orthostatic instability. In this regard, in the laboratory of sports cardiology of GCOLIFK, the test is assessed based on the real heart rate in an upright position of the body. If during 10 minutes of the study the heart rate does not exceed 89 beats/min, the reaction is considered normal; A heart rate of 90-95 beats/min indicates a decrease in orthostatic stability; if the heart rate exceeds 95 beats/min, resistance to changes in body position in space is low. Athletes with low stability may develop orthostatic collapse. This approach to assessing orthostatic reactions is based on the so-called invariance principle (V.L. Karpman), the essence of which is that, under the influence of one or another disturbing influence, the functioning indicators of the body’s autonomic systems do not depend (or depend to a small extent) on the initial ones indicators and are determined solely by the current needs of the body.

The response to the orthostatic test improves under the influence of sports training. This applies both to individuals in whose sports activities changing body position is a mandatory element, and to representatives of other sports (for example, runners).

When studying gymnasts, data from an orthostatic test are used to assess functional readiness. The higher the gymnasts' training, the better the results of the orthostatic test.

Orthostatic test - concept and types. Classification and features of the category "Orthostatic test" 2017, 2018.

(slope test) is a method for studying and diagnosing the condition of the cardiovascular and nervous systems. This simple test can detect problems in the regulation of the heart. The essence of the test is to transfer the body from a horizontal to a vertical position.

Indications for orthostatic test

It is prescribed to patients suffering from sudden changes in body position, dizziness, low blood pressure and even fainting. The orthostatic test is designed to record these sensations according to physiological signs.

Methods of conducting

Patient on a special inclined table

The test should be performed before meals, preferably in the morning. Perhaps the doctor will prescribe you to carry out tests over several days, then you need to carry them out at the same time.

The person being diagnosed lies down for at least 5 minutes, and then slowly rises to his feet. This method is called active orthostatic breakdown.

In addition, there is another option for conducting an orthostatic test, which is called an inclined test - this is passive orthostatic test. In this case, the person being diagnosed is placed on a special rotating table. The technique itself is the same: 5 minutes in a horizontal position, then quickly move the table to a vertical position.

During the study, the pulse is measured three times:

• (1) in a horizontal body position,
• (2) when rising to your feet or moving the table to a vertical position,
• (3) three minutes after transition to a vertical position.

Evaluation of results

Based on the heart rate values ​​and their difference, conclusions are drawn about functional state cardiovascular system.

The norm is an increase in heart rate of no more than 20 beats per minute. Reduction is acceptable upper pressure(systolic), as well as a slight increase in the lower (diastolic) - up to 10 mm Hg. Art.

1. If after rising to a vertical position your heart rate increases at 13-16 beats per minute or even less, and then after three minutes of standing it has stabilized to +0-10 beats from the initial (measured while lying down), then your orthostatic test readings are normal. In addition, this indicates good training.
2. Greater change in heart rate (up to +25 beats per minute) indicates that the body is poorly trained - you should spend more time physical exercise and healthy eating.
3. Increase in heart rate by more than 25 beats per minute indicates the presence of diseases of the cardiovascular and/or nervous systems.

« Healthy Heart » / Published: 02/21/2015