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At least 163 records · Page 9

Exercise as a countermeasure for physiological adaptation to prolonged spaceflight

Exercise represents the primary countermeasure used during spaceflight to maintain or restore maximal aerobic capacity (VO2max), musculoskeletal structure, and orthostatic function. However, no single exercise or combination of prescriptions has proven entirely effective in restoring cardiovascular and musculoskeletal functions to preflight levels following prolonged spaceflight. As human spaceflight exposures increase in duration, assessment and development of various effective exercise-based protective procedures become paramount. This must involve improvement in specific countermeasure prescription as well as development of additional approaches that will allow space travelers greater flexibility and medical safety during long flights. Effective exercise prescription will be based on identification of basic physiological stimuli that maintain normal function in terrestrial gravity and understanding of how specific combinations of exercise characteristics e.g., duration, frequency, intensity, mode) can mimic these stimuli and affect the overall process of adaptation to microgravity. This can be accomplished only with greater emphasis of research on ground-based experiments. Future attention must be directed to improving exercise compliance while minimizing both crew time and the impact of the exercise on life-support resources.

Skylab Project↗

Modeling and Simulation for Exercise Vibration Isolation and Stabilization System Design

The microgravity environment that crew members experience on orbit presents a well-known health challenge, particularly when it comes to loss of muscle and bone mass. To counteract these negative effects, exercise countermeasures play a critical role in the daily routine of the crew on the International Space Station (ISS). To help inform requirements for upcoming exploration missions such as the Gateway Program, a new device, called the European Enhanced Exploration Exercise Device (E4D), is being built by the European Space Agency through their contractor, the Danish Aerospace Company. The E4D is being demonstrated on the ISS and is unique from other current exercise devices in that it provides four separate modalities in a single device: resistive, cycle ergometry, seated aerobic rowing, and rope pulling. To support the integration of E4D on ISS, a passive Vibration Isolation and Stabilization (VIS) system was required by NASA, and this responsibility was given to the Johnson Space Center. This paper describes the end-to-end process of modeling, simulation, and analysis used to inform the mechanical design of the VIS system. The process begins with the collection of representative exerciser motion capture (MoCap) through ground-based testing with the developmental E4D in both the Prototype Immersive Technology (PIT) Laboratory and the Active Response Gravity Offload System (ARGOS) facility at the Johnson Space Center. These collected MoCap data are processed through human biomechanics modeling to create forcing functions as input to a multibody dynamics simulation of the combined E4D/VIS system, with numerous resulting outputs. These outputs include microgravity accelerations, overall system displacements, internal and transmitted loads, as well as collisions. Microgravity accelerations are compared for compliance against ISS requirements while displacements are used for sway space determinations on the design and volumetric constraints within the targeted module. Internal loads are supplied to the supporting stress analysis teams and external loads for structural loads and dynamics teams, both at NASA and ESA. Finally, contact and clearance analysis is performed using the simulation to eliminate potential design issues. To ensure that the elements of the multibody simulation were verified and validated, correlation against multiple VIS related ground hardware testbeds was performed and characterized. In addition to the isolation part of the VIS problem, stabilization is also key to the integrated performance and evaluation. Due to the difficulty in defining ISS requirements in this area, the stability of the exerciser was inspected via analysis. Loss of balance was defined analytically as occurring when the resultant force vector acting on the exerciser lies outside the base of support of the feet. Both the VIS and E4D teams have recently gone through their Critical Design Reviews (CDRs) and the iterative model-based approach has been integral to inform mechanical design, particularly in the case of the VIS. This same end-to-end approach is now being applied for the Gateway Program, where an Exploration Exercise Device (EED) derived from the E4D and notional VIS for the device are under concept development.

Countermeasures↗

Insulin and glucose responses during bed rest with isotonic and isometric exercise

The effects of daily intensive isotonic (68% maximum oxygen uptake) and isometric (21% maximum extension force) leg exercise on plasma insulin and glucose responses to an oral glucose tolerance test (OGTT) during 14-day bed-rest (BR) periods were investigated in seven young healthy men. The OGTT was given during ambulatory control and on day 10 of the no-exercise, isotonic, and isometric exercise BR periods during the 15-wk study. The subjects were placed on a controlled diet starting 10 days before each BR period. During BR, basal plasma glucose concentration remained unchanged with no exercise, but increased (P less 0.05) to 87-89 mg/100 ml with both exercise regimens on day 2, and then fell slightly below control levels on day 13. The fall in glucose content during BR was independent of the exercise regimen and was an adjustment for the loss of plasma volume. The intensity of the responses of insulin and glucose to the OGTT was inversely proportional to the total daily energy expenditure during BR. It was estimated that at least 1020 kcal/day must be provided by supplemental exercise to restore the hyperinsulinemia to control levels.

Dolkas, C. B.↗

Cardiovascular responses to static exercise in distance runners and weight lifters

Three groups of athletes including long-distance runners, competitive and amateur weight lifters, and age- and sex-matched control subjects have been studied by hemodynamic and echocardiographic methods in order to determine the effect of the training programs on the cardiovascular response to static exercise. Blood pressure, heart rate, and double product data at rest and at fatigue suggest that competitive endurance (dynamic exercise) training alters the cardiovascular response to static exercise. In contrast to endurance exercise, weight lifting (static exercise) training does not alter the cardiovascular response to static exercise: weight lifters responded to static exercise in a manner very similar to that of the control subjects.

Longhurst, J. C.↗

Effect of confinement in small space flight size cages on insulin sensitivity of exercise-trained rats

The effect of confinement in small cages (simulating the size to be used in future space Shuttle missions) on insulin sensitivity was studied in rats having an increased insulin sensitivity due to exercise training prior to confinement. Oral glucose tolerance tests (OGTT) were given to both control and exercise-trained rats before and after placement in the small cages for 7 days. The insulin resistance was assessed by the product of the area of the insulin and glucose curves of the OGTT (IG index). Results show that the values obtained before confinement were one-half as high in exercise-trained rats as those in control rats, reflecting an increased sensitivity to insulin with exercise training. After 7 days confinement, the IG index was found to be not significantly different from initial values for both control and exercise-trained rats. These findings suggest that increased insulin sensitivity in exercise-trained rats persists 7 days after cessation of running activity. The data also indicate that exercise training, before flight, may be beneficial in minimizing the loss of insulin sensitivity expected with decreased use of gravity dependent muscles during exposure to hypogravity in space flight.

Mondon, C. E.↗

Orthostatic responses following 30-day bed rest deconditioning with isotonic and isokinetic exercise training

The effects of intensive exercise training on tilt tolerance following deconditioning of astronauts were investigated by studying orthostatic responses of 19 subjects who underwent two intensive exercise-training regimens during 30 days of -6-deg head-down bed rest (BR). Subjects were divided into no-exercise control group, and two exercise groups, one performing isotonic (Quinton ergometer) exercises, the other doing isokinetic (Lido ergometer) exercises. A 60-deg head-up tilt test was administered on the control day 1 and BR day 30; the test was terminated at 60 min or when presyncopal signs and/or symptoms occurred. It was found that exercise training did not affect tilt tolerance significantly.

Greenleaf, J. E.↗

Modeling heat exchange characteristics of long term space operations: Role of skin wettedness and exercise

The problems of heat exchange during rest and exercise during long term space operations are covered in this report. Particular attention is given to the modeling and description of the consequences of requirement to exercise in a zero-g atmosphere during Space Shuttle flights, especially long term ones. In space environments, there exists no free convection therefore only forced convection occurring by movement, such as pedalling on a cycle ergometer, augments required heat dissipation necessary to regulate body temperature. The requirement to exercise at discrete periods of the day is good practice in order to resist the deleterious consequences of zero-gravity problems and improve distribution of body fluids. However, during exercise (ca. 180 to 250W), in zero-g environments, the mass of eccrine sweating rests as sheets on the skin surface and the sweat cannot evaporate readily. The use of exercise suits with fabrics that have hydrophobic or outwicking properties somewhat distributes the mass of sweat to a larger surface from which to evaporate. However, with no free convection, increased skin wettedness throughout the body surface induces increasing thermal discomfort, particularly during continuous exercise. This report presents several alternatives to aid in this problem: use of intermittent exercise, methods to quantify local skin wettedness, and introduction of a new effective temperature that integrates thermal stress and heat exchange avenues in a zero-g atmosphere.

Gonzalez, Richard R.↗

Effects of oral glucose on exercise thermoregulation in men after water immersion

To test the hypothesis elevated blood glucose would attenuate the rise in exercise rectal temperature, six men age 35 plus or minus S.D. 7 years participated in each of three trials by 4-hr water immersion to the neck: (1) 2.0 g/kg body wt of oral glucose (33.8 percent wt./vol.) was consumed followed by 80 min controlled rest (Glu/Rest), and 70 min horizontal supine cycle exercise at 62.8 percent plus or minus S.E. 0.5 percent (1.97 plus or minus 0.02 L/min) of peak O2 uptake followed by 10 min recovery (2) with (Glu/Ex) and (3) without prior flucose (No Glu/Ex). Blood samples were taken at -25, 0, 15, 45, and 68 min of exercise and after plus 10 min of recovery for measurement of hemoglobin, hematocrit, and blood glucose. Both mean skin (T sub sk) (from six sites) and rectal temperatures (T sub re) were monitored continuously. Sweat rate was measured by resistanc hygrometry. The mean of delta PV for the exercise trials was -12.2 plus or minus 2.1 percent. Mean blood glucose for the Glu/Ex trial was higher than that of the No Glu/Ex trial was (108.4 equal or minus 3.9 and 85.6 plus or minus 1.6 mg/dl, respectively, P less than 0.05. At the end of exercise T(sub sk) for the Glu/Ex trial was lower than for No Glu/Ex(32.0 plus or minus 0.3 and 32.4 equals or minus 0.2 C, respectively, P less than 0.05); T(sub re) for the Glu/Ex trial was lower than for No Glu/Es (38.22 plus or minus 0.17 and 38.60 plus or minus 0.11 C, respectively, P less than 0.05); and forearm sweat rate for the Glu/Ex trial (0.34 plus or minus 0.04 and 0.43 plus or minus g/sq cm, respectively, P less than 0.05). These data suggest that elevation of blood glucose prior to horizontal exercise following hypohydration attenuates the increase in body temperature without altering heat production or exercise hypovolemia.

Dearborn, Alan S.↗

Computer Aided Modeling to Determine the Effectiveness of Resistive Exercises as Countermeasures for Bone Mineral Density Loss

Due to the loss of gravitational loading, astronauts have a tendency to lose bone mineral density in their lumbar spine and lower extremities on orbit. NASA requires astronauts to perform exercises during space flight to help reduce the amount of demineralization. To test these exercises on earth, 17 week bed rest studies are conducted that consist of specific diet and exercise regimes. Developing a finite element model of these exercises will help to quantify the stress distribution imposed by of each of these exercises. To help develop this model, MRI images are acquired from individuals participating in the bed rest studies. The MRIs can be used to create a subject specific model of each individual for testing. The MRIs are processed in the Magnetic Resonance Imaging Data Transfer System program to develop a three-dimensional finite element model of the femur for evaluation. Modifications were made to the MRIDTS that simplified the model creation process. These modifications made it possible to construct two separate models of different portions of a bone simultaneously and then later connect them manually. This helped alleviate the warping problem associated with the drastic changes in geometry found in some body parts, such as the joints. The code was also modified to incorporate material properties of various bone components into the model. Interior meshing was also incorporated into the program to allow for both the cortical shell and the entire bone to be modeled. A prototype model of the right femur of an adult female is being constructed and tested to determine the feasibility of finite element analysis as a tool for evaluating exercise effectiveness. The model is being run through the ANSYS finite element program on the Alabama Super Computer Network. After the model is validated, models of bedrest subjects can be generated to investigate exercise countermeasures.

Murphy, Benjamin M.↗

Quantifying Biomechanical Characteristics of Jumping Exercises in 1G and in Simulated and True Microgravity

Exercise in microgravity is one of the most promising countermeasures to the dual problems of space flight-induced bone loss and muscle atrophy. Although exercise in microgravity has been studied extensively from a metabolic standpoint, little research has focused on the efficacy of different forms of exercise for maintaining musculoskeletal integrity. Exercise protocols have not been effective in preventing muscle atrophy and bone loss during space flight, especially in the lower extremities. In 1-G, however, animal experiments have clearly indicated that: (1) certain bone strains and strain rates do stimulate bone deposition, and (2) repetitive loading of the lower extremity can increase osteonal bone formation even as proximally as the vertebral column. Such studies have also indicated that a relatively small number of appropriate loading cycles may lead to bone deposition. This suggests that an optimal exercise regimen might be able to maintain bone and muscle integrity during space flight. Since there is evidence that the bones and muscles of the lower limbs are particularly affected by space flight, the present study addressed two major aims: (1) quantify externally applied impact loads and rates of loading under the feet during tethered jumping exercises, and (2) determine the amount of eccentric and concentric whole-muscle activity during these jumping exercises in true and in simulated zero-gravity.

Davis, B. L.↗

Effect of In-Flight Exercise and Extravehicular Activity on Postflight Stand Tests

The purpose of this study was to determine whether exercise performed by Space Shuttle crewmembers during short-duration spaceflights (9-16 days) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 hr of landing. Thirty crewmembers performed self-selected in-flight exercise and maintained exercise logs to monitor their exercise intensity and duration. A 10min stand test, preceded by at least 6 min of quiet supine rest, was completed 10- 15 d before launch (PRE) and within four hours of landing (POST). Based upon their in-flight exercise records, subjects were grouped as either high (HIex: = 3x/week, HR = 70% ,HRMax, = 20 min/session, n = 11), medium (MEDex: = 3x/week, HR = 70% HRmax, = 20 min/session, n = 10), or low (LOex: = 3x/week, HR and duration variable, n = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, or analysis of variance, P < 0.05). There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared to PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36+/-5 bpm) compared to HIex or MEDex groups (25+/-1bpm; 22+/-2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after spaceflight in the MEDex and HIex groups, but was significantly less in the LOex group (PRE: -9+/- 3, POST: -19+/- 4 mmHg). Thus, moderate to high levels of in-flight exercise attenuated HR and PP responses to standing after spaceflight compared.

Lee, Stuart M. C.↗

Blood Volume: Importance and Adaptations to Exercise Training, Environmental Stresses and Trauma/Sickness

This paper reviews the influence of several perturbations (physical exercise, heat stress, terrestrial altitude, microgravity, and trauma/sickness) on adaptations of blood volume (BV), erythrocyte volume (EV), and plasma volume (PV). Exercise training can induced BV expansion; PV expansion usually occurs immediately, but EV expansion takes weeks. EV and PV expansion contribute to aerobic power improvements associated with exercise training. Repeated heat exposure induces PV expansion but does not alter EV. PV expansion does not improve thermoregulation, but EV expansion improves thermoregulation during exercise in the heat. Dehydration decreases PV (and increases plasma tonicity) which elevates heat strain and reduces exercise performance. High altitude exposure causes rapid (hours) plasma loss. During initial weeks at altitude, EV is unaffected, but a gradual expansion occurs with extended acclimatization. BV adjustments contribute, but are not key, to altitude acclimatization. Microgravity decreases PV and EV which contribute to orthostatic intolerance and decreased exercise capacity in astronauts. PV decreases may result from lower set points for total body water and central venous pressure, which EV decrease bay result form increased erythrocyte destruction. Trauma, renal disease, and chronic diseases cause anemia from hemorrhage and immune activation, which suppressions erythropoiesis. The re-establishment of EV is associated with healing, improved life quality, and exercise capabilities for these injured/sick persons.

Sawka, Michael N.↗

Effects of Three-Day Bed Rest on Physiological Responses to Graded Exercise in Endurance Athletes, Body Builders and Sedentary Men

To test the hypotheses that short-term bed rest (BR) deconditioning influences metabolic, cardiorespiratory and neurohormonal responses to exercise and that these effects depend on the subjects' training status 12 sedentary men, and 10 endurance- and 10 strength-trained athletes were submitted to three-day BR. Before and after BR they performed incremental exercise test until volitional exhaustion. Respiratory gas exchange and HR were recorded continuously and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate [LA], adrenaline [A], noradrenaline, [NA], renting activity (PRA), growth hormone [hGH], testosterone and cortisol determination. Reduction of peak oxygen uptake (VO2peak) after BR was greater in the endurance athletes (than in the remaining groups (17 % vs. 100%). Decrements in VO2peak correlated positively with the initial values (r = 0.73, p less than 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased the in endurance athletes from 71 to 60 %VO2 peak (p less than 0.001); they also had an earlier increase in [NA], and an attenuated increase in [hGH), and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion: reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Smorawinski, J.↗

Effects of Three-Day Bed Rest on Physiological Responses to Graded Exercise in Endurance Athletes, Body Builders and Sedentary Men

To test the hypotheses that short-term bed rest (BR) deconditioning influences metabolic, cardiorespiratory and neurohormonal responses to exercise and that these effects depend on the subjects' training status, 12 sedentary men, and 10 endurance- and 10 strength-trained athletes were submitted to three-day BR. Before and after BR they performed incremental exercise tests until volitional exhaustion. Respiratory gas exchange and HR were recorded continuously and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate [LA], adrenaline [A], noradrenaline [NA], renin activity (PRA), growth hormone [hGH], testosterone and cortisol determination. Reduction of peak oxygen uptake (V02peak) after BR was greater in the endurance athletes than in the remaining groups (17 % vs. 10%). Decrements in VO2peak correlated positively with the initial values (r = 0.73, p is less than 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased the in endurance athletes from 71 to 60% V02 peak (p is less than0.001), they also had an earlier increase in [NA], an attenuated increase in [hGH], and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion: reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

Smorawinski, J.↗

Lower-body negative-pressure exercise and bed-rest-mediated orthostatic intolerance

PURPOSE: Supine, moderate exercise is ineffective in maintaining orthostatic tolerance after bed rest (BR). Our purpose was to test the hypothesis that adding an orthostatic stress during exercise would maintain orthostatic function after BR. METHODS: Seven healthy men completed duplicate 15-d 6 degrees head-down tilt BR using a crossover design. During one BR, subjects did not exercise (CON). During another BR, subjects exercised for 40 min.d(-1) on a supine treadmill against 50-60 mm Hg LBNP (EX). Exercise training consisted of an interval exercise protocol of 2- to 3-min intervals alternating between 41 and 65% (.)VO(2max). Before and after BR, an LBNP tolerance test was performed in which the LBNP chamber was decompressed in 10-mm Hg stages every 3 min until presyncope. RESULTS: LBNP tolerance, as assessed by the cumulative stress index (CSI) decreased after BR in both the CON (830 +/- 144, pre-BR vs 524 +/- 56 mm Hg.min, post-BR) and the EX (949 +/- 118 pre-BR vs 560 +/- 44 mm Hg.min, post-BR) conditions. However, subtolerance (0 to -50 mm Hg LBNP) heart rates were lower and systolic blood pressures were better maintained after BR in the EX condition compared with CON. CONCLUSION: Moderate exercise performed against LBNP simulating an upright 1-g environment failed to protect orthostatic tolerance after 15 d of BR.

NASA Center JSC↗

Exercise increases blood flow to locomotor, vestibular, cardiorespiratory and visual regions of the brain in miniature swine

1. The purpose of these experiments was to use radiolabelled microspheres to measure blood flow distribution within the brain, and in particular to areas associated with motor function, maintenance of equilibrium, cardiorespiratory control, vision, hearing and smell, at rest and during exercise in miniature swine. Exercise consisted of steady-state treadmill running at intensities eliciting 70 and 100 % maximal oxygen consumption (V(O(2),max)). 2. Mean arterial pressure was elevated by 17 and 26 % above that at rest during exercise at 70 and 100 % V(O(2),max), respectively. 3. Mean brain blood flow increased 24 and 25 % at 70 and 100 % V(O(2),max), respectively. Blood flow was not locally elevated to cortical regions associated with motor and somatosensory functions during exercise, but was increased to several subcortical areas that are involved in the control of locomotion. 4. Exercise elevated perfusion and diminished vascular resistance in several regions of the brain related to the maintenance of equilibrium (vestibular nuclear area, cerebellar ventral vermis and floccular lobe), cardiorespiratory control (medulla and pons), and vision (dorsal occipital cortex, superior colliculi and lateral geniculate body). Conversely, blood flow to regions related to hearing (cochlear nuclei, inferior colliculi and temporal cortex) and smell (olfactory bulbs and rhinencephalon) were unaltered by exercise and associated with increases in vascular resistance. 5. The data indicate that blood flow increases as a function of exercise intensity to several areas of the brain associated with integrating sensory input and motor output (anterior and dorsal cerebellar vermis) and the maintenance of equilibrium (vestibular nuclei). Additionally, there was an intensity-dependent decrease of vascular resistance in the dorsal cerebellar vermis.

Non-NASA Center↗

Effects of 3-day bed rest on physiological responses to graded exercise in athletes and sedentary men

To test the hypotheses that short-term bed-rest (BR) deconditioning influences metabolic, cardiorespiratory, and neurohormonal responses to exercise and that these effects depend on the subjects' training status, 12 sedentary men and 10 endurance- and 10 strength-trained athletes were submitted to 3-day BR. Before and after BR they performed incremental exercise test until volitional exhaustion. Respiratory gas exchange and heart rate (HR) were recorded continuously, and stroke volume (SV) was measured at submaximal loads. Blood was taken for lactate concentration ([LA]), epinephrine concentration ([Epi]), norepinephrine concentration ([NE]), plasma renin activity (PRA), human growth hormone concentration ([hGH]), testosterone, and cortisol determination. Reduction of peak oxygen uptake (VO(2 peak)) after BR was greater in the endurance athletes than in the remaining groups (17 vs. 10%). Decrements in VO(2 peak) correlated positively with the initial values (r = 0.73, P < 0.001). Resting and exercise respiratory exchange ratios were increased in athletes. Cardiac output was unchanged by BR in all groups, but exercise HR was increased and SV diminished in the sedentary subjects. The submaximal [LA] and [LA] thresholds were decreased in the endurance athletes from 71 to 60% VO(2 peak) (P < 0.001); they also had an earlier increase in [NE], an attenuated increase in [hGH], and accentuated PRA and cortisol elevations during exercise. These effects were insignificant in the remaining subjects. In conclusion, reduction of exercise performance and modifications in neurohormonal response to exercise after BR depend on the previous level and mode of physical training, being the most pronounced in the endurance athletes.

NASA Center ARC↗

Regulation of skeletal muscle perfusion during exercise

For exercise to be sustained, it is essential that adequate blood flow be provided to skeletal muscle. The local vascular control mechanisms involved in regulating muscle perfusion during exercise include metabolic control, endothelium-mediated control, propagated responses, myogenic control, and the muscle pump. The primary determinant of muscle perfusion during sustained exercise is the metabolic rate of the muscle. Metabolites from contracting muscle diffuse to resistance arterioles and act directly to induce vasodilation, or indirectly to inhibit noradrenaline release from sympathetic nerve endings and oppose alpha-adrenoreceptor-mediated vasoconstriction. The vascular endothelium also releases vasodilator substances (e.g., prostacyclin and nitric oxide) that are prominent in establishing basal vascular tone, but these substances do not appear to contribute to the exercise hyperemia in muscle. Endothelial and smooth muscle cells may also be involved in propagating vasodilator signals along arterioles to parent and daughter vessels. Myogenic autoregulation does not appear to be involved in the exercise hyperemia in muscle, but the rhythmic propulsion of blood from skeletal muscle veins facilitates venous return to the heart and muscle perfusion. It appears that the primary determinants of sustained exercise hyperemia in skeletal muscle are metabolic vasodilation and increased vascular conductance via the muscle pump. Additionally, sympathetic neural control is important in regulating muscle blood flow during exercise.

Non-NASA Center↗