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Meas."],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    . The effect of concurrent head-up tilt and lower body negative pressure (LBNP) have been examined on middle cerebral artery velocity (MCAv) at rest; however, it is unknown the superimposed effect these factors have on blunting the elevation in cerebral blood velocity associated with moderate-intensity exercise.\n                    <jats:italic>Methods<\/jats:italic>\n                    . 23 healthy adults (11 females \/ 12 males, 20\u201333 years) completed three visits. The first consisted of a maximal ramp supine cycling test to identify the wattage associated with individualized maximal MCAv. Subsequent visits included randomized no LBNP (control) or LBNP at \u221240 Torr (experimental) with successively increasing head-up tilt stages of 0, 15, 30, and 45 degrees during the pre-described individualized wattage. Transcranial Doppler ultrasound was utilized to quantify MCAv. Two-factorial repeated measures analysis of variance with effect sizes were used to determine differences between days and tilt stages.\n                    <jats:italic>Results<\/jats:italic>\n                    . Between-day baseline values for MCAv, heart rate, and blood pressure displayed low variability with &lt;5% variation. With no LBNP, MCAv was above baseline on average for all participants; however, 15 degrees and 30 degrees tilt with concurrent \u221240 Torr LBNP was sufficient to return MCAv to 100% of baseline values in females and males, respectively. Body-weight did not impact the association between tilt and pressure (\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    range: 0.01\u20130.12).\n                    <jats:italic>Conclusion<\/jats:italic>\n                    . Combined LBNP and tilt were sufficient to reduce the increase in MCAv associated with moderate-intensity exercise. This exercise modality shows utility to enable individuals with a concussion to obtain the positive physiological adaptions associated with exercise while minimizing symptom exacerbation due to the notion of the Monro-Kellie doctrine.\n                  <\/jats:p>","DOI":"10.1088\/1361-6579\/acecd4","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T18:42:17Z","timestamp":1691001737000},"page":"084002","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Cerebral blood velocity during concurrent supine cycling, lower body negative pressure, and head-up tilt challenges: implications for concussion rehabilitation"],"prefix":"10.1088","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-5793","authenticated-orcid":true,"given":"Joel S","family":"Burma","sequence":"first","affiliation":[{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jina","family":"Seok","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan E.","family":"Johnston","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1054-0038","authenticated-orcid":false,"given":"Jonathan D","family":"Smirl","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"266","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"pmeaacecd4bib1","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1152\/japplphysiol.00854.2014","type":"journal-article","article-title":"Transcranial doppler ultrasound: valid, invalid, or both?","volume":"117","author":"Ainslie","year":"2014","journal-title":"J. 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