{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:56:06Z","timestamp":1787162166131,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002631","name":"the Gachon University","doi-asserted-by":"publisher","award":["GCU-202503070001"],"award-info":[{"award-number":["GCU-202503070001"]}],"id":[{"id":"10.13039\/501100002631","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"the National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2024-00453658"],"award-info":[{"award-number":["RS-2024-00453658"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Blood flow is critical for tissue oxygenation, and alterations in cerebrovascular and peripheral circulation have important health implications. This study aimed to examine the impact of distinct mechanisms for increasing intra-cavity pressure through the abdominal bracing (AB) and Valsalva maneuver (VM) on central and peripheral hemodynamics. Materials and Methods: A randomized crossover design was used, and thirty healthy young adults (age 21.9 \u00b1 1.5 years; BMI 20.9 \u00b1 1.8 kg\/m2) performed AB and VM in a randomized order. All participants provided written informed consent, and the study protocol was approved by the Clinical Research Information Service (KCT0009742; registered on 30 August 2024). Hemodynamic responses were measured before and after each intervention, including heart rate, blood pressure, pulse wave velocity, carotid artery diameter, pulsatility index, resistive index, peripheral oxygen saturation, and cerebral oxygenation. Repeated-measures analysis of variance and paired t-tests were conducted on the datasets. Results: Both the VM and AB significantly increased heart rate (p &lt; 0.001) and systolic blood pressure (VM: p = 0.015; AB: p &lt; 0.001). Cerebral oxygen saturation decreased significantly (VM: p &lt; 0.05; AB: p &lt; 0.05), whereas oxyhemoglobin increased during both interventions, suggesting higher cerebral oxygen demand. The VM specifically increased the carotid pulsatility index (pre = 1.76 \u00b1 0.28; post2 = 1.87 \u00b1 0.33; p = 0.008), reflecting elevated central vascular resistance. In contrast, AB decreased peripheral oxygen saturation (pre = 98.43 \u00b1 0.71; post1 = 97.49 \u00b1 1.76; p &lt; 0.001) and increased peripheral (heart\u2013finger) pulse wave velocity (Lt: p = 0.026; Rt: p = 0.010), indicating greater stimulation of peripheral circulation. Conclusions: Distinct mechanisms that elevate intra-cavity pressure differentially influence central and peripheral hemodynamics. These findings suggest that intra-cavity pressure can selectively modulate hemodynamic responses, with potential applications in both clinical and exercise settings.<\/jats:p>","DOI":"10.3390\/medicina61112031","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:06:36Z","timestamp":1763111196000},"page":"2031","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Effects of Abdominal Bracing and Valsalva Maneuver on Cerebral and Peripheral Hemodynamics in Healthy Adults: A Randomized Crossover Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Ji-Hyeon","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Gachon Advanced Institute for Health Sciences & Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Yeon","family":"Jung","sequence":"additional","affiliation":[{"name":"Institute of Human Convergence Health Science, Gachon University, Incheon 21936, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5952-1423","authenticated-orcid":false,"given":"Yeong-Bae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gil Medical Center, College of Medicine, Gachon University, Incheon 21565, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6152-4551","authenticated-orcid":false,"given":"Jeong-Min","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Gachon Advanced Institute for Health Sciences & Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7029-2422","authenticated-orcid":false,"given":"Young-Don","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, College of IT Convergence, Gachon University, Seongnam 13120, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gil Medical Center, College of Medicine, Gachon University, Incheon 21565, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9573-8432","authenticated-orcid":false,"given":"Chang-Ki","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Gachon Advanced Institute for Health Sciences & Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea"},{"name":"Institute of Human Convergence Health Science, Gachon University, Incheon 21936, Republic of Korea"},{"name":"Department of Radiological Science, College of Medical Science, Gachon University, Incheon 21936, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/s41597-023-02018-0","article-title":"Anatomical Structures, Cell Types, and Biomarkers of the Healthy Human Blood Vasculature","volume":"10","author":"Boppana","year":"2023","journal-title":"Sci. Data"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1161\/CIRCRESAHA.116.303849","article-title":"Epidemiology of Peripheral Artery Disease","volume":"116","author":"Criqui","year":"2015","journal-title":"Circ. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.gerinurse.2015.03.004","article-title":"Characterization of the Peripheral Artery Disease Symptom Experience","volume":"36","author":"Schorr","year":"2015","journal-title":"Geriatr. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2934","DOI":"10.1001\/archinte.160.19.2934","article-title":"Determinants of Peripheral Arterial Disease in the Elderly: The Rotterdam Study","volume":"160","author":"Meijer","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/j.jvs.2025.04.058","article-title":"Peripheral Arterial Disease Prevalence among Sepsis Hospitalizations and Associated Outcomes","volume":"82","author":"Iyer","year":"2025","journal-title":"J. Vasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1056\/NEJMcp1507631","article-title":"Peripheral Artery Disease","volume":"374","author":"Kullo","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.mpaic.2014.02.002","article-title":"Intracranial Pressure and Cerebral Blood Flow","volume":"15","author":"Partington","year":"2014","journal-title":"Anaesth. Intensive Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1159\/000049119","article-title":"Perfusion Thresholds in Human Cerebral Ischemia: Historical Perspective and Therapeutic Implications","volume":"11","author":"Baron","year":"2010","journal-title":"Cerebrovasc. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/apha.12639","article-title":"The Valsalva Manoeuvre: Physiology and Clinical Examples","volume":"217","author":"Pstras","year":"2016","journal-title":"Acta Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jelekin.2015.11.011","article-title":"Comparison between the Effectiveness of Expiration and Abdominal Bracing Maneuvers in Maintaining Spinal Stability Following Sudden Trunk Loading","volume":"26","author":"Ishida","year":"2016","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Nakai, Y., Kijimuta, T., Takeshita, Y., Kiyama, R., Araki, S., Miyazaki, T., and Kawada, M. (2023). Effects of External Abdominal Pressure Support on Dynamic Balance: A Randomized Crossover Study. Sports, 11.","DOI":"10.3390\/sports11110217"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s13102-023-00729-w","article-title":"The Effect of Abdominal Bracing on Respiration during a Lifting Task: A Cross-Sectional Study","volume":"15","author":"Sembera","year":"2023","journal-title":"BMC Sports Sci. Med. Rehabil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1621617","DOI":"10.3389\/fphys.2025.1621617","article-title":"Standing under Pressure: Hemodynamic Effects of Abdominal Compression Type and Intensity in Healthy Adults","volume":"16","author":"Mitra","year":"2025","journal-title":"Front. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1152\/physrev.00035.2013","article-title":"Regulation of Increased Blood Flow (Hyperemia) to Muscles During Exercise: A Hierarchy of Competing Physiological Needs","volume":"95","author":"Joyner","year":"2015","journal-title":"Physiol. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Jung, J.-Y., Lee, Y.-B., and Kang, C.-K. (2024). Effect of Controlled Expiratory Pressures on Cerebrovascular Changes During Valsalva Maneuver. Appl. Sci., 14.","DOI":"10.3390\/app142210132"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"349","DOI":"10.3389\/fphys.2014.00349","article-title":"Cerebral Hemodynamics during Graded Valsalva Maneuvers","volume":"5","author":"Perry","year":"2014","journal-title":"Front. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/jhn.12103","article-title":"Assessing the Accuracy and Reliability of Direct Height Measurement for Use in Adult Neurological Patients with Contractures: A Comparison with Height from Ulna Length","volume":"27","author":"Finch","year":"2013","journal-title":"J. Human. Nutr. Diet."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"478965","DOI":"10.1155\/2014\/478965","article-title":"Neural Regulation of Cardiovascular Response to Exercise: Role of Central Command and Peripheral Afferents","volume":"2014","author":"Nobrega","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2847","DOI":"10.1113\/jphysiol.2010.204461","article-title":"The Distribution of Blood Flow in the Carotid and Vertebral Arteries during Dynamic Exercise in Humans","volume":"589","author":"Sato","year":"2011","journal-title":"J. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"15225","DOI":"10.1038\/s41598-021-94717-0","article-title":"The Association between Carotid Blood Flow and Resting-State Brain Activity in Patients with Cerebrovascular Diseases","volume":"11","author":"Matsumoto","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1161\/01.STR.22.3.319","article-title":"Correlation of Common Carotid Flow Volume Measured by Ultrasonic Quantitative Flowmeter with Pathological Findings","volume":"22","author":"Wada","year":"1991","journal-title":"Stroke"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Jung, J.-Y., Cho, H.-Y., and Kang, C.-K. (2022). Effects of a Traction Device for Head Weight Reduction and Neutral Alignment during Sedentary Visual Display Terminal (VDT) Work on Postural Alignment, Muscle Properties, Hemodynamics, Preference, and Working Memory Performance. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192114254"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e0308866","DOI":"10.1371\/journal.pone.0308866","article-title":"Effects of Low-Pressure Valsalva Maneuver on Changes in Cerebral Arterial Stiffness and Pulse Wave Velocity","volume":"19","author":"Yang","year":"2024","journal-title":"PLoS ONE"},{"key":"ref_24","first-page":"255","article-title":"Can Emergency Physicians Perform Common Carotid Doppler Flow Measurements to Assess Volume Responsiveness?","volume":"16","author":"Stolz","year":"2015","journal-title":"West. J. Emerg. Med. Integr. Emerg. Care Popul. Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Jung, J.-Y., Lee, Y.-B., and Kang, C.-K. (2021). Novel Technique to Measure Pulse Wave Velocity in Brain Vessels Using a Fast Simultaneous Multi-Slice Excitation Magnetic Resonance Sequence. Sensors, 21.","DOI":"10.3390\/s21196352"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"70","DOI":"10.29273\/jmst.2020.4.2.70","article-title":"Effects of the Abdominal Hollowing and Abdominal Bracing Maneuvers on the Pelvic Rotation Angle during Leg Movement","volume":"4","author":"Lee","year":"2020","journal-title":"J. Musculoskelet. Sci. Technol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"8383021","DOI":"10.1155\/2022\/8383021","article-title":"Comparison of the Effect of EMLATM Cream and the Valsalva Maneuver on Pain Severity during Vascular Needle Insertion in Hemodialysis Patients: A Controlled, Randomized, Clinical Trial","volume":"2022","author":"Babamohamadi","year":"2022","journal-title":"Evid.-Based Complement. Altern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.resp.2005.01.003","article-title":"The Valsalva Manoeuvre\u2014Cardiovascular Effects and Performance Technique: A Critical Review","volume":"147","author":"Looga","year":"2005","journal-title":"Respir. Physiol. Neurobiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13613-024-01356-5","article-title":"Heart\u2013Lungs Interactions: The Basics and Clinical Implications","volume":"14","author":"Jozwiak","year":"2024","journal-title":"Ann. Intensive Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1113\/EP091387","article-title":"The Heart, a Secondary Organ in the Control of Blood Circulation","volume":"110","author":"Furst","year":"2025","journal-title":"Exp. Physiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Golob, I., Opara Zupan\u010di\u010d, M., and Kozinc, \u017d. (2024). Abdominal Hollowing vs. Abdominal Bracing: A Scoping Review of Clinical Trials on Effectiveness for Trunk Stability and Rehabilitation. J. Funct. Morphol. Kinesiol., 9.","DOI":"10.3390\/jfmk9040193"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.apmr.2006.10.014","article-title":"Quantification of Lumbar Stability by Using 2 Different Abdominal Activation Strategies","volume":"88","author":"Grenier","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"328","DOI":"10.5606\/tftrd.2018.1418","article-title":"Does a Core Stabilization Exercise Program Have a Role on Shoulder Rehabilitation? A Comparative Study in Young Females","volume":"64","author":"Eren","year":"2018","journal-title":"Turk. J. Phys. Med. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1007\/s00421-016-3424-9","article-title":"Effect of Abdominal Bracing Training on Strength and Power of Trunk and Lower Limb Muscles","volume":"116","author":"Tayashiki","year":"2016","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1161\/01.CIR.20.4.574","article-title":"Effect of Valsalva Maneuver on Oxygen Saturation in Patients with Intracardiac Shunts","volume":"20","author":"Carter","year":"1959","journal-title":"Circulation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1111\/j.1742-6723.2009.01228.x","article-title":"The 10 mL Syringe Is Useful in Generating the Recommended Standard of 40 mmHg Intrathoracic Pressure for the Valsalva Manoeuvre","volume":"21","author":"Smith","year":"2009","journal-title":"Emerg. Med. Australas."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40885-022-00232-3","article-title":"An Evidence-Based Guide to the Efficacy and Safety of Isometric Resistance Training in Hypertension and Clinical Implications","volume":"29","author":"Pearson","year":"2023","journal-title":"Clin. Hypertens."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Lima, N.S., Jackson, R.E., Hibner, B.A., Sherman, S.R., Fernhall, B., Baynard, T., Crandall, C., Phillips, S.A., Zejnullahi, R., and Clifford, P.S. (2025). Mechanisms of Exercise-Induced Reduction in Peripheral Arterial Stiffness. Eur. J. Appl. Physiol., epub ahead of print.","DOI":"10.1007\/s00421-025-05821-2"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1139\/h06-107","article-title":"Arterial Stiffness Following Repeated Valsalva Maneuvers and Resistance Exercise in Young Men","volume":"32","author":"Heffernan","year":"2007","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1513\/AnnalsATS.201909-693CC","article-title":"\u201cBelly Breathing\u201d: The Physiologic Underpinnings of Abdominal Rounding","volume":"17","author":"Petri","year":"2020","journal-title":"Ann. ATS"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3977","DOI":"10.1038\/s41598-021-83420-9","article-title":"An Analysis Framework for the Integration of Broadband NIRS and EEG to Assess Neurovascular and Neurometabolic Coupling","volume":"11","author":"Pinti","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s10877-012-9348-y","article-title":"Monitoring Tissue Oxygenation by near Infrared Spectroscopy (NIRS): Background and Current Applications","volume":"26","author":"Scheeren","year":"2012","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3389\/fnint.2017.00025","article-title":"Hyperbaric Oxygen Environment Can Enhance Brain Activity and Multitasking Performance","volume":"11","author":"Vadas","year":"2017","journal-title":"Front. Integr. Neurosci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3389\/fphys.2018.01078","article-title":"Hyper-Oxygenation Attenuates the Rapid Vasodilatory Response to Muscle Contraction and Compression","volume":"9","author":"Messere","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Park, C.-S., Kim, M.-J., Kim, D.-H., Lee, Y.-B., and Kang, C.-K. (2024). Functional Near-Infrared Spectroscopy Analysis of Cerebral Physiological Changes in Response to Atmospheric Gas Concentrations. Appl. Sci., 14.","DOI":"10.3390\/app142411525"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/2031\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T09:51:51Z","timestamp":1763113911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/11\/2031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,14]]},"references-count":45,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["medicina61112031"],"URL":"https:\/\/doi.org\/10.3390\/medicina61112031","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,14]]}}}