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Watenpaugh, Donald E.

Publications and source records attributed to Watenpaugh, Donald E..

At least 19 records

WISE-2005: LBNP/Treadmill and Resistive Exercise Countermeasures Maintain Aerobic Capacity during a 60-d Bed Rest

We have previously documented that supine treadmill exercise within lower body negative pressure (LBNPex) performed 6 sessions (raised dot) wk(sup -1) during 15- and 30-day bed rests (BR) maintained upright aerobic capacity (VO2pk). In the present study, ure are evaluating whether aerobic capacity is maintained during a 60-d BR when the LBNPex frequency is reduced to 2-4 sessions (raised dot) wk(sup -1) and resistance exercise (REX) is added 2-3 sessions (raised dot) wk(sup -1). Eight healthy women (32 plus or minus 4 yrs; 56.4 plus or minus 3.6 kg; 164 plus or minus 8 cm; mean plus or minus SD) performed maximal-exertion, graded treadmill tests before and 3 days after a 60-d, 6 deg. head-down tilt BR. (Earliest day the medical monitors would permit a maximal exercise test post-BR). During BR, four subjects performed no exercise (CON), while four other subjects (EX) performed LBNPex and REX on separate days. The LBNPex countermeasure employed an intermittent (40-80% pre-BR VO2pk), 40-min protocol against an LBNP pressure (-49 plus or minus 3 mmHg) applied to provide a footward force equivalent to 1.0-1.2 body weight. REX consisted of maximal concentric and eccentric supine leg press and heel raise exercises using a gravity-independent flywheel ergometer. Comparisons were performed using paired (within-group) or non-paired (between-group) t-tests. Three days post-BR, VO2pk of the CON group was reduced significantly from pre-BR (Pre:37.2 plus or minus 1.2, Post: 29.4 plus or minus 2 ml (raised dot) kg(sup -1) (raised dot) min(sup -1), P less than 0.05), while the VO2pk of the EX group was not significantly reduced (Pre: 39.6 plus or minus 1.9, Post: 38.0 plus or minus 0.6 ml (raised dot) kg(sup -1) (raised dot) min(sup -1)). Peak heart rate, ventilation, rating of perceived exertion, and respiratory exchange ratio were not significantly different between the two groups pre- and post-BR. These preliminary results suggest that the combined LBNPex and REX countermeasures may be sufficient to maintain upright aerobic capacity after long-duration space flights.

Schneider, Suzanne M.

Twins Bed Rest Project: LBNP/Exercise Minimizes Changes in Lean Leg Mass, Strength and Endurance

Decreases in muscle strength and endurance frequently are observed in non-weightbearing conditions such as bed rest (BR), spaceflight or limb immobilization. Purpose: Ow purpose was to determine if supine treadmill exercise against simulated gravity, by application of lower body negative pressure (LBNP), prevents loss of lean leg mass, strength and endurance during 30 d of 6deg head-down bed rest (BR). Methods: Fifteen pairs of monozygous twins (8 male, 7 female pairs; 26+/-4 yrs; 170+/-12 cm; 62.6+/-11.3 kg; mean+/-SD) were subjects in the present study. One sibling of each pair of twins was randomly assigned to either an exercise (EX) or non-exercise (CON) group. The EX twin walked/jogged on a vertical treadmill within LBNP chamber 6 d/wk using a 40-min interval exercise protocol at 40-80% of pre-BR VO(sub 2peak). LBNP was adjusted individually for each subject such that footward force was between 1.0 and 1.2 times body weight (-53+/-5 mmHg LBNP). The CON twin performed no exercise during BR. Subjects performed isokinetic knee (60 and 120deg/s) and ankle (60deg/s) testing to assess strength and endurance (End) before and after BR. They also had their lean leg mass (L(sub mass)) evaluated by DEXA before and after BR. Results: Changes in peak torque (T(sub pk)) were smaller for flexion (flex) than for extension (ext) after BR and did not differ between groups. The CON group had larger decreases (P<0.05) in L(sub mass), knee and ankle ext T(sub pk), and knee ext End.

Amorim, Fabiano T.

Supine Lower Body Negative Pressure Exercise Maintains Upright Exercise Capacity in Male Twins during 30 Days of Bed Rest

Exercise capacity is reduced following both short and long duration exposures to microgravity. We have shown previously that supine lower body negative pressure with exercise (LBNP(sub ex) maintains upright exercise capacity in men after 5d and 15d bed rest, as a simulation of microgravity. We hypothesized that LBNP(sub ex) would protect upright exercise capacity (VO2pk) and sprint performance in eight sets of identical male twins during a 30-d bed rest. Twins within each set were randomly assigned to either a control group (CON) who performed no exercise or to an exercise group (EX) who performed a 40-min interval (40-80% pre-BR VO2pk) LBNP(sub ex) (55+/-4 mmHg) exercise protocol, plus 5 min of resting LBNP, 6 d/wk. LBNP produced footward force equivalent to 1.0- 1.2 times body weight. Pre- and post-bed rest, subjects completed an upright graded exercise test to volitional fatigue and sprint test of 30.5 m. After bed rest, VO2pk was maintained in the EX subjects (-3+/-3%), but was significantly decreased in the CON subjects (-24+/-4%). Sprint time also was increased in the CON subjects (24+/-8%), but maintained in the EX group (8+/-2%). The performance of a supine, interval exercise protocol with LBNP maintains upright exercise capacity and sprint performance during 30 d of bed rest. This exercise countermeasure protocol may help prevent microgravity-induced deconditioning during long duration space flight.

Lee, Stuart M. C.

Human cutaneous vascular responses to whole-body tilting, Gz centrifugation, and LBNP

We hypothesized that gravitational stimuli elicit cardiovascular responses in the following order with gravitational stress equalized at the level of the feet, from lowest to highest response: short-(SAC) and long-arm centrifugation (LAC), tilt, and lower body negative pressure (LBNP). Up to 15 healthy subjects underwent graded application of the four stimuli. Laser-Doppler flowmetry measured regional skin blood flow. At 0.6 G(z) (60 mmHg LBNP), tilt and LBNP similarly reduced leg skin blood flow to approximately 36% of supine baseline levels. Flow increased back toward baseline levels at 80-100 mmHg LBNP yet remained stable during 0.8-1.0 G(z) tilt. Centrifugation usually produced less leg vasoconstriction than tilt or LBNP. Surprisingly, SAC and LAC did not differ significantly. Thigh responses were less definitive than leg responses. No gravitational vasoconstriction occurred in the neck. All conditions except SAC increased heart rate, according to our hypothesized order. LBNP may be a more effective and practical means of simulating cardiovascular effects of gravity than centrifugation.

Motor Activity/physiology

Do vestibular otolith organs participate in human orthostatic blood pressure control?

We hypothesized that vestibular otolith organ stimulation contributes to human orthostatic responses. Twelve subjects underwent three 60 degrees upright tilts: (1) with the neck flexed from 0 degrees to 30 degrees relative to the body during 60 degrees tilt, such that the head moved from horizontal to 90 degrees above horizontal (0 to 1 Gz otolith stimulation); (2) with the head and body aligned, such that they tilted together to 60 degrees (0 to 0.87 Gz otolith stimulation); and (3) with the neck flexed 30 degrees relative to the body during supine conditions, and the neck then extended to -30 degrees during 60 degrees body tilting, such that the head remained at 30 degrees above horizontal throughout body tilting (constant 0.5 Gz otolith stimulation). All three tilt procedures increased thoracic impedance, sympathetic nerve activity (N = 8 of 12), arterial pressure, and heart rate relative to supine conditions (all P < 0.04). Within the first 20 s of tilt, arterial pressure increased most obviously in the 0 to 1 Gz otolith condition. Thoracic impedance tended to increase more in otolith-constant conditions, but no dependent variable differed significantly between tilt conditions, and no significant time x tilt interactions emerged. Otolith inputs may contribute to early transient adjustments to orthostasis. However, lack of significant main effects of tilt condition and time x tilt interactions suggests that potential otolith effects on the variables we studied are relatively subtle and ephemeral, or that other mechanisms compensate for a lack of change in otolith input with orthostasis.

Non-NASA Center

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

Physiologic Pressure and Flow Changes During Parabolic Flight (Pilot Study)

The objective of this study was to obtain measurement of cutaneous tissue perfusion central and peripheral venous pressure, and esophageal and abdominal pressure in human test subjects during parabolic flight. Hemodynamic data recorded during SLS-I and SLS-2 missions have resulted in the paradoxical finding of increased cardiac stroke volume in the presence of a decreased central venous pressure (CVP) following entry in weightlessness. The investigators have proposed that in the absence of gravity, acceleration-induced peripheral vascular compression is relieved, increasing peripheral vascular capacity and flow while reducing central and peripheral venous pressure, This pilot study seeks to measure blood pressure and flow in human test subjects during parabolic flight for different postures.

Pantalos, George

Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is relatively unimportant. Low calf venous compliance probably results from stiffer venous, skeletal muscle, and connective tissues, and better-developed local and central neural controls of venous distensibility. This research establishes that upper-to-lower body reduction of venous compliance can explain headward positioning of the hydrostatic indifference level in humans.

Watenpaugh, Donald E.

Simulated Microgravity Increases Cutaneous Blood Flow in the Head and Leg of Humans

The cutaneous micro-circulation vasodilates during acute 6 deg. head-down tilt (HDT, simulated microgravity) relative to upright conditions, more in the lower body than in the upper body. We expected that relative magnitudes of and differences between upper and lower body cutaneous blood flow elevation would be sustained during initial acclimation to simulated microgravity. We measured cutaneous micro-vascular blood flow with laser-Doppler flowmetry at the leg (over the distal tibia) and cheek (over the zygomatic arch) of eight healthy men before, during, and after 24 h of HDT. Results were calculated as a percentage of baseline value (100% measured during pre-tilt upright sitting). Cutaneous blood flow in the cheek increased significantly to 165 +/- 37% (mean + SE, p less than 0.05) at 9-12 h HDT, then returned to near baseline values by 24 h HDT (114 +/- 29%, NSD), despite increased local arterial pressure. Microvascular flow in the leg remained significantly elevated above baseline throughout 24 h HDT (427 +/- 85% at 3 h HDT and 215 +/- 142% at 24 h HDT, p less than 0.05). During the 6-h upright sitting recovery period, cheek and leg blood flow levels returned to near pre-tilt baseline values. Because hydrostatic effects of HDT increase local arterial pressure at the carotid sinus, baroreflex-mediated withdrawal of sympathetic tone probably contributed to increased microvascular flows at the head and leg during HDT. In the leg, baroreflex effects combined with minimal stimulation of local veno-arteriolar and myogenic autoregulatory vasoconstriction to elicit relatively larger and more sustained increases in cutaneous flow during HDT. In the cheek, delayed myogenic vasoconstriction and/or humoral effects apparently compensated for flow elevation by 24 h of HDT. Therefore, localized vascular adaptations to gravity probably explain differences in acclimation of lower and upper body blood flow to HDT and actual microgravity.

Stout, M. Shannon

Simulated Microgravity Increases Cutaneous Blood Flow in the Head and Leg of Humans

The cutaneous microcirculation vasodilates during acute 6 degree head-down tilt (HDT, simulated microgravity) relative to upright conditions, more in the lower body than in the upper body. Cutaneous microvascular blood flow was measured with laser-Doppler flowmetry at the leg (over the distal tibia) and cheek (over the zygomatic arch) of eight healthy men before, during, and after 24 h of HDT. Results were calculated as a percentage of baseline value (100% measured during pre-tilt upright sitting). Cutaneous blood flow in the cheek increased significantly to 165 +/- 37% (mean +/- SE, p less than 0.05) at 9-12 h HDT, then returned to near baseline values by 24 h HDT (114 +/- 29%, NSD), despite increased local arterial pressure. Microvascular flow in the leg remained significantly elevated above baseline througout 24 h HDT (427 +/- 85% at 3 h HDT and 215 +/- 142% at 24 h HDT, p less than 0.05). During the 6-h upright sitting recovery period, cheek and leg blood flow levels returned to near pre-tilt baseline values. Because hydrostatic effects of HDT increase local arterial pressure at the carotid sinus, baroreflex-mediated withdrawal of sympathetic tone probably contributed to increased microvascular flows at the head and leg during HDT. In the leg baroreflex effects combined with minimal stimulation of local veno-arteriolar and myogenic autoregulatory vasoconstriction to elicit relatively larger and more sustained increases in cutaneous flow during HDT. In the cheek, delayed myogenic vasoconstriction and/or hurmonal effects apparently compensated for flow elevation by 24 h of HDT. Therefore, localized vascular adaptations to gravity probably explain differences in acclimation of lower and upper body blood flow to HDT and actual microgravity.

Stout, M. Shannon

Pharmacologic Atrial Natriuretic Peptide Reduces Human Leg Capillary Filtration

Atrial natriuretic peptide (ANP) is produced and secreted by atrial cells. We measured calf capillary filtration rate with prolonged venous-occlusion plethysmography of supine healthy male subjects during pharmacologic infusion of ANP (48 pmol/kg/min for 15 min; n = 6) and during placebo infusion (n = 7). Results during infusions were compared to prior control measurements. ANP infusion increased plasma (ANP) from 30 +/- 4 to 2,568 +/- 595 pmol/L. Systemic hemoconcentration occurred during ANP infusion: mean hematocrit and plasma colloid osmotic pressure increased 4.6 and 11.3%, respectively, relative to preinfusion baseline values (p less than 0.05). Mean calf filtration, however, was significantly reduced from 0.15 to 0.08 ml/100 ml/min with ANP. Heart rate increased 20% with ANP infusion, whereas blood pressure was unchanged. Calf conductance (blood flow/ arterial pressure) and venous compliance were unaffected by ANP infusion. Placebo infusion had no effect relative to prior baseline control measurements. Although ANP induced systemic capillary filtration, in the calf, filtration was reduced with ANP. Therefore, pharmacologic ANP infusion enhances capillary filtration from the systemic circulation, perhaps at upper body or splanchnic sites or both, while having the opposite effect in the leg.

Watenpaugh, Donald E.

Pharmacologic Atrial Natriuretic Peptide Reduces Human Leg Capillary Filtration

Atrial natriuretic peptide (ANP) is produced and secreted by atrial cells. We measured calf capillary filtration rate with prolonged venous-occlusion plethys-mography of supine health male subjects during pharmacologic infusion of ANP (48 pmol/kg/min for 15 min; n equals 6) and during placebo infusion (n equals 7). Results during infusions were compared to prior control measurements. ANP infusion increased plasma (ANP) from 30 plus or minus 4 to 2,568 plus or minus 595 pmol/L. Systemic hemoconcentration occurred during ANP infusion; mean hematocrit and plasma colloid osmotic pressure increased 4.6 and 11.3 percent respectively, relative to pre-infusion baseline values (p is less than 0.05). Mean calf filtration, however was significantly reduced from 0.15 to 0.08 ml/100 ml/min with ANP. Heart rate increased 20 percent with ANP infusion, wheras blood pressure was unchanged. Calf conductance (blood flow/arterial pressure) and venous compliance were unaffected by ANP infusion. Placebo infusion had no effect relative to prior baseline control measurements. Although ANP induced systemic capillary filtration, in the calf, filtration was reduced with ANP. Therefore, phamacologic ANP infusion enhances capillary filtration from the systemic circulation, perhaps at upper body or splanchic sites or both, while having the opposite effect in the leg.

Watenpaugh, Donald E.

Calf Venous Compliance in Supine Posture Equals that Measured with Head-up Tilt

Calf venous compliance is measured conventionally with venous occlusion, where compliance equals calf volume elevation per mmHg thigh occlusion pressure in relaxed legs of supine subjects. Compliance may also be measured during stepwise head-up tilt (HUT) as calf volume elevation per mmHg gravitational venous pressure elevation produced by HUT. Although HUT on a tilt table with a footplate activates calf muscles which could reduce compliance, this muscle activation is relatively small (less than or = 10% of maximal voluntary levels). Therefore, we hypothesized that calf compliance measured with HUT equals that measured with conventional supine venous occlusion. The venous occlusion protocol consisted of 20, 40, 60 and 80 mmHg thigh cuff inflations held for 1, 2, 3 and 4 min, respectively, in 14 supine subjects. One min of cuff deflation to 0 mmHg separated occlusions. Nine other subjects underwent HUT through the following angles held for 30s each: -12 deg., -6 deg., 0 deg., 12 deg., 30 deg., 54 deg., and 90 deg. HUT calf venous pressure data were interpolated from Katkov and Chestukhin; these data correspond to 70-80% of calculated calf venous pressure changes (pgh). Liquid metal-in-silastic strain gauges measured calf volume for both venous occlusion and HUT compliance. Relaxed calf compliance in supine subjects equaled 4.6 +/- 0.4 ml/mmHg (X +/- SE), as measured with venous occlusion. Calf compliance during HUT equaled 4.6 +/- 1.0 ml/mmHg. Therefore, calf compliance in supine, relaxed subjects equals that measured during head-up tilt. We conclude that the minimal calf muscle activation which occurs during HUT does not importantly affect calf compliance.

Watenpaugh, Donald E.

Self-generating oscillating pressure exercise device

An exercise device, especially suitable for zero gravity workouts, has a collapsible chamber which generates negative pressure on the lower portion of a body situated therein. The negative pressure is generated by virtue of leg, hand and shoulder interaction which contracts and expands the chamber about the person and by virtue of air flow regulation by valve action.

Watenpaugh, Donald E.

Mechanism of Headward Fluid Shift During Exposure To Microgravity

A prominent feature of early cardiovascular adaptation to the microgravity of space flight is a shift of blood and tissue fluid from the lower body to the upper body. Symptoms of this fluid shift include facial edema, nasal congestion, and headache. Normally on Earth, the human body is exposed to hydrostatic (gravitational) blood pressure gradients during upright posture. In this posture, mean arterial pressures at head, heart, and foot levels are approximately 70, 100, and 200 mm Hg, respectively. Theoretically, all hydrostatic pressures within arteries and veins are lost during exposure to microgravity so that mean arterial pressure in all regions of the body is uniform and approximately equal to that at heart level (100 mm Hg). Acute studies of 60 head-down tilt (simulated microgravity on Earth) indicate that facial edema is caused by: 1) elevation of capillary blood pressure from 28 to 34 mm Hg, 2) reduction of blood colloid osmotic pressure 22 to 18 mm Hg, and 3) 50% increase of blood perfusion in tissues of the head. Furthermore, as compared to microvasculature in the feet, microvessels of the head have a low capacity to constrict and diminish local perfusion. Elevation of blood and tissue fluid pressures/flow in the head may also explain the higher headward bone density associated with long-term head-down tilt. These mechanistic studies of head-down tilt, along with a better understanding of the relative stresses involved with upright posture and lower body negative pressure, have facilitated development of physiologic countermeasures to maintain astronaut health during microgravity. Presently no exercise hardware is available to provide a blood pressure gradient from head to feet in space. However, recent studies in our laboratory suggest that treadmill exercise within lower body negative pressure provides equivalent or greater physiologic stress as compared to similar upright exercise on Earth.

Hargens, Alan R.

Transcapillary fluid responses to lower body negative pressure

The effect of lower body negative pressure (LBNP) on transcapillary fluid balance, with and without saline ingestion, was investigated in normally hydrated human subjects by measuring leg interstitial fluid pressure, leg circumference, plasma volume, and net whole body transcapillary fluid transport during and after supine LBNP in human subjects. The results indicate that prolonged LBNP, especially with saline ingestion, promotes fluid filtration into lower body tissues.

Aratow, Michael

Acute Cutaneous Microvascular Flow Responses to Whole-Body Tilting in Humans

The transition from upright to head-down tilt (HDT) posture in humans increases blood pressure superior to the heart and decreases pressure inferior to the heart. Consequently, above heart level, myogenic arteriolar tone probably increases with HDT, in opposition to the withdrawal of baroreceptor-mediated sympathetic tone. We hypothesized that due to antagonism between central and local controls, the response of the facial cutaneous microcirculation to acute postural change will be weaker than that in the leg, where these two mechanisms reinforce each other. Cutaneous microvascular flow was measured by laser Doppler flowmetry simultaneously at the shin and the neck of 7 male and 3 female subjects. Subjects underwent a stepwise tilt protocol from standing control to 54 deg head-up tilt (HUT), 30 deg, 12 deg, O deg, -6 deg (HDT), -12 deg, -6 deg, O deg, 12 deg, 30 deg, 54 deg, and standing, for 30-sec periods with 10-sec transitions between postures. Flows at the shin and the neck increased significantly (P less than 0.05) from standing baseline to 12 deg HUT (252 +/- 55 and 126 +/- 9% (bar X +/- SE) of baseline, respectively). From 12 deg to -12 deg tilt, flows continued to increase at the shin (509 +/- 71% of baseline) but decreased at the neck to baseline levels (100 +/- 15% of baseline). Cutaneous microvascular flow recovered at both sites during the return to standing posture with significant hysteresis. Flow increases from standing to near-supine posture are attributed at both sites to baroreceptor-mediated vasodilation. The great dissimilarity in flow response magnitudes at the two measurement sites may be indicative of central/local regulatory antagonism above heart level and reinforcement below heart level.

Breit, Gregory A.

Regional cutaneous microvascular flow responses during gravitational and LBNP stresses

Due to the regional variability of local hydrostatic pressures, microvascular flow responses to gravitational stress probably vary along the length of the body. Although these differences in local autoregulation have been observed previously during whole-body tilting, they have not been investigated during application of artificial gravitational stresses, such as lower body negative pressure or high gravity centrifugation. Although these stresses can create equivalent G-levels at the feet, they result in distinct distributions of vascular transmural pressure along the length of the body, and should consequently elicit different magnitudes and distributions of microvascular response. In the present study, the effects of whole-body tilting and lower body negative pressure on the level and distribution of microvascular flows within skin along the length of the body were compared.

Breit, Gregory A.