A Randomized Clinical Trial of Autonomic Nervous Dysfunction by Valsalva Maneuver (V.M) and Sustained Hand Grip (S.H.G) Responses in Middle Aged Subjects having Hypertension and Diabetes Mellitus

To assess Autonomous Nervous System responses in the middle aged persons by using Valsalva Maneuver and Sustained Hand Grip tests in different postures.

67 subjects reporting to department of physiotherapy of K.L.E.S Hospital and MRC were evaluated after inform consent and they were subdivided into grouped into 4 groups (Group 1 control; Group 2 H.T. Group 3 D.M; and Group 4 H.Twith D.M) by simple random sampling method taking into inclusion and exclusion criteria. Baseline data for study were noted with respect to DBP;P.R;G.S.R level in 3 positions and body composition (fat and BMR). Then the participants were subjected to V.M and S.H.G tests and DBP;P.R;G.S.R level changes were noted.

The DBP fall after VM and S.H.G tests in all above 3 groups in different positions was not statistically significant; whereas combined group which showed a statistically significant DBP fall with ‘P’ value = <.001. The P.R increase after V.M and S.H.G tests in all above 3 groups in different positions was statistically significant with ‘P’ value = <.0001, except in the combined group which was not defined. G.S.R showed no change statistically in any group.

Taking in to account of fall of D.B.P and increase in P.R following post V.M and post S.H.G tests in 3 different positions; it is concluded here that V.M and S.H.G tests are simple, reliable and bedside clinical tests which can be used to assess the ANS dysfunction in subjects with Dm, HT and DM+HT.