Physiological Correlates of Applied Tension May Contribute to Reduced Fainting During Medical Procedures

  title={Physiological Correlates of Applied Tension May Contribute to Reduced Fainting During Medical Procedures},
  author={Blaine Ditto and Nelson Byrne and Crystal D. Holly},
  journal={Annals of Behavioral Medicine},
BackgroundApplied tension (AT) is a behavioral technique used to reduce symptoms such as dizziness and fainting in people with blood and injury phobias as well as medical patients undergoing invasive procedures. AT has been found to reduce dizziness and fainting in several studies of blood donors.PurposeThe purpose of this study was to examine the psychophysiological effects of AT in the context of blood donation.MethodsNinety-eight young adult blood donors wore ambulatory physiological… 

Applied tension and blood donation symptoms: the importance of anxiety reduction.

  • C. HollySaharnaz BaleghB. Ditto
  • Medicine, Psychology
    Health psychology : official journal of the Division of Health Psychology, American Psychological Association
  • 2011
Analytical data and self-reported anxiety supports the conclusion that the reduction in vasovagal symptoms was due more to decreased anxiety rather than exercise-related cardiovascular change, suggesting that AT may provide a useful means of coping with invasive medical procedures in part by reducing anxiety.

Physiologic strategies to prevent fainting responses during or after whole blood donation

Interventions that have been useful in controlling VVS in patients with fainting syndromes are described and the potential of these interventions in the blood donation context is examined, based on the physiologic principles involved.


Results support the notion that the effects of AT are not only due to exercise-related cardiovascular change and that they may be through a reduction of anxiety and that anxiety reduction plays an important role.

Orthostatic hypotension after whole blood donation with various physiologic strategies to prevent fainting responses

Physiologic strategies may be advised to prevent fainting responses but need further studies to consider as protocol & compulsory and it is better to advice rest for minimum of 15 minutes.

Applied Tension and Coping with Blood Donation: A Randomized Trial

The results of this study suggest that the effects of applied tension on vasovagal symptoms are not mediated entirely by exercise-related changes in blood pressure and heart rate, rather, it may reduce anxiety or physiological consequences of anxiety.

The effects of blood-draw and injection stimuli on the vasovagal response.

Comparing vasovagal symptoms during intravenous-injection and blood-draw videos and the relevance of specific stimuli and emotions in VVR found thatSympathetic nervous system activity decreased during both videos but significantly more during the blood- draw video, although this could be reversed by the Applied Tension technique.

Variation in Cerebral Oxygenation during Whole Blood Donation: The Impact of Applied Muscle Tension

Results showed that participants who engaged in applied muscle tensing were shown to have attenuated decreases in cerebral oxygenation across the three intervals of the blood draw relative to the distraction manipulation.

Effects of Performing Applied Muscle Tension during Recovery after Phlebotomy in Young, First-Time Donors: A Pilot Study

Performing applied muscle tension after donation resulted in sustained haemodynamic improvements beyond the donation period, despite the reduction in delayed VVR was insignificant compared to the control group, and a larger sample size is needed to validate the effectiveness of performing AMT after donation to mitigate delayed V VR.

Therapy: Conclusive Remarks

Clinical experience suggests that a convincing advice often improves the quality of life of patients with recurrent VVS, and conventional therapy of VVS includes lifestyle modification, pharmacological treatment, and cardiac pacing.



Psychophysiologic effects of applied tension on the emotional fainting response to blood and injury.

Arousal elicits exaggerated inhibition of sympathetic nerve activity in phobic syncope patients.

The findings suggest that the degree of inhibition in response to arousal stimuli is related to a subjective factor coupled to fear of blood/injury, and may be a factor predisposing to syncope in patients with a history of vasovagal syncope.

Management of Vasovagal Syncope: Controlling or Aborting Faints by Leg Crossing and Muscle Tensing

Leg crossing combined with tensing muscles at the onset of prodromal symptoms can postpone and in some subjects prevent vasovagal syncope.

Cardiovascular dynamics in blood phobia: evidence for a key role of sympathetic activity in vulnerability to syncope.

An impaired vasomotor response under sympathetic control might be the key mechanism underlying the phobic dysfunctional response.

On-Site Training in Applied Muscle Tension to Reduce Vasovagal Reactions to Blood Donation

Applied muscle tension reduced the number of symptoms reported on a postdonation questionnaire and the amount of medical treatment required among those who practiced applied tension for the entire period they were in the donation chair.

Management of vasovagal syncope: controlling or aborting faints by leg crossing and muscle tensing.

Clinicians and researchers may be unaware that a similar behavioral treatment has been shown to be very effective for syncope, and a randomized trial of applied tension for injection phobia is recommended.

Hemodynamics of blood pressure responses during active and passive coping.

This laboratory study was designed to address a number of interrelated issues regarding cardiovascular reactivity to psychological stress, and indicated that the hemodynamic basis of reactivity is an individual characteristic only partially modified by coping demands.

Lesser vagal withdrawal during isometric exercise with age.

It is concluded that the smaller tachycardiac response to isometric exercise in older humans is associated with an inability to decrease cardiac vagal tone below an already reduced baseline level.

Autonomic mechanisms in hemodynamic responses to isometric exercise.

The role of the sympathetic nervous system was delineated in the heart rate and pressor responses to sustained handgrip and it was concluded that the increase in resistance was the result of sympathetically induced vasoconstriction.