The Effect of Positional Changes during Heavy Weight Lifting on Intraocular Pressure

Hae Yoon Song; Sang Moon Jeoung; Jae Seok Im; Eung Lee; Jeong Do Kwon

doi:10.3341/jkos.2009.50.12.1831

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Song, Jeoung, Im, Lee, and Kwon: The Effect of Positional Changes during Heavy Weight Lifting on Intraocular Pressure

Original Article

J Korean Ophthalmol Soc 2009;50(12):1831-1839.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.12.1831

The Effect of Positional Changes during Heavy Weight Lifting on Intraocular Pressure

Hae Yoon Song, MD, Sang Moon Jeoung, MD, Jae Seok Im, MD, Eung Lee, MD, Jeong Do Kwon, MD

Department of Ophthalmology, Wallace Memorial Baptist Hospital, Busan Korea

Address reprint requests to Jeong Do Kwon, MD, Department of Ophthalmology, Wallace Memorial Baptist Hospital #374-75 Namsan-dong, Gumjung-gu, Busan 609-813, Korea Tel: 82-51-580-1359, Fax: 82-51-512-1354, E-mail: kjdeye@naver.com

Received 26 October 2009 Accepted 3 December 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To measure intraocular pressure (IOP) as a function of positional changes of the head during heavy weight lifting.

Methods

The subjects of this study were 30 healthy adult males in their twenties to forties. This study investigated their ophthalmic examinations, BMI (body mass index), and 1RM (one repetition maximum) according to the three bench press positions.

The baseline IOP was measured in each position before starting exercise. IOP was measured during pre-exercise and then lift down, lift up when exerting 80% of 1RM in three bench press positions.

Results

Before exercising, the IOP was higher in the lowered head position in the decline bench press (18.20±2.89 mmHg) than in the incline bench press (14.38±2.32 mmHg) (p<0.001). The IOP increased significantly during the bench press exercise, relative to during the pre-exercise (p<0.001). Upon lift down, IOP increased by 3.72±1.85 mmHg greater than upon lift up, and mean IOP increased by 2.61±1.63 mmHg (p<0.001). In our experiments, IOP increased to a maximum of 22.10±2.79 mmHg, measured during lift down in the decline bench press configuration. The BMI and the IOP before exercise showed significant correlation (p<0.05).

Conclusions

IOP increased more during exercise involving a lower head position. Further study is needed to know the extent to which this result is relevant for glaucoma patients and which activities and head positions during exercise may worsen glaucoma. In the meantime, patients with severe glaucoma may need to avoid lifting heavy objects with a lowered head position.

Keywords: Bench press, Intraocular pressure, Positional change, Valsalva maneuver, Weight lifting

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Figure 1.

Comparison of intraocular pressure (IOP) on pre-exercising and lift down, lift up when exerted 80% of 1RM 2′ (repetition maximum) at the point of keeping breath hold in 3 exercising positions.

Figure 2.

Scatterplot of the distribution of intraocular pressure(IOP) variations 5 minutes to maintain posture in 3 positions before exercise.

Table 1.

Mean values of age, ophthalmic and health parameters

Variables	Mean^*	Range
Mean age (years)	26.57±4.77	20∼39
BMI^† (kg/m²)	24.40±2.74	18.4∼31.0
Mean Weight (kg)	74.67±8.52	58∼92
Mean Height (cm)	174.83±4.42	167∼183
Mean IOP^‡ (mmHg)	13.21±0.08	10∼19
BCVA^§	0.95±0.02	0.5∼1.0
Refraction error	−4.06±0.16	−9∼0
PAC^Π	0.82±0.32	1∼2
C/D ratio^＃	0.42±0.27	0.2∼0.6

^* Values are given as a mean± standard deviation

^† Body mass index=weight (kg) divided by height (m) square

^‡ Intraocular pressure

^§ Best corrected visual acuity

^Π Peripheral anterior chamber

^＃ Cup to disc ratio.

Table 2.

Mean values of 1 repetition maximum, 80% of 1 repetition maximum

Position	1RM^*	80% of 1RM
Incline bench press (kg)	70.3±2.85^*	56.24±2.28
Flat bench press (kg)	74.33±2.95	59.46±2.36
Decline bench press (kg)	78.33±3.68	62.66±2.94
P^†	<0.001

^* Repetition maximum

^† P value for linear trend which adjusted for 3 positions by ANACOVA test.

Table 3.

Mean values of IOP on three bench press positions and exercising

Position	Pre-exercising	Lift up	Lift down
Incline bench IOP^† (mmHg)	14.38±2.32^*	17.27±2.57	18.03±2.75
Flat bench IOP(mmHg)	14.57±2.07	17.35±2.64	18.20±2.89
Decline bench IOP (mmHg)	18.20±2.89	20.38±2.66	22.10±2.79
P^‡	<0.001

^* Values are given as a mean± standard deviation

^† Intraocular pressure

^‡ P value for linear trend which adjusted for 3 positions by ANACOVA test.

Table 6.

Correlation of between BMI, refractive error, peripheral anterior chamber, C/D ratio, VF, RNFL defect parameters and comparison of intraocular pressure (IOP) on pre-exercising and lift down, lift up in 3 positions

Position	Comparison of	BMI	Refraction error	PAC	C/D ratio^‡	VF^§	RNFLΠ defect
	IOP^†	P value (R)^*	P value (R)^*	P value (R)^*	P value (R)^*	P value (R)^*	P value (R)^*
Incline	Lift down and	0.182	0.982	0.203	0.151	0.920	0.920
bench	Pre-exercising	(−0.347)	(0.003)	(−0.167)	(0.188)	(0.13)	(0.13)
press	Lift up and	0.525	0.880	0.401	0.136	0.983	0.537
	Pre-exercising	(−0.170)	(0.020)	(−0.110)	(0.195)	(0.003)	(−0.081)
Flat bench	Lift down and	0.114	0.667	0.775	0.503	0.771	0.771
press	Pre-exercising	(−0.206)	(0.057)	(−0.380)	(0.088)	(0.38)	(0.38)
	Lift up and	0.180	0.653	0.815	0.179	0.859	0.859
	Pre-exercising	(0.320)	(0.059)	(0.031)	(0.176)	(0.023)	(0.023)
Decline	Lift down and	0.414	0.885	0.478	0.819	0.571	0.959
bench	Pre-exercising	(0.107)	(0.019)	(0.093)	(−0.030)	(0.750)	(0.007)
press	Lift up and	0.227	0.876	0.146	0.754	0.608	0.252
	Pre-exercising	(0.158)	(−0.021)	(0.190)	(−0.041)	(0.067)	(0.150)

^* P value(R). R=Pearson's correlation coefficient; P=Pearson's correlation

^† IOP=intraocular pressure

^‡ C/D ratio=cup to disc ratio

^§ VF=visual field

^Π RNFL=retinal nerve fiber layer.

Table 4.

Correlation of between BMI, refractive error, peripheral anterior chamber, C/D ratio parameters and intraocular pressure (IOP) in 3 positions before exercise

IOP^† in 3 position	BMI P value (R)^*	Refractive error P value (R).	PAC P value (R).	C/D ratio P value (R).
Incline Bench press	0.035 (0.730)	0.588 (−0.071)	0.888 (0.019)	0.073 (−0.233)
Flat bench press	0.038 (0.720)	0.538 (−0.810)	0.729 (−0.460)	0.229 (−0.158)
Decline bench press	0.009 (0.910)	0.982 (−0.003)	0.377 (−0.116)	0.867 (−0.220)

^* Values are number of P value (R). R=Pearson's correlation coefficient; P=Pearson's correlation; Correlation analysis

^† IOP=intraocular pressure.

Table 5.

Comparison of IOP on lift down, lift up and pre-exercising

Position	Lift down-Lift up	P value^‡	Lift up-Pre-exercising	P value^‡	Lift down-Pre-exercising	P value^‡
Incline bench IOP^† (mmHg)	0.76±2.49^*	<0.001	2.89±2.44	<0.001	3.65±2.53	<0.001
Flat bench IOP^* (mmHg)	0.85±2.41	<0.001	2.78±2.37	<0.001	3.63±2.48	<0.001
Decline bench IOP^* (mmHg)	1.78±2.81	<0.001	2.18±2.77	<0.001	3.90±2.84	<0.001

^* Values are given as a mean± standard deviation

^† Intraocular pressure

^‡ Student T test.

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