Effects of body weight-supported treadmill training on heart rate variability and blood pressure variability in individuals with spinal cord injury

2005 ◽  
Vol 98 (4) ◽  
pp. 1519-1525 ◽  
Author(s):  
David S. Ditor ◽  
Mark V. Kamath ◽  
Maureen J. MacDonald ◽  
Joanne Bugaresti ◽  
Neil McCartney ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Autonomic Regulation ◽  
Treadmill Training ◽  
Increased Risk ◽  
Cord Injury ◽  
Head Up Tilt

Individuals with spinal cord injury are prone to cardiovascular dysfunction and an increased risk of cardiovascular disease. Body weight-supported treadmill training (BWSTT) may enhance ambulation in individuals with incomplete spinal cord injury; however, its effects on cardiovascular regulation have not been investigated. The purpose of this study was to examine the effects of 6-mo of BWSTT on the autonomic regulation of heart rate (HR) and blood pressure (BP) in individuals with incomplete tetraplegia. Eight individuals [age 27.6 yr (SD 5.2)] with spinal cord injury [C4–C5; American Spinal Injury Association B-C; 9.6 yr (SD 7.5) postinjury] participated. Ten-minute HR and finger arterial pressure (Finapres) recordings were collected during 1) supine rest and 2) an orthostatic stress (60° head-up tilt) before and after 6 mo of BWSTT. Frequency domain measures of HR variability [low-frequency (LF) power, high-frequency (HF) power, and LF-to-HF ratio] and BP variability (systolic and diastolic LF power) were used as clinically valuable indexes of neurocardiac and neurovascular control, respectively. There was a significant reduction in HR [61.9 (SD 6.9) vs. 55.7 beats/min (SD 7.7); P = 0.05] and LF-to-HF ratio [1.23 (SD 0.47) vs. 0.99 (SD 0.40); P < 0.05] after BWSTT. There was a significant reduction in LF systolic BP [183.1 (SD 46.8) vs. 158.4 mmHg2 (SD 45.2); P < 0.01] but no change in BP. There were no significant effects of training on HR variability or BP variability during 60° head-up tilt. In conclusion, individuals with incomplete tetraplegia retain the ability to make positive changes in cardiovascular autonomic regulation with BWSTT without worsening orthostatic intolerance.

scholarly journals A call to reevaluate cardiac autonomic assessment after spinal cord injury

2018 ◽  
Vol 315 (5) ◽  
pp. H1088-H1090
Author(s):  
Hisham Sharif ◽  
Michael F. La Fountaine ◽  
Jill M. Wecht ◽  
David S. Ditor
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Heart Rate Variability ◽  
Autonomic Regulation ◽  
Cardiac Autonomic Regulation ◽  
Cord Injury ◽  
Cold Face ◽  
Head Up Tilt ◽  
Cold Face Test

This “Perspectives” article puts forward the notion that measuring heart rate variability, or other forms of cardiac autonomic regulation, after spinal cord injury must be performed during a test of autonomic stress. Resting values of heart rate variability are often similar to those obtained from able-bodied individuals, which may therefore be falsely interpreted as normal or healthy autonomic regulation. However, evidence shows that despite normal resting values, cardiac autonomic control is impaired when individual with spinal cord injury are subjected to a cold face test, head-up tilt, or recovery from exercise. Accordingly, examination of cardiac autonomic function must be performed during an autonomic challenge, as resting measures do not accurately reflect the state of cardiovascular regulation after spinal cord injury and can provide false information.

Diurnal Blood Pressure Variation in Quadriplegic Chronic Spinal Cord Injury Patients

1991 ◽  
Vol 80 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Henry Krum ◽  
William J. Louis ◽  
Douglas J. Brown ◽  
Graham P. Jackman ◽  
Laurence G. Howes
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Ambulatory Monitoring ◽  
Pressure Variation ◽  
Night Time ◽  
Cord Injury ◽  
Blood Pressure Variation ◽  
Neurologically Intact

1. Measurement of blood pressure and heart rate over a 24 h period was peformed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

scholarly journals Short Term Effects of Rhythmic Auditory Stimulation with Body Weight Supported Treadmill Training on Gait and Balance in Individuals with Incomplete Spinal Cord Injury

2021 ◽  
Vol 6 (4) ◽  
pp. 191-197
Author(s):  
Kanika Singhal ◽  
Chitra Kataria
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Gait Training ◽  
Auditory Stimulation ◽  
Treadmill Training ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Rhythmic Auditory Stimulation ◽  
Gait Trainer

Background: Rhythmic auditory stimulation and body weight supported treadmill training both are standardized gait rehabilitation techniques. However there is limited literature evaluating the effect of rhythmic auditory stimulation and its combination with gait training in spinal cord injury. Aim of this study is to determine the short term effectiveness of rhythmic auditory stimulation with body weight supported treadmill training on gait and balance in individuals with incomplete Spinal Cord Injury. Method: A randomized control study design. 8 subjects with incomplete spinal cord injury who met the inclusion criteria were randomly allocated into two groups: Experimental and Control. Subjects in experimental group were given body weight supported treadmill training with rhythmic auditory stimulation. Subjects in Control Group were given Body weight supported treadmill training alone. Both the groups received conventional rehabilitation as well. Both groups received training for 30 minutes, five times a week for two weeks (10 sessions). Outcome Measures: Gait parameters i.e. cadence, velocity, step length were measured using the Biodex Gait Trainer 2TM, level of walking performance measured using Walking Index for Spinal Cord Injury II, and balance was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale. Results: No significant improvement was found on gait parameters i.e. cadence, velocity, step length which were measured using the Gait Trainer, level of walking performance measured using WISCI II, and balance which was evaluated using Prokin 252NTM , Berg Balance Scale, and Activity specific Balance Confidence scale. Conclusion: Rhythmic auditory stimulation didn’t have any positive effect on gait training in incomplete spinal cord injured patients. Further studies are warranted to explore the entrainment effects of rhythmic auditory stimulation in spinal cord injured individuals on gait rehabilitation. Keywords: Rhythmic Auditory Stimulation (RAS), Body Weight Supported Treadmill Training (BWSTT), Metronome, Incomplete spinal cord injury, Biodex Gait Trainer 2.0, Prokin 252N

scholarly journals Treino Locomotor com Suporte de Peso Corporal na Lesão Medular Incompleta

2001 ◽  
Vol 19 (4) ◽  
pp. 702-710
Author(s):  
Renata Teles Vieira ◽  
Rafaela Machado de Gusmão Oliveira ◽  
Camila Alves Nogueira Barros ◽  
Leonardo Caixeta
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Treadmill Training ◽  
Body Weight Support ◽  
Locomotor Training ◽  
Weight Support ◽  
Cord Injury

Objetivo. O objetivo deste trabalho foi realizar uma revisão de literatura sobre o uso do treino locomotor em pacientes portadores de lesão medular incompleta, a fim de verificar os seus efeitos para a marcha destes pacientes. Método. Foi realizada uma busca utilizando os bancos de dados medline, scielo e bvs a partir dos descritores: body weight-support treadmill training (suporte parcial de peso com treinamento em esteira), locomotor training (treino locomotor), spinal cord injury (lesão medular), gait (marcha). Todos os artigos coletados nos últimos 18 anos foram analisados. Discussão. A lesão medular é uma grave síndrome neurológica que causa diversos comprometimentos, inclusive da marcha. Para aperfeiçoar este processo, deu-se início à prática de reabilitação na esteira com suporte de peso corporal. A ampla utilização desta técnica de reabilitação deve-se a maior facilidade para o treino da marcha, a satisfação dos pacientes durante o tratamento e, principalmente, aos bons resultados gerados. Conclusão. Um número significante de estudos mostrou que o treino de marcha com suporte de peso corporal é um meio seguro e confiável, e que surgiu para inovar a reabilitação funcional da marcha. Não há evidência científica para afirmar que o treino locomotor com suporte de peso seja um método superior a outras terapias.

scholarly journals Robotic-Assisted, Body-Weight–Supported Treadmill Training in Individuals Following Motor Incomplete Spinal Cord Injury

2005 ◽  
Vol 85 (1) ◽  
pp. 52-66 ◽  
Author(s):  
T George Hornby ◽  
David H Zemon ◽  
Donielle Campbell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Physical Therapists ◽  
Treadmill Training ◽  
Neurological Injury ◽  
Walking Ability ◽  
Incomplete Spinal Cord Injury ◽  
Robotic Assisted ◽  
Cord Injury

AbstractBackground and Purpose. Performance of therapist-assisted, body-weight–supported treadmill training (BWSTT) to enhance walking ability of people with neurological injury is an area of intense research. Its application in the clinical setting, however, is limited by the personnel and labor requirements placed on physical therapists. Recent development of motorized (“robotic”) rehabilitative devices that provide assistance during stepping may improve delivery of BWSTT. Case Description. This case report describes the use of a robotic device to enhance motor recovery and ambulation in 3 people following motor incomplete spinal cord injury. Interventions. Changes in motor impairment, functional limitations, and locomotor disability were monitored weekly during robotic-assisted BWSTT and following transition to therapist-assisted BWSTT with the assistance of one therapist. Outcomes. Following this training, 2 patients recovered independent over-ground walking and another improved his gait speed and endurance. Discussion. The use of robotic devices may assist physical therapists by providing task-specific practice of stepping in people following neurological injury.

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