Article

Autonomic dysfunction after spinal cord injury (SCI) is an
under-researched area when compared with motor and sensory dysfunction.
Cardiovascular autonomic dysfunction is a particular concern, leading to impaired
control of blood pressure and heart rate. OBJECTIVES:
(1) To determine the
prevalence of hypotension in individuals with SCI during and after rehabilitation; (2) To investigate changes in cardiovascular variables during and after rehabilitation;
(3) To evaluate the influence of personal and lesion
characteristics on cardiovascular variables. METHODS: Cardiovascular variables
(resting systolic [SAP] and diastolic [DAP] arterial pressures and resting
[HRrest] and peak heart rates [HRpeak]) were measured on 5 test occasions: start
of inpatient rehabilitation, 3 months later, at discharge, and at 1 and 5 years
after discharge. The time course and effects of personal and lesion
characteristics on cardiovascular variables were studied using multilevel
regression analyses. RESULTS: The prevalence of hypotension was unchanged during
rehabilitation and for 5 years after discharge. Odds for hypotension were highest
in those with cervical and high thoracic lesions, younger individuals, and men.
DAP increased during the 5 years after discharge. HRrest decreased during and
after rehabilitation. SAP, DAP, HRrest, and HRpeak were lowest in those with
cervical and high thoracic lesions. SAP and DAP increased with age; HRpeak
decreased with age. CONCLUSIONS: These longitudinal data provide normative values
for blood pressure and heart rate changes with time after injury according to
lesion and personal characteristics. These results can be used to guide clinical
practice and place changes in cardiovascular function caused by interventions in perspective.

Langue : ANGLAIS