Document Detail


Effect of different sympathetic stimuli-autonomic dysreflexia and head-up tilt-on leg vascular resistance in spinal cord injury.
MedLine Citation:
PMID:  21112436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effect of different sympathetic stimuli, that is, exaggerated sympathetic activity and orthostatic challenges, on the increase in leg vascular resistance in persons with spinal cord injury (SCI) without and controls with supraspinal sympathetic control.
DESIGN: Case-control intervention study.
SETTING: Physiology research laboratory.
PARTICIPANTS: Persons with SCI (N=9; motor and sensory complete spinal cord lesion above the sixth thoracic spinal segment) and able-bodied controls (N=9).
INTERVENTIONS: In persons with SCI, exaggerated sympathetic activity was evoked by autonomic dysreflexia, and in controls, by using a cold pressor test (CPT). A 30° head-up tilt (HUT) was performed in both groups.
MAIN OUTCOME MEASURE: Leg blood flow was measured by using venous occlusion plethysmography during the different sympathetic stimuli. Leg vascular resistance was calculated as the arterial-venous pressure gradient divided by blood flow.
RESULTS: In persons with SCI, leg vascular resistance significantly increased during autonomic dysreflexia and 30° HUT (25±20 and 24±13 arbitrary units [AU], respectively), with no difference (P=.87) between stimuli. In controls, leg vascular resistance significantly increased during CPT and 30° HUT (15±13 and 29±12AU, respectively) with no difference (P=.03) between stimuli. There were no differences (P=.22) in increase in leg vascular resistance during the different sympathetic stimuli between persons with SCI and controls.
CONCLUSIONS: The increase in leg vascular resistance during autonomic dysreflexia in persons with SCI is not different from that during 30° HUT, which might be caused by a limited vasoconstrictor reserve. Despite the lack of supraspinal sympathetic control in persons with SCI, the increase in leg vascular resistance during exaggerated sympathetic activity was not different from controls.
Authors:
Jan T Groothuis; Gerard A Rongen; Alexander C Geurts; Paul Smits; Maria T Hopman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  91     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1930-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Physiology, Radboud University Nijmegen Medical Centre, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Blood Pressure / physiology
Case-Control Studies
Hemodynamics / physiology
Humans
Intervention Studies
Leg / blood supply*,  physiopathology
Male
Middle Aged
Plethysmography
Posture / physiology
Spinal Cord Injuries / physiopathology*
Sympathetic Nervous System / physiopathology
Vascular Resistance / physiology*

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