Evidence of autonomic dysreflexia during functional electrical stimulation in individuals with spinal cord injuries
| Autor: | Euan A. Ashley, Robert S. Burnham, Garry D. Wheeler, D C Cumming, L M Olenik, J J Laskin, Robert D. Steadward |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac output Adolescent Blood Pressure Electric Stimulation Therapy Oxygen Consumption Heart Rate Internal medicine Reflex Heart rate medicine Humans Functional electrical stimulation Cardiac Output Cardiovascular fitness Respiratory exchange ratio Spinal Cord Injuries Physical Education and Training business.industry VO2 max General Medicine medicine.disease Respiratory Function Tests Autonomic Nervous System Diseases Neurology Physical therapy Cardiology Female Autonomic dysreflexia Neurology (clinical) business Respiratory minute volume |
| Zdroj: | Spinal Cord. 31:593-605 |
| ISSN: | 1476-5624 1362-4393 |
| Popis: | The purpose of the investigation was to examine the safety and efficacy of functional electrical stimulation (FES)-assisted hydraulic resistance training in improving cardiovascular fitness in persons with spinal cord injuries. The cardiopulmonary responses of 10 high spinal cord injured (SCI) and five able bodied (AB) subjects were assessed during three bouts of FES-assisted leg extension exercise. The protocol involved three 30-minute tests: (1) unloaded leg extension, (2) hydraulically-resisted leg extension (loaded), and (3) a reproduction of the unloaded and loaded protocols to measure cardiac output (Q). Pre-measurements were made of body mass, mean limb weight, maximal force output and maximal oxygen uptake (incremental arm ergometry). Oxygen uptake (VO2), minute ventilation (Ve), respiratory exchange ratio (RER), heart rate (HR), blood pressure (BP) were recorded before, during and after tests. There was a significant difference in VO2 max between SCI and AB subjects. Cardiac output significantly increased between the loaded and unloaded tests. The significant increases from rest to unloaded and loaded exercise pointed to the potential value of adding resistance to a leg extension training regime. Heart rate and BP of the participants with SCI consistently demonstrated a response suggestive of autonomic dysreflexia. Upon stimulation an immediate increase in (predominantly systolic) BP was observed, followed by a fall in HR. On cessation of stimulation HR exhibited a substantial rebound effect and BP returned to normal levels. This response was highly reproducible and suggests caution be exercised in the use of FES for people with SCI with lesion levels above the major splanchnic outflow (T6). |
| Databáze: | OpenAIRE |
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