Unusual blood pressure response during standing therapy in tetraplegic man.
ABSTRACT We report a case of an individual with cervical spinal cord injury who showed a unique blood pressure response during passive standing and passive walking-like leg movement, i.e., hypertension with standing and hypotension with leg movement.
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ABSTRACT: 1. A study has been made of the effect of spontaneous and induced muscle spasms on blood pressure, heart rate, hand blood flow, calf blood flow and occluded vein pressure in the hand and foot in non-bedridden patients with chronic, closed, complete, localized transection of the cervical spinal cord.2. Both types of spasm produced a similar response consisting of an increase in blood pressure and occluded vein pressure and a decrease in heart rate and hand and calf blood flow. The changes commenced within 2-3 sec and usually reached maxima in 20-30 sec. On some occasions there was a temporary initial increase in heart rate and calf blood flow.3. The changes occurred independently of changes in bladder pressure.4. It is concluded that the changes in peripheral blood vessels result from a spinal sympathetic reflex to somatic afferents associated with muscular contraction.The Journal of Physiology 07/1971; 215(2):381-93. · 4.38 Impact Factor
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ABSTRACT: Prospective assessment of cardiovascular parameters in individuals with spinal cord injury (SCI) in response to harness application and postural changes including orthostatic stress. To evaluate arterial blood pressure and heart rate (HR) with and without harness application during sitting, supine, and standing positions in able-bodied and SCI individuals. Measurements were obtained in all SCI research participants (n=11) before a locomotor training intervention and compared to data with able-bodied individuals (n=9). During standing, all research participants wore a harness and were suspended by an overhead, pneumatic body weight support system. Resting arterial blood pressure and HR in individuals with cervical SCI were significantly lower during sitting than in thoracic SCI and able-bodied individuals (P<0.05). Orthostatic stress significantly decreased arterial blood pressure only in individuals with cervical SCI (P<0.05). Harness application had no effect on cardiovascular parameters in able-bodied individuals, whereas diastolic blood pressure was significantly increased in those with SCI. Orthostatic changes in cervical SCI when sitting were ameliorated by harness application. However, while standing with harness, individuals with cervical SCI still developed orthostatic hypotension. Level of injury to the spinal cord influences baseline cardiovascular parameters. Application of harness in individuals with SCI could alter baseline cardiovascular parameters and the response to orthostatic stress. This should be carefully considered when assessing effects of therapeutic interventions using body weight support in individuals with SCI.Spinal Cord 01/2007; 44(12):780-6. · 1.90 Impact Factor
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ABSTRACT: To examine blood pressure responses during passive walking-like exercise in the standing posture (PWE) in spinal cord-injured (SCI) humans. Twelve motor-complete SCI individuals (cervical level 6 to thoracic level 12, ASIA grade: A or B) and twelve able-bodied controls (CON) participated in this study. SCI individuals were divided into a group with injury level at or above thoracic (T) 6 (HSCI, n = 7) and a group with injury level at or below T10 (LSCI, n = 5). Subjects carried out 6-minute quiet standing and then 12-minute PWE at 1 Hz using a gait training apparatus that enables subjects to stand and move their legs passively. Mean arterial blood pressures (MAPs) at standing in HSCI, LSCI and CON were 69 +/- 5, 83 +/- 4 and 93 +/- 2 mmHg, respectively. MAP changed significantly during PWE only in HSCI and CON, increasing to 88 +/- 4 (P < 0.001) and 98 +/- 1 mmHg (P < 0.01), respectively. The former group showed a larger increase in MAP (P < 0.001). Spinal sympathetic reflexes can be induced in a region isolated from the brainstem in response to a stimulus originating below the level of the spinal cord injury, and the magnitude of increase in blood pressure is greater in SCI individuals with lesion level at or above T6 due to loss of supraspinal control of the major sympathetic outflow. This central mechanism may be one of the reasons why greater pressor response to PWE was observed in HSCI.Clinical Autonomic Research 12/2008; 19(2):113-22. · 1.48 Impact Factor