Comparison of changes in heart rate variability and sacral skin perfusion in response to postural changes in people with spinal cord injury

J Rehabil Res Dev, 2013 · DOI: · Published: April 1, 2013

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

This study looks at how the autonomic nervous system, which controls heart rate and blood pressure, affects blood flow in the skin of people with spinal cord injuries (SCI). The researchers measured heart rate variability (HRV), which is a measure of how much the time between heartbeats varies, and skin blood flow in the sacrum (lower back) of people with and without SCI as they changed position from sitting up to lying down. The results showed that in healthy people, changes in posture caused changes in both HRV and skin blood flow. However, in people with SCI, these changes were not as significant, suggesting that SCI affects the connection between the autonomic nervous system and skin blood flow.

Study Duration

Not specified

Participants

26 (12 with SCI, 14 healthy controls)

Evidence Level

Not specified

Key Findings

1
Postural changes in healthy individuals produced significant changes in the sympathovagal balance, with lower balance correlating to higher skin perfusion.
2
Individuals with SCI did not exhibit significant changes in HRV and skin perfusion in response to postural changes.
3
The study demonstrated that the sympathovagal balance, as assessed by HRV, was associated with the skin vasoconstrictive response to postural changes.

Research Summary

This study investigated the relationship between sympathovagal balance, assessed by heart rate variability (HRV), and sacral skin perfusion in response to postural changes in individuals with spinal cord injury (SCI) and healthy controls. The findings revealed that postural changes significantly altered sympathovagal balance and skin perfusion in healthy controls, while individuals with SCI showed minimal changes in both measures. The study concludes that impaired skin perfusion response to postural changes is associated with regulation of sympathovagal balance following SCI, suggesting a potential link between autonomic dysfunction and microvascular function.

Practical Implications

Assessment of Autonomic Impairment

The study suggests that HRV could be used to quantify the severity of autonomic damage and its impact on microvascular dysfunction in SCI patients.

Prediction of Risk

The findings may help identify individuals with SCI who are at higher risk for pressure ulcers due to impaired microvascular reactivity.

Evaluation of Interventions

The method used in this study might be used to differentiate physical inactivity-induced microvascular dysfunction.

Study Limitations

1
The study did not control or measure the respiration rate of research participants, limiting the analysis of respiration's effects on HRV.
2
The sample size of the SCI group was relatively small (n=12), which may limit the generalizability of the findings.
3
The SCI group had more male participants and was older compared to the control group, potentially affecting the validity of the results.

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