Inter-day reliability of blood pressure and cerebral blood flow velocities in persons with spinal cord injury and intact controls

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2015.1135556 · Published: January 1, 2017

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Unstable blood pressure is common in individuals with spinal cord injury (SCI) above the sixth thoracic vertebral level due to interruption of cardiovascular autonomic control. The study measured seated blood pressure and cerebral blood flow in participants with SCI and able-bodied controls on three lab visits to determine inter-day reliability. The data indicates good inter-day reliability of brachial blood pressure and TCD recording of cerebral blood flow velocity.

Study Duration

Not specified

Participants

15 participants with chronic SCI (C3-T4) and 10 AB controls

Evidence Level

Not specified

Key Findings

1
Brachial blood pressure assessment showed fair to substantial inter-day reliability.
2
Finger blood pressure assessment was less reliable than brachial blood pressure assessment.
3
Cerebral blood flow velocity assessment showed fair to substantial inter-day reliability.

Research Summary

The study aimed to determine the inter-day reliability of blood pressure (brachial and finger) and cerebral blood flow velocity (CBFv) assessments in individuals with spinal cord injury (SCI) and able-bodied (AB) controls. The results indicated that brachial BP and CBFv assessments have good inter-day reliability, while finger BP assessment is less reliable. Individuals with SCI had significantly reduced BP and CBFv compared to controls. The study concludes that brachial BP and TCD ultrasound assessment of CBFv are reliable in hypotensive individuals with SCI and AB controls with low BP.

Practical Implications

Clinical Tool Validation

Brachial BP and TCD can be used to assess the effects of interventions aimed at improving systemic BP and CBF in SCI individuals.

Understanding Cerebrovascular Health

Reduced CBFv in hypotensive SCI individuals may contribute to cerebrovascular disease and cognitive deficits.

Methodological Considerations

Finger photoplethysmography may not be a reliable tool for inter-day BP assessment in SCI and AB cohorts.

Study Limitations

1
The SCI participants were hypotensive, limiting the generalizability of CBFv findings.
2
The level of SCI was restricted to individuals with disruption in supraspinal sympathetic cardiovascular control.
3
The finger photoplethysmographer used did not include return-to-flow calibration.

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