J N Myers1, L Hsu, D Hadley, M Y Lee, B J Kiratli. 1. Spinal Cord Injury Center, VA Palo Alto Health Care System, Stanford University, Palo Alto, CA 94304, USA. drj993@aol.com
Abstract
STUDY DESIGN: Prospective comparison of spinal cord injured (SCI) subjects and ambulatory subjects. OBJECTIVES: To determine the effects of the presence and level of SCI on heart rate recovery (HRR). SETTING: Outpatient SCI center. METHODS: HRR was determined in 63 SCI subjects (26 with tetraplegia, 22 with high-level paraplegia, 15 with low-level paraplegia) and 26 ambulatory subjects. To adjust for differences in heart rate reserve between groups (HR peak minus HR rest), HRR was also 'normalized' to a range of 1 at peak heart rate and to 0 at 8 min, and the shapes of HRR curves were compared. RESULTS: Although absolute HRR was similar between high- and low-level paraplegia, it was significantly more rapid in participants with paraplegia at 2, 5 and 8 min after exercise than in those with tetraplegia (39+/-14 vs 29+/-14 b.p.m., P<0.05; 51+/-14 vs 33+/-16 b.p.m., P<0.01 and 52+/-16 vs 36+/-17 b.p.m., P<0.01, respectively). HRR among ambulatory subjects was more rapid than among those with tetraplegia at all time points in recovery. However, when normalized for heart rate reserve, HRR was significantly more rapid in tetraplegic subjects (P<0.001 vs paraplegia and ambulatory subjects). CONCLUSION: In SCI, HRR is strongly associated with the peak exercise level and peak heart rate achieved during exercise testing.
STUDY DESIGN: Prospective comparison of spinal cord injured (SCI) subjects and ambulatory subjects. OBJECTIVES: To determine the effects of the presence and level of SCI on heart rate recovery (HRR). SETTING:Outpatient SCI center. METHODS: HRR was determined in 63 SCI subjects (26 with tetraplegia, 22 with high-level paraplegia, 15 with low-level paraplegia) and 26 ambulatory subjects. To adjust for differences in heart rate reserve between groups (HR peak minus HR rest), HRR was also 'normalized' to a range of 1 at peak heart rate and to 0 at 8 min, and the shapes of HRR curves were compared. RESULTS: Although absolute HRR was similar between high- and low-level paraplegia, it was significantly more rapid in participants with paraplegia at 2, 5 and 8 min after exercise than in those with tetraplegia (39+/-14 vs 29+/-14 b.p.m., P<0.05; 51+/-14 vs 33+/-16 b.p.m., P<0.01 and 52+/-16 vs 36+/-17 b.p.m., P<0.01, respectively). HRR among ambulatory subjects was more rapid than among those with tetraplegia at all time points in recovery. However, when normalized for heart rate reserve, HRR was significantly more rapid in tetraplegic subjects (P<0.001 vs paraplegia and ambulatory subjects). CONCLUSION: In SCI, HRR is strongly associated with the peak exercise level and peak heart rate achieved during exercise testing.
Authors: William A Bauman; Mark A Korsten; Miroslav Radulovic; Gregory J Schilero; Jill M Wecht; Ann M Spungen Journal: Top Spinal Cord Inj Rehabil Date: 2012
Authors: Elizângela Márcia de Carvalho Abreu; Lucas Pinto Salles Dias; Fernanda Pupio Silva Lima; Alderico Rodrigues de Paula Júnior; Mário Oliveira Lima Journal: Clin Auton Res Date: 2016-03-07 Impact factor: 4.435