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Rehabilitation Practice and Science

Translated Title

手指容積脈波測量在脊髓損傷患者的應用

Abstract

Orthostatic hypotension is a common complication following spinal cord injury (SCI). However, an easy method to quantify the degree of vasomotor impairment below the level of injury is lacking. We postulated that SCI patients with different sympathetic reserves exhibited different digital volume pulse contours. Thirty-one patients with high chronic SCI (above the T6 neurologic level) and 28 low-level SCI patients (below T6) were recruited. Thirty-two age- and BMI-matched healthy participants were enrolled in the control group. All participants were positioned on a tilting table for five minutes in each of the following: supine rest (SR), 60-degree head-up tilt (HUT), and recovery to supine position. Digital volume pulse (DVP), heart rate variability (HRV), and blood pressure were measured. The reflection index (RI) was calculated as the amplitude of reflection wave divided by directly-transmitted wave. The RI ratio is the RI value in the fifth minute during the HUT position divided by RI in SR. Low frequency to high frequency power ratio (LF/HF), high frequency power (HFP), normalized low frequency power (LFn) and high frequency power (HFn) were recorded in HRV analysis. Our results revealed that patients with a higher level of injury had a reduced reflection wave of DVP in SR and HUT. High-level SCI patients also had a smaller RI ratio. Additionally, the increase of LF/HF during the transition from SR to HUT was attenuated in high SCI patients. However, the decrease of HF power was normally preserved in high SCI patients. We concluded that posture change alters the contour of the pulse wave, which is related to the level of injury. The RI ratio could be used to quantify the degree of vasoconstriction impairment below the injury level in SCI patients.

Language

English

First Page

189

Last Page

196

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