Issue №6-88, 2018

External Compression on the Anterior Abdominal Wall and Orthostatic Hypotension in Patients with Chronic Tetraplegia

View article (Download PDF file)



Download XML file

1 Bushkov F.A., 1 Ivanova G.E.

1 Rehabilitation center for disability patients «Overcoming», Moscow


ABSTRACT

The aim of this work was to study the effect of positive pressure on the anterior abdominal wall (abdominal bandage) onorthostatic tolerance in patients with chronic tetraplegia. The study included 20 patients with traumatic tetraplegia (C5-D1neurological level). We investigated the status of the autonomic nervous system using heart rate variability (HRV) at restand in one-stage head-up tilt test (700), severity of sinus arrhythmia depending on the availability of external compressionof the anterior abdominal wall (20–30 mm Hg). As a result, notes in a positive pressure on the anterior abdominal wall thelack of effect on sinus arrhythmia, heart rate variability, respiratory rate and heart rate at rest, and a decrease in orthostatichypotension and a greater increase LFn/HFn HRV in orthostatic stress. Conclusion: abdominal bandage decrease orthostatichypotension in patient with chronic tetraplegia in tilt test.


KEYWORDS: chronic tetraplegia, orthostatic hypotension, abdominal bandage



References:

  1. Alexander M. S., Biering-Sorensen F., Bodner D., Brackett N. L. et al. International standards to document remaining autonomic function after spinal cord injury. Spinal Cord, 2009, Vol. 47, - № 1, - P. 36-43.
  2. Baydur A., Adkins R. H., Milic-Emili J. Lung mechanics in individuals with spinal cord injury: effects of injury level and posture. J. Appl. Physiol. 2001 Feb; 90(2):405-11.
  3. Cariga P., Ahmed S., Mathias C.J., Gardner B.P. The prevalence and association of neck (coat hanger) pain and orthostatic (postural) hypotension in human spinal cord injury. Spinal Cord 2002; 40: 77-82.
  4. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multipl system atrophy. The Consensus Committee of the American Society and the American Academy pf Neurology. Neurology. -1996. - Vol. - 46. - P. 1470.
  5. Duschek S., Weisz N., Schandry R. Reduced cognitive performance and prolonged reaction time accompany moderate hypotension. Clin. Auton. Res. 2003; 13: 427-432.
  6. Eng J.J., Levins S.M., Townson A.F., Mah-Jones D., Bremner J., Huston G. Use of prolonged standing for individuals with spinal cord injuries. Phys. Ther. 2001;81:1392-1399.
  7. Figoni S.F. Cardiovascular and haemodynamic responses to tilting and to standing in tetraplegic patients: a review. Paraplegia. 1984;22: 99-109.
  8. Gillis D. J., Wouda M., Hjeltnes N. Non-pharmacological management of orthostatic hypotension after spinal cord injury: a critical review of the literature. Spinal Cord (2008) 46, 652-659.
  9. Glaydon VE, Krassioukov AV. Orthostatic hypotension and autonomic pathways after spinal cord injury. J. Neurotrauma 2006; 23:1713-1725.
  10. Gonzalez F., Chang JY, Banovac K., Messina D., Martinez-Arizala A., Kelley RE. Autoregulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury. Paraplegia 1991; 29: 1-7;
  11. Hopman M. T., Monroe M., Dueck C., Phillips W. T., Skinner J. S. Blood redistribution and circulatory responses to submaximal arm exercise in persons with spinal cord injury. Scan J Rehabil Med 1998; 30: 167-174.
  12. Houtman S., Colier WN, Oeseburg B., and Hopman MT. Systemic circulation and cerebral oxygenation during head-up tilt in spinal cord injured individuals. Spinal Cord 38: 158-163, 2000.
  13. Illman A., Stiller K., Williams M. The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury. Spinal Cord 2000;38:741-747.
  14. Kerk J. K., Clifford P. S., Snyder A. C., Prieto T .E., O’Hagan K. P., Schot P. K. et al. Myklebust effect of an abdominal binder during wheelchair exercise. Med. Sci Sports Exerc. 1995; 27: 913-919.
  15. Maury M. About orthostatic hypotension in tetraplegic individuals reflections and experience. Spinal Cord. 1998 Feb; 36(2): 87-90.
  16. Maynard F. M. Jr., Bracken M. B., Creasey G., Ditunno J. F. Jr., Donovan W. H., Ducker T. B., Garber SL, Marino R. J., Stover S. L., Tator C. H., Waters R. L., Wilberger J. E., Young W. International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association. Spinal Cord. 1997 May.; 35(5):266-74.
  17. McCool F.D., Pichurko B.M., Slutsky A.S., Sarkarati M., Rossier A., Brown R. Changes in lung volume and rib cage configuration with abdominal binding in quadriplegia. J Appl Physiol. 1986 Apr;60(4):1198-202.
  18. Rosner M.J., Coley I.B. Cerebral perfusion pressure, intracranial pressure, and head elevation. J Neurosurg.. 1986 Nov.; 65(5):636-41.
  19. Teasell R.W., Malcolm O.A., Krassioukov A., Delaney G.A. Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injury. Arch. Phys. Med. Rehabil. 2000, - Vol.81, - P.: 506-516.
  20. Vallbona C., Spencer W.A., Cardus D., Dale J.W. Control of orthostatic hypotension of quadriplegic patients with pressure suits. Arch. Phys. Med. Reha-bil. 1963; 44: 7-18.
  21. Wecht J.M., Radulovic M., Lessey J., Spungen A.M., Bauman W.A. Common carotid and common femoral arterial dynamics during head-up tilt in persons with spinal cord injury. J. Rehab. Res. Dev. 2004; 41: 89-94.
  22. Wessely S., Nickson J., Cox B. Symptoms of lowblood pressure: a population study. BMJ 1990; 301: 362-365.
  23. Mikhailov V. M. Heart rate variability: experience of practical application of the method. Ed. the second, Rev. Ivanovo : Ivan. state med. academy, 2002. 290 P.
  24. Moiseev V. Possibilities of struggle against orthostatic instability in spinal cord injuries. Questions neurosurgery n.a. N. N. Burdenko, Medicine, M., 1984, No. 3, p. 45.
  25. Gercik Yu. G., Ivanova G. E., Ragutkin A.V., Gercik G. Y., et al. Improving the efficiency of operation of high-tech medical products by expanding the competencies of health workers in technical, information and telemedicine technologies. Bulletin of restorative medicine. 2018. № 1 (83). P. 61-68.



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.