6 résultat(s) recherche sur le mot-clé 'orthostatic'    

 trié(s) par (Pertinence décroissant(e), Titre croissant(e)) 

Nonpharmacologic Management of Orthostatic Hypotension: A Systematic Review / Patricia Branco Mills in Archives of Physical Medicine and Rehabilitation, 2015/2 (2015)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > 2015/2 (2015) . - p. 366-375 Titre : Nonpharmacologic Management of Orthostatic Hypotension: A Systematic Review Type de document : Article Auteurs : Patricia Branco Mills ; Carlen K. Fung ; Angelique Travlos Article en page(s) : p. 366-375 Langues : Anglais (eng) Descripteurs : HE Vinci Diétothérapie ; Hypotension ; Hypotension orthostatique ; Rééducation et réadaptation Mots-clés : Diet therapy  orthostatic  Orthostatic intolerance  Intolérance orthostatique  Physical therapy modalities  Techniques de physiothérapie Résumé : Objective To systematically review the literature on nonpharmacologic treatment of orthostatic hypotension. Data Sources MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central Register of Controlled Trials, and SPORTDiscus were searched for human studies written in the English language between January 1980 and April 2013. Reference lists of relevant articles were reviewed for citations to expand the data set. Study Selection Prospective experimental studies assessing nonpharmacologic interventions for management of orthostatic drop in blood pressure in various patient populations were included. All studies identified through the literature search were reviewed independently in duplicate. Of the 642 studies, 23 met the selection criteria. Data Extraction Two reviewers independently extracted data for analysis, including systolic and diastolic blood pressure and orthostatic symptoms in response to postural challenge before and after the intervention. All 23 studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database scale for randomized controlled trials and the Downs and Black tool for nonrandomized trials. Data Synthesis There were 8 identified nonpharmacologic interventions for management of orthostatic hypotension under 2 general categories: physical modalities (exercise, functional electrical stimulation, compression, physical countermaneuvers, compression with physical countermaneuvers, sleeping with head up) and dietary measures (water intake, meals). Owing to the clinically diverse nature of the studies, statistical comparison (meta-analysis) was deemed inappropriate. Instead, descriptive comparisons were drawn. Levels of evidence were assigned. Conclusions Strong levels of evidence were found for 4 of the 8 interventions: functional electrical stimulation in spinal cord injury, compression of the legs and/or abdomen, physical countermaneuvers in various patient populations, and eating smaller and more frequent meals in chronic autonomic failure. However, this conclusion is based on a limited number of studies with small sample sizes. Further research into all interventions is warranted. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118553 [article] Nonpharmacologic Management of Orthostatic Hypotension: A Systematic Review [Article] / Patricia Branco Mills ; Carlen K. Fung ; Angelique Travlos . - p. 366-375. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > 2015/2 (2015) . - p. 366-375 Descripteurs : HE Vinci Diétothérapie ; Hypotension ; Hypotension orthostatique ; Rééducation et réadaptation Mots-clés : Diet therapy  orthostatic  Orthostatic intolerance  Intolérance orthostatique  Physical therapy modalities  Techniques de physiothérapie Résumé : Objective To systematically review the literature on nonpharmacologic treatment of orthostatic hypotension. Data Sources MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central Register of Controlled Trials, and SPORTDiscus were searched for human studies written in the English language between January 1980 and April 2013. Reference lists of relevant articles were reviewed for citations to expand the data set. Study Selection Prospective experimental studies assessing nonpharmacologic interventions for management of orthostatic drop in blood pressure in various patient populations were included. All studies identified through the literature search were reviewed independently in duplicate. Of the 642 studies, 23 met the selection criteria. Data Extraction Two reviewers independently extracted data for analysis, including systolic and diastolic blood pressure and orthostatic symptoms in response to postural challenge before and after the intervention. All 23 studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database scale for randomized controlled trials and the Downs and Black tool for nonrandomized trials. Data Synthesis There were 8 identified nonpharmacologic interventions for management of orthostatic hypotension under 2 general categories: physical modalities (exercise, functional electrical stimulation, compression, physical countermaneuvers, compression with physical countermaneuvers, sleeping with head up) and dietary measures (water intake, meals). Owing to the clinically diverse nature of the studies, statistical comparison (meta-analysis) was deemed inappropriate. Instead, descriptive comparisons were drawn. Levels of evidence were assigned. Conclusions Strong levels of evidence were found for 4 of the 8 interventions: functional electrical stimulation in spinal cord injury, compression of the legs and/or abdomen, physical countermaneuvers in various patient populations, and eating smaller and more frequent meals in chronic autonomic failure. However, this conclusion is based on a limited number of studies with small sample sizes. Further research into all interventions is warranted. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118553

Aerobic Capacity, Orthostatic Tolerance, and Exercise Perceptions at Discharge From Inpatient Spinal Cord Injury Rehabilitation / Chelsea Pelletier in Archives of Physical Medicine and Rehabilitation, 2013/10 (2013)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 2013-2019 Titre : Aerobic Capacity, Orthostatic Tolerance, and Exercise Perceptions at Discharge From Inpatient Spinal Cord Injury Rehabilitation Type de document : Article Auteurs : Chelsea Pelletier ; Graham Jones ; Amy E. Latimer-Cheung ; [et al.] Article en page(s) : pp. 2013-2019 Langues : Anglais (eng) Descripteurs : HE Vinci Exercice physique ; Hypotension ; Hypotension orthostatique ; Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Exercise  Orthostatic  Self Efficacy  Auto-efficacité  Spinal Cord Injuries Résumé : Objective To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI). Design Cross-sectional. Setting Two inpatient SCI rehabilitation programs in Canada. Participants Participants (N=41; mean age + SD, 38.9+13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean + SD, 112.9+52.5d postinjury). Interventions Not applicable. Main Outcome Measures Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire. Results There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2+3.4;mL·kg−1·min−1 113.9+19.7beats/min) and LP (17.1+7.5mL·kg−1·min−1; 142.8+22.7beats/min). Peak power output was also significantly lower in the TP group (30.0+6.9W) compared with the HP (55.5+7.56W) and LP groups (62.5+12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (−3.0+33.5mmHg in TP, 17.8+14.7mmHg in HP, 21.6+18.7mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise. Conclusions Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117618 [article] Aerobic Capacity, Orthostatic Tolerance, and Exercise Perceptions at Discharge From Inpatient Spinal Cord Injury Rehabilitation [Article] / Chelsea Pelletier ; Graham Jones ; Amy E. Latimer-Cheung ; [et al.] . - pp. 2013-2019. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 2013-2019 Descripteurs : HE Vinci Exercice physique ; Hypotension ; Hypotension orthostatique ; Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Exercise  Orthostatic  Self Efficacy  Auto-efficacité  Spinal Cord Injuries Résumé : Objective To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI). Design Cross-sectional. Setting Two inpatient SCI rehabilitation programs in Canada. Participants Participants (N=41; mean age + SD, 38.9+13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean + SD, 112.9+52.5d postinjury). Interventions Not applicable. Main Outcome Measures Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire. Results There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2+3.4;mL·kg−1·min−1 113.9+19.7beats/min) and LP (17.1+7.5mL·kg−1·min−1; 142.8+22.7beats/min). Peak power output was also significantly lower in the TP group (30.0+6.9W) compared with the HP (55.5+7.56W) and LP groups (62.5+12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (−3.0+33.5mmHg in TP, 17.8+14.7mmHg in HP, 21.6+18.7mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise. Conclusions Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117618

Association Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients / L.C. Hartog in Archives of Physical Medicine and Rehabilitation, 2017/8 (2017)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > 2017/8 (2017) . - pp. 1544–1550 Titre : Association Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients Type de document : Article Auteurs : L.C. Hartog ; A.M. Winters ; H. Roijen Article en page(s) : pp. 1544–1550 Langues : Anglais (eng) Descripteurs : HE Vinci Hypotension ; Hypotension orthostatique ; Pression sanguine ; Rééducation et réadaptation Mots-clés : Blood pressure  orthostatic Résumé : Objective To investigate the relationship between orthostatic hypotension (OH) and muscle strength versus time to successful rehabilitation within elderly patients with hip fracture. Design A prospective, observational cohort study. Handgrip strength was measured at the day of admission and OH as soon as possible after surgery. Cox proportional hazard modeling was used to investigate the relationship between OH or handgrip strength (kg) and time to successful rehabilitation, expressed as hazard ratios (HRs). OH was defined as a decrease in systolic blood pressure of ≥20mmHg or diastolic blood pressure of ≥10mmHg after postural change (dichotomous). Handgrip strength was measured with a hand dynamometer (continuous). Setting General hospital. Participants Patients (N=116) aged ≥70 years with a hip fracture were recruited on the day of hospital admission. Interventions Not applicable. Main Outcome Measures Primary outcome was time to successful rehabilitation, which was defined as discharge to patients' own homes. Results During a median follow-up period of 36 days (interquartile range, 9–57d), 103 patients (89%) were successfully rehabilitated. No statistically significant relationships were found between OH and time to successful rehabilitation (HR=1.05; 95% confidence interval [CI], .67–1.66). Also, handgrip strength and successful rehabilitation were not statistically significantly related (HR=1.03; 95% CI, .99–1.06). Conclusions OH measured during the first days of hospitalization is not related to time to successful rehabilitation in patients with hip fracture who have undergone surgery. Although no significant relationship was seen in the present study, the width of the CIs does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118173 [article] Association Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients [Article] / L.C. Hartog ; A.M. Winters ; H. Roijen . - pp. 1544–1550. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > 2017/8 (2017) . - pp. 1544–1550 Descripteurs : HE Vinci Hypotension ; Hypotension orthostatique ; Pression sanguine ; Rééducation et réadaptation Mots-clés : Blood pressure  orthostatic Résumé : Objective To investigate the relationship between orthostatic hypotension (OH) and muscle strength versus time to successful rehabilitation within elderly patients with hip fracture. Design A prospective, observational cohort study. Handgrip strength was measured at the day of admission and OH as soon as possible after surgery. Cox proportional hazard modeling was used to investigate the relationship between OH or handgrip strength (kg) and time to successful rehabilitation, expressed as hazard ratios (HRs). OH was defined as a decrease in systolic blood pressure of ≥20mmHg or diastolic blood pressure of ≥10mmHg after postural change (dichotomous). Handgrip strength was measured with a hand dynamometer (continuous). Setting General hospital. Participants Patients (N=116) aged ≥70 years with a hip fracture were recruited on the day of hospital admission. Interventions Not applicable. Main Outcome Measures Primary outcome was time to successful rehabilitation, which was defined as discharge to patients' own homes. Results During a median follow-up period of 36 days (interquartile range, 9–57d), 103 patients (89%) were successfully rehabilitated. No statistically significant relationships were found between OH and time to successful rehabilitation (HR=1.05; 95% confidence interval [CI], .67–1.66). Also, handgrip strength and successful rehabilitation were not statistically significantly related (HR=1.03; 95% CI, .99–1.06). Conclusions OH measured during the first days of hospitalization is not related to time to successful rehabilitation in patients with hip fracture who have undergone surgery. Although no significant relationship was seen in the present study, the width of the CIs does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118173

Hemodynamic Effects of l-Threo-3,4-Dihydroxyphenylserine (Droxidopa) in Hypotensive Individuals With Spinal Cord Injury / Jill Wecht in Archives of Physical Medicine and Rehabilitation, 2013/10 (2013)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 2006-2012 Titre : Hemodynamic Effects of l-Threo-3,4-Dihydroxyphenylserine (Droxidopa) in Hypotensive Individuals With Spinal Cord Injury Type de document : Article Auteurs : Jill Wecht ; Dwindally Rosado Rivera ; Joseph Weir ; [et al.] Article en page(s) : pp. 2006-2012 Langues : Anglais (eng) Descripteurs : HE Vinci Hypotension ; Hypotension arterielle ; Hypotension orthostatique ; Paraplégie ; Pression sanguine ; Rééducation et réadaptation ; Tetraplegie Mots-clés : Blood Pressure  Droxidopa  Orthostatic  Paraplegia  Quadriplegia Résumé : Objectives To determine the effect of an escalating dose of droxidopa (100, 200, and 400mg) compared with placebo on seated blood pressure (BP) in hypotensive individuals with spinal cord injury (SCI). Secondarily, we aimed to determine the effect of droxidopa on (1) supine BP and heart rate, (2) the change in BP and heart rate when these individuals were transferred from the supine to the seated position, and (3) adverse event (AE) reporting. Design Open-label dose titration trial. Setting A Veterans Administration Medical Center. Participants Participants with SCI (C3-T12) (N=10) were studied during 4 laboratory visits. Subjects visited the laboratory for about 5 hours on each visit, which incorporated a 30-minute seated baseline, a 30- to 60-minute supine, and a 4-hour seated postdrug observation. Interventions Placebo on visit 1, droxidopa 100mg on visit 2, droxidopa 200mg on visit 3, and droxidopa 400mg on visit 4. Main Outcome Measures BP and heart rate changes from baseline to the postdrug period, orthostatic heart rate and BP responses, and subjective AE reporting. Results Seated BP was significantly elevated with 400mg droxidopa compared with placebo and 100mg droxidopa for 3 hours and was elevated for 2 hours compared with 200mg droxidopa. Increase in supine BP was not worsened following droxidopa, and the expected fall in BP when transferred to the seated position was prevented with droxidopa 200 and 400mg. There were no significant differences in the heart rate response or AE reporting among the study visits. Conclusions Our preliminary findings suggest that droxidopa, at the doses tested, does not cause excessive increases in supine BP and the 400-mg dose appears to be effective at increasing seated BP for up to 3 hours in persons with SCI. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117617 [article] Hemodynamic Effects of l-Threo-3,4-Dihydroxyphenylserine (Droxidopa) in Hypotensive Individuals With Spinal Cord Injury [Article] / Jill Wecht ; Dwindally Rosado Rivera ; Joseph Weir ; [et al.] . - pp. 2006-2012. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 2006-2012 Descripteurs : HE Vinci Hypotension ; Hypotension arterielle ; Hypotension orthostatique ; Paraplégie ; Pression sanguine ; Rééducation et réadaptation ; Tetraplegie Mots-clés : Blood Pressure  Droxidopa  Orthostatic  Paraplegia  Quadriplegia Résumé : Objectives To determine the effect of an escalating dose of droxidopa (100, 200, and 400mg) compared with placebo on seated blood pressure (BP) in hypotensive individuals with spinal cord injury (SCI). Secondarily, we aimed to determine the effect of droxidopa on (1) supine BP and heart rate, (2) the change in BP and heart rate when these individuals were transferred from the supine to the seated position, and (3) adverse event (AE) reporting. Design Open-label dose titration trial. Setting A Veterans Administration Medical Center. Participants Participants with SCI (C3-T12) (N=10) were studied during 4 laboratory visits. Subjects visited the laboratory for about 5 hours on each visit, which incorporated a 30-minute seated baseline, a 30- to 60-minute supine, and a 4-hour seated postdrug observation. Interventions Placebo on visit 1, droxidopa 100mg on visit 2, droxidopa 200mg on visit 3, and droxidopa 400mg on visit 4. Main Outcome Measures BP and heart rate changes from baseline to the postdrug period, orthostatic heart rate and BP responses, and subjective AE reporting. Results Seated BP was significantly elevated with 400mg droxidopa compared with placebo and 100mg droxidopa for 3 hours and was elevated for 2 hours compared with 200mg droxidopa. Increase in supine BP was not worsened following droxidopa, and the expected fall in BP when transferred to the seated position was prevented with droxidopa 200 and 400mg. There were no significant differences in the heart rate response or AE reporting among the study visits. Conclusions Our preliminary findings suggest that droxidopa, at the doses tested, does not cause excessive increases in supine BP and the 400-mg dose appears to be effective at increasing seated BP for up to 3 hours in persons with SCI. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117617

Prevalence of Abnormal Systemic Hemodynamics in Veterans With and Without Spinal Cord Injury / Jill M. Wecht in Archives of Physical Medicine and Rehabilitation, 2015/6 (2015)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > 2015/6 (2015) . - p. 1071–1079 Titre : Prevalence of Abnormal Systemic Hemodynamics in Veterans With and Without Spinal Cord Injury Type de document : Article Auteurs : Jill M. Wecht ; Joseph P. Weir ; Marinella Galea Article en page(s) : p. 1071–1079 Langues : Anglais (eng) Descripteurs : HE Vinci Hypertension arterielle ; Hypotension ; Hypotension arterielle ; Hypotension orthostatique ; Rééducation et réadaptation ; Tachycardie Mots-clés : Orthostatic  Tachycardia Résumé : Objective Increased prevalence of heart rate and blood pressure abnormalities are evident in persons with spinal cord injury (SCI), but age, comorbid medical conditions, and prescription medication use may contribute. To determine differences in the prevalence of cardiac acceleration (heart rate ≥80 beats per minute), hypotension (blood pressure ≤110/70mmHg), orthostatic hypotension (OH) (−20/−10mmHg with upright positioning), and hypertension (HTN) (blood pressure ≥140/90mmHg) in veterans with and without SCI. Design Observational trial. Setting Medical center. Participants Subjects included veterans with SCI (n=62; cervical: tetraplegia, C3-8; high thoracic, T1-5; low thoracic, T7-L2) and veterans without SCI (n=160). Interventions None. Main Outcome Measures We assessed medical history, prescription medication use, and heart rate and blood pressure during a routine clinical visit. Prevalence rates of cardiac acceleration, hypotension, OH, and HTN were calculated using binary logistic regression analysis with 95% confidence intervals. The influence of SCI status, age, smoking status, cardiovascular diagnoses, and use of prescribed antihypertensive medications on the prevalence of abnormal heart rate and blood pressure recordings was determined. Results The diagnosis of HTN was reduced in the high thoracic and tetraplegia groups compared with the non-SCI and low thoracic groups. Use of antihypertensive medications was increased in the low thoracic group compared with the other 3 groups and was increased in the non-SCI group compared with the tetraplegia group. The prevalence of cardiac acceleration was reduced, and the prevalence of systolic hypotension was increased in the tetraplegia group. The prevalence of diastolic hypotension was increased in all SCI groups compared with the non-SCI group. For all analyses, increased prevalence of abnormal heart rate and blood pressure recordings was not further explained by the covariates, with the exception of age, cardiovascular diagnoses, and antihypertensive medications in the cardiac acceleration model; however, SCI status remained significant and was the dominant predictor variable. Conclusions Our data suggest that SCI status contributes to the prevalence of cardiac acceleration and systolic and diastolic hypotension regardless of cardiovascular medical conditions or prescription antihypertensive medication use. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118382 [article] Prevalence of Abnormal Systemic Hemodynamics in Veterans With and Without Spinal Cord Injury [Article] / Jill M. Wecht ; Joseph P. Weir ; Marinella Galea . - p. 1071–1079. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > 2015/6 (2015) . - p. 1071–1079 Descripteurs : HE Vinci Hypertension arterielle ; Hypotension ; Hypotension arterielle ; Hypotension orthostatique ; Rééducation et réadaptation ; Tachycardie Mots-clés : Orthostatic  Tachycardia Résumé : Objective Increased prevalence of heart rate and blood pressure abnormalities are evident in persons with spinal cord injury (SCI), but age, comorbid medical conditions, and prescription medication use may contribute. To determine differences in the prevalence of cardiac acceleration (heart rate ≥80 beats per minute), hypotension (blood pressure ≤110/70mmHg), orthostatic hypotension (OH) (−20/−10mmHg with upright positioning), and hypertension (HTN) (blood pressure ≥140/90mmHg) in veterans with and without SCI. Design Observational trial. Setting Medical center. Participants Subjects included veterans with SCI (n=62; cervical: tetraplegia, C3-8; high thoracic, T1-5; low thoracic, T7-L2) and veterans without SCI (n=160). Interventions None. Main Outcome Measures We assessed medical history, prescription medication use, and heart rate and blood pressure during a routine clinical visit. Prevalence rates of cardiac acceleration, hypotension, OH, and HTN were calculated using binary logistic regression analysis with 95% confidence intervals. The influence of SCI status, age, smoking status, cardiovascular diagnoses, and use of prescribed antihypertensive medications on the prevalence of abnormal heart rate and blood pressure recordings was determined. Results The diagnosis of HTN was reduced in the high thoracic and tetraplegia groups compared with the non-SCI and low thoracic groups. Use of antihypertensive medications was increased in the low thoracic group compared with the other 3 groups and was increased in the non-SCI group compared with the tetraplegia group. The prevalence of cardiac acceleration was reduced, and the prevalence of systolic hypotension was increased in the tetraplegia group. The prevalence of diastolic hypotension was increased in all SCI groups compared with the non-SCI group. For all analyses, increased prevalence of abnormal heart rate and blood pressure recordings was not further explained by the covariates, with the exception of age, cardiovascular diagnoses, and antihypertensive medications in the cardiac acceleration model; however, SCI status remained significant and was the dominant predictor variable. Conclusions Our data suggest that SCI status contributes to the prevalence of cardiac acceleration and systolic and diastolic hypotension regardless of cardiovascular medical conditions or prescription antihypertensive medication use. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118382

Respiratory Training Improves Blood Pressure Regulation in Individuals With Chronic Spinal Cord Injury / Sevda C. Aslan in Archives of Physical Medicine and Rehabilitation, 2016/6 (2016)  

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