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Relationships between physiological responses and presyncope symptoms during tilting up in patients with spinal cord injury

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Abstract

This study attempted to use the eyesight range to quantify presyncope symptoms (PS), assess the relation between angle of head-up tilt, severity of injury on the American Spinal Injury Association (ASIA) scale, and PS on physiological signals, and determine the notable signals that represent PS in spinal cord injury (SCI) patients. Thirty-eight quadriplegic SCI subjects were recruited, in which the mean blood pressure (MBP), oxygen saturation (SpO2), heart rate (HR), and the low-frequency/high-frequency (LF/HF) ratio of the HR variability were measured during tilting up of the head. The SpO2 and LF/HF differed significantly with the level of PS. These findings of the studied variables suggest that SpO2 and LF/HF are the physiological signals that are most sensitive to detect in PS, and could be used for the optimal biofeedback design of tilt-table training systems aimed at overcoming posture hypotension in SCI patients.

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References

  1. American Autonomic Society and American Academy of Neurology (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy. Neurology 46:1470

    Google Scholar 

  2. Cariga P, Ahmed S, Mathias CJ, Gardner BP (2002) The prevalence and association of neck (coat-hanger) pain and orthostatic (postural) hypotension in human spinal cord injury. Spinal Cord 40:77–82

    Article  Google Scholar 

  3. Chao CY, Cheing GL (2005) The effects of lower-extremity functiona electric stimulation on the orthostatic response of people with tetraplegia. Arch Phys Med Rehabil 86:1427–1433

    Article  Google Scholar 

  4. Engel P, Hildebrandt G (1976) Long-term studies about orthostatic training after high spinal cord injury. Paraplegia 14:159–164

    Google Scholar 

  5. Figoni SF (1984) Cardiovascular and haemodynamic responses to tilting and to standing in tetraplegic patients: a review. Paraplegia 22:99–109

    Google Scholar 

  6. Gonzalez F, Chang JY, Banovac K, Messina D, Martinez-Arizala A, Kelley RE (1991) Autoregulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury. Paraplegia 29:1–7

    Google Scholar 

  7. Houtman S, Colier WNJM, Oeseburg B, Hopman MTE (2000) Systemic circulation and cerbral oxygenation during head-up tilt in spinal cord injured individuals. Spinal Cord 38:158–163

    Article  Google Scholar 

  8. Illman A, Stiller K, Williams M (2000) The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury. Spinal Cord 38:741–747

    Article  Google Scholar 

  9. Kochiadakis GE, Kanoupakis EM, Igoumenidis NE, Marketou ME, Solomou MC, Vardas PE (1997) Spectral analysis of heart rate variability in the analysis of autonomic nervous system activity during tilt-table testing in patients with unexplained syncope. IEEE Comput Cardiol 24:367–369

    Google Scholar 

  10. Legramante JM, Raimondi G, Massaro M, Iellamo F (2001) Positive and negative feedback mechanisms in the neural regulation of cardiovascular function in healthy and spinal cord-injured humans. Circulation 103:1250–1255

    Google Scholar 

  11. Liu DS, Chang WH, Wong AMK, Chen SC, Lin KP, Lai CH (2007) Development of a biofeedback tilt table for investigating orthostatic syncope in patients with spinal cord injury. Med Biol Eng Comput 45:1223–1228

    Article  Google Scholar 

  12. Merati G, Di Rienzo M, Parati G, Veicsteinas A, Castiglioni P (2005) Assessment of the autonomic control of heart rate variability in healthy and spinal-cord injured subjects: contribution of different complexity-based estimators. IEEE Trans Biomed Eng 53:43–52

    Article  Google Scholar 

  13. Mukai S, Hayano J (1995) Heart rate and blood pressure variabilities during graded head-up tilt. J Appl Physiol 78:212–216

    Article  Google Scholar 

  14. Onrot J, Goldberg MR, Hollister AS (1986) Management of chronic orthostatic hypotension. Am J Med 80:454–464

    Article  Google Scholar 

  15. Paul S, Zygmunt D, Haile V (1988) Chronic orthostatic hypotension. Compr Ther 14:58–65

    Google Scholar 

  16. Pongiglione G, Fish FA, Strasburger JF, Benson DW (1990) Heart rate and blood pressure response to upright tilt in young patients with unexplained syncope. J Am Coll Cardiol 16:165–170

    Article  Google Scholar 

  17. Sampson EE, Burnham RS, Andrews BJ (2000) Function electrical stimulation effect on orthostatic hypotension after spinal cord injury. Arch Phys Med Rehabil 81:139–143

    Google Scholar 

  18. Schatz IJ (1984) Orthostatic hypotension. I. Functional and neurogenic causes. Arch Intern Med 144:773–777

    Article  Google Scholar 

  19. Theodorakis G, Kremastinos D, Avrambos G (1992) Heart rate variability in patients with vasovagal syndrome. PACE 15:2221–2225

    Google Scholar 

  20. Tompkins WJ (1993) ECG QRS detection. Biomedical digital signal processing: C-language examples and laboratory experiments for the IBM PC. Prentice-Hall, New Jersey, pp 236–263

    Google Scholar 

  21. Wall BM, Runyan KR, Williams HH, Bobal MA, Crofton JT, Share L, Cooke CR (1994) Characteristics of vasopressin release during controlled reduction in arterial pressure. J Lab Clin Med 124:554–563

    Google Scholar 

Download references

Acknowledgments

This work was supported by the National Science Council, Taiwan, Republic of China, under Grants NSC 90-2213-E-033-056 and NSC 91-2614-E-038-004.

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Authors and Affiliations

  1. Department of Biomedical Engineering, Chung Yuan Christian University, No.200, Chung Bei Rd., Chung Li, 32023, Taiwan

    David S. Liu, Walter H. Chang & Chien-Hung Lai

  2. Department of Rehabilitation Medicine, Chang-Gung Memorial Hospital, Taipei, Taiwan

    Alice M. K. Wong

  3. Department of Physical Medicine and Rehabilitation, Taipei Medical University and Hospital, Taipei, Taiwan

    Shih-Ching Chen & Chien-Hung Lai

  4. Department of Electrical Engineering, Chung Yuan Christian University, Chung Li, Taiwan

    Kang-Ping Lin

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  1. David S. Liu
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  2. Walter H. Chang
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  3. Alice M. K. Wong
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  4. Shih-Ching Chen
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  5. Kang-Ping Lin
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  6. Chien-Hung Lai
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Correspondence to Walter H. Chang.

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Liu, D.S., Chang, W.H., Wong, A.M.K. et al. Relationships between physiological responses and presyncope symptoms during tilting up in patients with spinal cord injury. Med Biol Eng Comput 46, 681–688 (2008). https://doi.org/10.1007/s11517-008-0322-2

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  • DOI: https://doi.org/10.1007/s11517-008-0322-2

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