Rianne Ravensbergen H J, de Groot Sonja, Post Marcel W, Bongers-Janssen Helma M, van der Woude Lucas H, Claydon Victoria E
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada; International Collaboration On Repair Discoveries, Vancouver, BC, Canada; Research Institute MOVE Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands.
Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands; Center for Human Movement Sciences Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Arch Phys Med Rehabil. 2016 Sep;97(9):1431-1439. doi: 10.1016/j.apmr.2016.03.010. Epub 2016 Apr 13.
To determine whether physical activity and participation 1 and 5 years after discharge are associated with measures of cardiovascular autonomic function: prevalence of hypotension and reduced peak heart rate at discharge from initial inpatient spinal cord injury (SCI) rehabilitation.
Prospective cohort study.
Rehabilitation centers.
Individuals with SCI (N=146).
Not applicable.
We recorded markers of cardiovascular autonomic dysfunction (resting blood pressure and peak heart rate) and personal and lesion characteristics at the time of discharge from rehabilitation. Parameters for participation (social health status dimension of the Sickness Impact Profile) and physical activity (Physical Activity Scale for Individuals with Physical Disabilities [PASIPD]) were measured 1 and 5 years after discharge. Effects of prevalence of cardiovascular autonomic dysfunction were analyzed using linear regression analysis while correcting for possible confounders.
We found no significant association between hypotension and social health status dimension of the Sickness Impact Profile or PASIPD, either at 1 or at 5 years after discharge. A significant association between peak heart rate and social health status dimension of the Sickness Impact Profile was found at 1 year after discharge, showing poorer participation in individuals with low peak heart rate (ie, cardiovascular autonomic dysfunction). The unadjusted relation between peak heart rate and the social health status dimension of the Sickness Impact Profile was significant at 5 years, but not when adjusted for confounders. We found associations between peak heart rate and PASIPD for both 1 and 5 years after discharge; however, these were not significant after correction for potential confounding factors.
Autonomic dysfunction after SCI is a crucial factor influencing quality of life. We found that cardiovascular autonomic impairment, assessed from low peak heart rate, was associated with reduced participation after 1 year. The results suggest that peak heart rate at discharge from rehabilitation after SCI should be used to identify those needing additional support to facilitate physical activity and participation after discharge.
确定出院后1年和5年的身体活动及参与情况是否与心血管自主神经功能指标相关：初始住院脊髓损伤（SCI）康复出院时低血压患病率及心率峰值降低情况。
前瞻性队列研究。
康复中心。
SCI患者（N = 146）。
不适用。
我们记录了康复出院时心血管自主神经功能障碍的标志物（静息血压和心率峰值）以及个人和损伤特征。出院后1年和5年测量参与情况（疾病影响量表的社会健康状况维度）和身体活动（残疾个体身体活动量表[PASIPD]）。在校正可能的混杂因素后，使用线性回归分析心血管自主神经功能障碍患病率的影响。
我们发现出院后1年或5年，低血压与疾病影响量表的社会健康状况维度或PASIPD之间均无显著关联。出院后1年发现心率峰值与疾病影响量表的社会健康状况维度之间存在显著关联，表明心率峰值低的个体（即心血管自主神经功能障碍）参与情况较差。心率峰值与疾病影响量表的社会健康状况维度之间未校正的关系在5年时显著，但校正混杂因素后不显著。我们发现出院后1年和5年心率峰值与PASIPD之间均有关联；然而，校正潜在混杂因素后这些关联并不显著。
SCI后的自主神经功能障碍是影响生活质量的关键因素。我们发现，从低心率峰值评估的心血管自主神经损伤与1年后参与情况减少有关。结果表明，SCI康复出院时的心率峰值应用于识别那些出院后需要额外支持以促进身体活动和参与的患者。
