Sorek Gilad, Gagnon Isabelle, Schneider Kathryn, Chevignard Mathilde, Stern Nurit, Fadida Yahaloma, Kalderon Liran, Shaklai Sharon, Katz-Leurer Michal
Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec province, Canada.
Brain Inj. 2022 Jul 3;36(8):1033-1038. doi: 10.1080/02699052.2022.2110942. Epub 2022 Aug 15.
To assess the recovery of the cardiac autonomic control system (CACS) response to the modified tilt-test during rehabilitation, in children post moderate-severe TBI at the subacute phase post-injury.
Thirty-seven children aged 6-18 years, 14-162 days post moderate-severe TBI, participated in the study. The assessment included CACS values evaluation (heart rate (HR), heart rate variability (HRV) and blood pressure) during the modified tilt-test: five minutes lying supine and five minutes passive standing. Re-assessment was performed after eight weeks of rehabilitation.
In both assessments, only four children reported symptoms associated with orthostatic intolerance during the modified tilt-test. No change was found over time in the HR and HRV values at rest. In response to the modified tilt-test, the systolic blood pressure showed change over time, with a significant interaction effect (p=0.04); while in the first assessment the SBP values showed a hypertension trend in the second assessment the SBP values showed a hypotension trend.
Children post moderate-severe TBI at the sub-acute phase post-injury, have a better systolic blood pressure response during the modified tilt-test after eight weeks of individually tailored rehabilitation program, despite no change in the CACS values at rest.
CLINICAL TRIAL GOV. NUMBER: NCT03215082.
评估中重度创伤性脑损伤（TBI）患儿在伤后亚急性期康复过程中，心脏自主控制系统（CACS）对改良倾斜试验的反应恢复情况。
37名年龄在6 - 18岁、中重度TBI伤后14 - 162天的儿童参与了该研究。评估包括改良倾斜试验期间的CACS值评估（心率（HR）、心率变异性（HRV）和血压）：仰卧5分钟和被动站立5分钟。康复8周后进行重新评估。
在两次评估中，只有4名儿童在改良倾斜试验期间报告了与直立不耐受相关的症状。静息时的HR和HRV值随时间未发现变化。对改良倾斜试验的反应中，收缩压随时间有变化，存在显著的交互作用（p = 0.04）；在第一次评估中收缩压值呈高血压趋势，在第二次评估中收缩压值呈低血压趋势。
中重度TBI患儿在伤后亚急性期，经过8周个体化定制的康复计划后，尽管静息时CACS值无变化，但在改良倾斜试验期间收缩压反应更好。
NCT03215082。
