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自主神经功能障碍、脑血流动力学和睡眠相互作用在 SCI 患者中的临床相关性。

The Clinical Relevance of Autonomic Dysfunction, Cerebral Hemodynamics, and Sleep Interactions in Individuals Living With SCI.

机构信息

Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY.

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Centre for Trauma Science Research, University of Birmingham, Birmingham, UK; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.

出版信息

Arch Phys Med Rehabil. 2024 Jan;105(1):166-176. doi: 10.1016/j.apmr.2023.08.006. Epub 2023 Aug 23.

Abstract

A myriad of physiological impairments is seen in individuals after a spinal cord injury (SCI). These include altered autonomic function, cerebral hemodynamics, and sleep. These physiological systems are interconnected and likely insidiously interact leading to secondary complications. These impairments negatively influence quality of life. A comprehensive review of these systems, and their interplay, may improve clinical treatment and the rehabilitation plan of individuals living with SCI. Thus, these physiological measures should receive more clinical consideration. This special communication introduces the under investigated autonomic dysfunction, cerebral hemodynamics, and sleep disorders in people with SCI to stakeholders involved in SCI rehabilitation. We also discuss the linkage between autonomic dysfunction, cerebral hemodynamics, and sleep disorders and some secondary outcomes are discussed. Recent evidence is synthesized to make clinical recommendations on the assessment and potential management of important autonomic, cerebral hemodynamics, and sleep-related dysfunction in people with SCI. Finally, a few recommendations for clinicians and researchers are provided.

摘要

脊髓损伤 (SCI) 后,个体存在多种生理障碍。这些包括自主功能改变、脑血流动力学和睡眠障碍。这些生理系统相互关联,可能会相互影响,导致继发性并发症。这些损伤会对生活质量产生负面影响。全面了解这些系统及其相互作用,可能会改善 SCI 患者的临床治疗和康复计划。因此,这些生理措施应该得到更多的临床关注。本专题通讯旨在向参与 SCI 康复的利益相关者介绍 SCI 患者中研究不足的自主神经功能障碍、脑血流动力学和睡眠障碍。我们还讨论了自主神经功能障碍、脑血流动力学和睡眠障碍之间的联系,并讨论了一些次要结果。综合最近的证据,就 SCI 患者重要的自主神经、脑血流动力学和与睡眠相关的功能障碍的评估和潜在管理提出临床建议。最后,为临床医生和研究人员提供了一些建议。

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