Influence of neurological lesion level on heart rate variability and fatigue in adults with spinal cord injury

Rodrigues, D; Tran, Y; Guest, R; Middleton, J; Craig, A

Influence of neurological lesion level on heart rate variability and fatigue in adults with spinal cord injury

Rodrigues, D Tran, Y

Guest, R Middleton, J Craig, A

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Publication Type:: Journal Article
Citation:: Spinal Cord, 2016, 54 (4), pp. 292 - 297
Issue Date:: 2016-04-01

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Field	Value	Language
dc.contributor.author	Rodrigues, D	en_US
dc.contributor.author	Tran, Y https://orcid.org/0000-0002-1741-4205	en_US
dc.contributor.author	Guest, R	en_US
dc.contributor.author	Middleton, J	en_US
dc.contributor.author	Craig, A	en_US
dc.date.available	2015-08-30	en_US
dc.date.issued	2016-04-01	en_US
dc.identifier.citation	Spinal Cord, 2016, 54 (4), pp. 292 - 297	en_US
dc.identifier.issn	1362-4393	en_US
dc.identifier.uri	http://hdl.handle.net/10453/95734
dc.description.abstract	© 2016 International Spinal Cord Society. Study design:Group cohort design.Objectives:To determine the influence of spinal cord injury (SCI) and neurological level on heart rate variability (HRV) and associations with fatigue.Setting:SCI rehabilitation outpatient and community settings in New South Wales, Australia.Methods:Participants included 45 adults with SCI living in the community and 44 able-bodied controls. Socio-demographic, neurological injury, psychological, HRV and eye blink variables were assessed. Multivariate analysis of variance and post hoc protected t-tests were used to determine differences in HRV and fatigue as a function of the neurological level. Pearson's correlation analysis was used to determine the relationships between these factors.Results:Participants with SCI had significantly reduced sympathetic activity. Those with tetraplegia had lowered sympathetic activity compared with those with paraplegia and able-bodied controls. Neither were differences in parasympathetic activity found between groups nor were there any significant differences found for the time domain or non-linear domains. Higher levels of fatigue were found in the SCI sample, and participants with tetraplegia had higher fatigue levels compared with those with paraplegia. Fatigued participants were more likely to have altered autonomic function - that is, reduced sympathetic activity.Conclusions:Higher levels of neurological impairment in people with SCI are more likely to result in disordered cardiovascular control involving reduced sympathetic activity, whereas elevated fatigue was found to be associated with increased sympathetic dysfunction. Findings highlight the need to address risks associated with this dysfunction, such as improved HRV and fatigue screening for people with SCI and improved education on cardiovascular risk factors.	en_US
dc.relation.ispartof	Spinal Cord	en_US
dc.relation.isbasedon	10.1038/sc.2015.174	en_US
dc.subject.classification	Rehabilitation	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Nervous System Diseases	en_US
dc.subject.mesh	Spinal Cord Injuries	en_US
dc.subject.mesh	Fatigue	en_US
dc.subject.mesh	Electrocardiography	en_US
dc.subject.mesh	Neurologic Examination	en_US
dc.subject.mesh	Electrooculography	en_US
dc.subject.mesh	Multivariate Analysis	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Residence Characteristics	en_US
dc.subject.mesh	Heart Rate	en_US
dc.subject.mesh	Blinking	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Outpatients	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Influence of neurological lesion level on heart rate variability and fatigue in adults with spinal cord injury	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	54	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1109 Neurosciences	en_US
utslib.for	1106 Human Movement and Sports Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	54	en_US

Abstract:

© 2016 International Spinal Cord Society. Study design:Group cohort design.Objectives:To determine the influence of spinal cord injury (SCI) and neurological level on heart rate variability (HRV) and associations with fatigue.Setting:SCI rehabilitation outpatient and community settings in New South Wales, Australia.Methods:Participants included 45 adults with SCI living in the community and 44 able-bodied controls. Socio-demographic, neurological injury, psychological, HRV and eye blink variables were assessed. Multivariate analysis of variance and post hoc protected t-tests were used to determine differences in HRV and fatigue as a function of the neurological level. Pearson's correlation analysis was used to determine the relationships between these factors.Results:Participants with SCI had significantly reduced sympathetic activity. Those with tetraplegia had lowered sympathetic activity compared with those with paraplegia and able-bodied controls. Neither were differences in parasympathetic activity found between groups nor were there any significant differences found for the time domain or non-linear domains. Higher levels of fatigue were found in the SCI sample, and participants with tetraplegia had higher fatigue levels compared with those with paraplegia. Fatigued participants were more likely to have altered autonomic function - that is, reduced sympathetic activity.Conclusions:Higher levels of neurological impairment in people with SCI are more likely to result in disordered cardiovascular control involving reduced sympathetic activity, whereas elevated fatigue was found to be associated with increased sympathetic dysfunction. Findings highlight the need to address risks associated with this dysfunction, such as improved HRV and fatigue screening for people with SCI and improved education on cardiovascular risk factors.

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http://hdl.handle.net/10453/95734