Associations between autonomic nervous system health and cognitive performance have been described in different populations. Autonomic disturbances are a common phenomenon in patients post stroke. Little is known about the relationship between post stroke disturbances of the autonomic nervous system and the commonly occurring disturbances of cognitive functions revealed by victims of stroke. To assess the association between heart rate variability (HRV) and cognitive performance among patients post ischemic stroke and healthy age-matched controls, 13 patients post first-ever ischemic stroke aged 40-80 years and 15 age-matched healthy controls were evaluated. HRV was monitored during sustained handgrip, while breathing at a rate of six breaths per minute, while performing the serial-3 subtraction task sitting at rest, and while cycling. Patients post stroke had greater error rate in the serial-3 subtraction task, and lower HRV (both at rest and during task performance) relative to healthy controls (at rest 26 ms [10-53] vs. 43 ms [29-88]). The HRV of stroke patients showed less sensitivity to changes in testing conditions, and also failed to show the correlation with cognitive performance exhibited by the healthy subjects. Stroke patients experience autonomic nervous system dysfunction in parallel to their motor and cognitive impairments. Too often only the latter receive appropriate treatment consideration in the rehabilitation setting. The current results, and earlier research, point to the importance of focusing clinical attention to the status of the autonomic nervous system, as amelioration of its functioning is likely to enhance motor and cognitive functioning as well.
Reduced sympathetic tone in women with OAB may explain their attainment of lower volumes of MC and their sensation of urgency. The rapid decrease in sympathetic neural activity that accompanies the sensation of an SDV may be related to the pathophysiology of the urgency symptom in these women.
BACKGROUND: Nearly half of individuals post-stroke are dependent in their daily activities. The ability to ascend and descend stairs is an important component of independence in the community. OBJECTIVE: To predict the future ability of post-stroke individuals at the beginning of the sub-acute rehabilitation phase to achieve ascending and descending staircase independence. METHODS: 36 participants were recruited for the study. Outcome measures: independence in ascending and descending stairs up to the end of the sub-acute rehabilitation phase. Predictive measures included the knee extensors Muscles Strength (MS), the seated Modified Functional Reach (MFR) test, and Heart Rate Variability (HRV) measures. Logistic and Cox regression were used. RESULTS: Twenty-four participants (66.7%) completed the sub-acute rehabilitation phase being independent in ascending and descending stairs. MFR was the best predictor (R2 = 0.18), and with MS the best predictors for the time (days) to achieve this goal during the sub-acute rehabilitation. HRV measure was found to be the main predictor of the staircase ascent model (R2 = 0.32), and MFR the best predictor for the descent model (R2 = 0.24). CONCLUSIONS: Balance performance is the main predictor of independence in ascending and descending stairs. Improving this component during the sub-acute rehabilitation phase might be reflected in achieving staircase independence.
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