Damaged cardiovascular autonomic control in wheelchair-using children and adolescents with myelomeningocele: a case–control study

Leonardi-Figueiredo, Marisa Maia; Souza, Hugo Celso Dutra de; Martins, Emanuela Juvenal; Squiaveto, Monalisa; Mattiello-Sverzut, Ana Cláudia

doi:10.1016/j.bjpt.2018.09.001

Cited by 8 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is limited information on the factors contributing to increased cardiovascular disease risk in the MMC population. One study investigating cardiovascular autonomic nervous system functioning in children and young adult patients with MMC found that those who used a wheelchair showed lower spontaneous baroreflex sensitivity than their healthy counterparts ( Leonardi-Figueiredo et al, 2019 ). This was explained as an effect of lower limb hypomobility and muscle pump inefficiency or of peripheral vascular remodeling due to low orthostatic stress, even in the recumbent position ( Leonardi-Figueiredo et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…One study investigating cardiovascular autonomic nervous system functioning in children and young adult patients with MMC found that those who used a wheelchair showed lower spontaneous baroreflex sensitivity than their healthy counterparts ( Leonardi-Figueiredo et al, 2019 ). This was explained as an effect of lower limb hypomobility and muscle pump inefficiency or of peripheral vascular remodeling due to low orthostatic stress, even in the recumbent position ( Leonardi-Figueiredo et al, 2019 ). These findings were partly confirmed by our recent work showing that children and adolescents with MMC tend to develop venous insufficiency, with increased duration of retrograde flow at proximal and peripheral locations in the great saphenous vein compared with their normally developing peers ( Domagalska-Szopa et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

Szopa

Domagalska-Szopa

Siwiec³

et al. 2021

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

Szopa

Domagalska-Szopa

Siwiec³

et al. 2021

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

show abstract

“…In wheelchair users, mainly those diagnosed with spinal cord injury, the impairment of autonomic control in high lesions (above T6) is explained by changes in the cardiac baroreflex arc and cardiac autonomic innervations [38]. However, in patients with a low level of the lesion, where these structures are intact, this dysfunction is associated with some physiological adaptation of the cardiovascular system to sedentary behaviour and immobility of the lower limbs [14,38,39]. As the majority of SB participants in the current study were classified as extremely sedentary, and we did not find differences between lesion levels in the SB group (supplementary data), we believe that the attenuated heart rate response could be a reflection of an inactive lifestyle [34].…”

Section: Discussionmentioning

confidence: 99%

“…A recent study that investigated autonomic cardiovascular function in children with SB observed a reduced baroreflex sensitivity in those subjects when compared to controls 14 . This was found together with the lower physical fitness already reported in this group 6 7 14 15 and reinforces the hypothesis that subjects with SB could present decreased function of cardiac autonomic control assessed by a non-invasive and easily accessible tool, i. e. HRR. To the best of our knowledge, no research on HRR in children and adolescents with SB have been described in the literature.…”

Section: Introductionmentioning

confidence: 92%

Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida

et al. 2021

Self Cite

View full text Add to dashboard Cite

We aimed to analyse cardiac autonomic control by assessing the post-exercise heart rate recovery (HRR) and physical fitness in children and adolescents with spina bifida (SB), compared to participants with typical development. A total of 124 participants, 42 with spina bifida (SB group) and 82 typical developmental controls (CO group) performed the arm cranking exercise test with a gas analysis system. HRR was determined at the first (HRR_1) and second (HRR_2) minute at recovery phase. Data are shown as [mean difference (95% CI)]. The SB group showed reduced HR reserve [14.5 (7.1–22.0) bmp, P<0.01], slower HRR_1 [12.4 (7.4–17.5) bpm, P<0.01] and HRR_2 [16.3 (10.6–21.9) bpm; P<0.01], lower VO2peak [VO2peak relative: 7.3 (4.2–10.3) mL·min−1·kg−1, P<0.01; VO2peak absolute: 0.42 (0.30–0.54) L·min−1, P<0.01], and lower O2 pulse [2.5 (1.8–3.2) mL·bpm, P<0.01] and ventilatory responses [13.5 (8.8–18.1) L·min−1, P<0.01] than the CO group. VE/VO2 was not different between groups [−2.82 (−5.77– −0.12); P=0.06], but the VE/VCO2 [−2.59 (−4.40–0.78); P<0.01] and the values of the anaerobic threshold corrected by body mass [−3.2 (−5.8– −0.6) mL·min−1·kg−1, P=0.01] were higher in the SB group than in the CO group. We concluded that children and adolescents with SB have reduced physical fitness and a slower HRR response after maximal effort.

show abstract

“…Recently, autonomic cardiovascular function was evaluated in wheelchair-using children with MMC, and RMSSD at rest were reduced compared to the control group, which agrees with our results of reduced RMSSD, pNN50, and HF in the spinal bi da group at baseline. 19 The pathology underlying reduced vagal tone and increased LF/HF ratio in spina bi da patients is uncertain. In patients with thoracic spinal cord injuries, higher heart rates and reduced vagal tone has been documented.…”

Section: Discussionmentioning

confidence: 99%

Alterations of Autonomic Nervous System Activity in Children with Spina Bifida: A Case-Control Study

Kim

Franco

Lee

et al. 2021

Preprint

View full text Add to dashboard Cite

We compared heart rate variability parameters of patients with spina bifida with those of a control group during urodynamic study to evaluate the autonomic nervous system dysfunction of spina bifida. Continuous heart rate variability parameters were recorded during 3 successive periods (P0: 2 minutes before the start of filling; P1: start of filling to the first desire to void; P2: P1 to the end of filling or the start of voiding). Children with vesicoureteral reflux who underwent video-urodynamic study were established as a control group. We included 11 patients with spina bifida and 9 controls. At baseline, patients with spina bifida had lower values of RMSSD, pNN50, and HF, while LF/HF ratio was increased (5.04 ± 4.75 vs 0.67 ± 0.42, p = 0.014). During bladder filling, LF/HF values increased in the control group (P0 0.67 ± 0.42 vs P1 0.89 ± 0.34 vs P2 1.21 ± 0.64, p = 0.018) while it was decreased in spina bifida patients (P0 5.04 ± 4.75 vs P1 3.96 ± 4.35 vs P2 3.26 ± 4.03, p < 0.001). HF were significantly increased in spina bifida children during bladder filling (p = 0.002). In time domain, SDNN was increased only in control group during bladder filling. Parasympathetic activity domains were decreased in children with spina bifida at baseline. During the bladder filling phase, parasympathetic activity increased with fixed sympathetic activity in spina bifida group while the control group demonstrated a shifted balance toward sympathetic preponderance at the end of bladder filling. These findings may be related to the pathophysiology of neurogenic bladder in spina bifida.

show abstract

Damaged cardiovascular autonomic control in wheelchair-using children and adolescents with myelomeningocele: a case–control study

Abstract: Wheelchair-using children and adolescents with myelomeningocele presented differences in the autonomic cardiovascular function. This may be associated with hypomobility due to wheelchair dependence, and venous muscle pump insufficiency due to paraplegia.

Cited by 8 publications

References 19 publications

Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida

Alterations of Autonomic Nervous System Activity in Children with Spina Bifida: A Case-Control Study

Contact Info

Product

Resources

About