Blood flow in muscles of paraplegic patients under various conditions measured by a double isotope technique

A systematic review of exercise as a therapeutic intervention to improve arterial function in persons living with spinal cord injury

“…Only one study has examined arterial function after a single bout of active arm exercise combined with passive leg movement. 61 This pre-post investigation showed that blood flow measured by double isotope disappearance rate increased in the tibialis anterior after simultaneous 30 repetition bouts of arm movement against resistance and passive leg movement performed by a physiotherapist.…”

“…Eight articles were prospective control trials 31,41,[51][52][53][54][55][56] and six were pre-post design. 40,[57][58][59][60][61] Papers investigating acute exercise included: passive leg exercise (n ¼ 3), 53,57,60 FES (n ¼ 3), 54,55,59 single muscle electrical stimulation (n ¼ 1), 56 upper body continuous aerobic exercise (arm cycling or wheeling) (n ¼ 5), 31,40,41,52,58 acute combined arm passive leg exercise (n ¼ 1) 61 and stretchinduced contractions (n ¼ 1). 51 Tables 1 and 2 are a summary of published investigations researching the effect of acute exercise on arterial function in SCI individuals.…”

Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.

“…With and without preventative measures, VTE remains a rela-tively common and costly complication after traumatic SCI. The major factors predisposing persons with acute SCI to VTE make up the quintessential Virchow's Triad: venostasis (due to failure of the venous muscle pump with paralysis) (Seifert, 1972), a transient hypercoagulable state (Rossi, 1980), and frequent endothelial injury due to concomitant injuries, venous dilatation, and pressure on the veins (Miranda, 2000). The end result is that persons with acute SCI demonstrate the highest incidence of VTE compared to other patients with severe trauma (Geerts, 1994).…”

Optimal Drug Therapy and Therapeutic Drug Monitoring After Spinal Cord Injury: A Population-Specific Approach

“…Impaired heparin absorption is reflective of and consistent with well-described changes in postinjury physiology such as the altered musculocutaneous blood flow seen in paralyzed limbs. 52 These changes may suggest a shared mechanism that also contributes to the impairment in bioavailability of the aminoglycoside antibiotics observed after intramuscular administration. 53 Relatively few classes of antibiotics have been studied in the SCI population even though antibiotics are among the most commonly prescribed medications.…”

“…For example, after SCI, blood flow through the muscle and overlying tissue of paralyzed limbs is markedly diminished. 52 Hence, it should be anticipated that flow-dependent drug uptake from depot will be impaired. 53 Recognizing an increase in the volume of distribution (Vd) and total body clearance of the aminoglycosides attributable to SCI continues to be a prerequisite to individualizing and optimizing therapy.…”