Improvements in Orthostatic Instability with Stand Locomotor Training in Individuals with Spinal Cord Injury
Improvements in Orthostatic Instability with Stand Locomotor Training in Individuals with Spinal Cord Injury
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DOI：
10.1089/neu.2008.0572
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发表时间：
2008-12-01
影响因子：
4.2
通讯作者：
Krassioukov, Andrei V.
中科院分区：
文献类型：
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作者：
Harkema, Susan J.;Ferreira, Christie K.;Krassioukov, Andrei V.
主动站立训练对脊髓损伤（SCI）患者心血管控制的前瞻性评估。本研究的目的是评估主动站立训练对脊髓损伤患者动脉血压和心率的影响，以及对直立应激反应的变化。在运动训练干预（站立LT）的站立部分进行40次和80次之前和之后，对脊髓损伤患者（n = 8）进行了测量。在站立期间，所有参与者都戴着安全带，并由头顶的气动体重支撑（BWS）系统悬挂在跑步机上。教练员在必要时为躯干和腿部提供手动便利。所有个体在站立LT训练后都能承受更多的重量。经过80次训练后，颈椎脊髓损伤患者的静息动脉血压显著升高。训练结束时，坐位颈椎脊髓损伤患者的静息收缩压（BP）增加24%（从84 +/- 5增加到104 +/- 7 mmHg）。此外,训练前站立后出现的直立性低血压（收缩压降低24 +/- 14 mmHg）不明显（80次站立lt后收缩压降低0 mmHg 11 mmHg）。胸椎脊髓损伤患者的血流动力学参数在训练前相对稳定，在80次站立lt后无显著差异。临床完全性脊髓损伤患者静息动脉血压和对直立应激反应的改善颈椎脊髓损伤发生在高强度站立LT训练后。这些结果可能归因于重复性的腿部神经肌肉激活负荷和/或心血管反应的条件反射，从重复假设一个直立的姿势。
Prospective assessment of cardiovascular control in individuals with spinal cord injury (SCI) in response to active stand training. Cardiovascular parameters were measured at rest and in response to orthostatic challenge before and after training in individuals with clinically complete SCI The goal of this study was to evaluate the effect of active stand training on arterial blood pressure and heart rate and changes in response to orthostatic stress in individuals with SCI. Measurements were obtained in individuals with SCI (n = 8) prior to and after 40 and 80 sessions of the standing component of a locomotor training intervention (stand LT). During standing, all participants wore a harness and were suspended by an overhead, pneumatic body weight support (BWS) system over a treadmill. Trainers provided manual facilitation as necessary at the trunk and legs. All individuals were able to bear more weight on their legs after the stand LT training. Resting arterial blood pressure significantly increased in individuals with cervical SCI after 80 training sessions. At the end of the training period, resting systolic blood pressure (BP) in individuals with cervical SCI in a Seated position, increased by 24% (from 84 +/- 5 to 104 +/- 7 mmHg). Furthermore, orthostatic hypotension present in response to standing prior to training (decrease in systolic BP of 24 +/- 14 mmHg) was not evident (decrease in systolic BP of 0 mmHg 11 mmHg) after 80 sessions of stand LT. Hemodynamic parameters of individuals with thoracic SCI were relatively stable prior to training and not significantly different after 80 sessions of stand LT. Improvements in resting arterial blood pressure and responses to orthostatic stress in individuals with clinically complete cervical SCI occurred following intensive stand LT training. These results may be attributed to repetitive neuromuscular activation of the legs from loading and/or conditioning of cardiovascular responses from repetitively assuming an upright posture.