截瘫患者对直立挑战和电刺激引起的腿部肌肉收缩的心血管反应。

J Raymond, G M Davis, G Bryant, J Clarke
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引用次数: 32

摘要

本研究的目的是研究截瘫患者在中度直立挑战时发生的心血管和血流动力学反应,以及电刺激(ES)诱导的腿部肌肉收缩对其直立挑战反应的影响。8名在第5至第12节胸椎(PARA)之间有完全脊柱病变的男性和8名健全个体(AB)自愿参加了这项研究。评估心率(fc)、卒中量(SV)、心输出量(Qc)、平均动脉压(MAP)、总外周阻力(TPR)、肢体体积和fc神经调节指标的变化,[副交感神经系统(PNS)和交感神经系统(SNS)指标]:(1)仰卧休息(rest),(2)下体负压在-30托(LBNP -30,其中1托= 133.32 N/m2)休息,(3)仅PARA, LBNP -30伴有ES诱导的腿部肌肉收缩(LBNP + ES)。LBNP -30引起SV(23%和22%)、Qc(15%和18%)和PNS指标的下降,但在PARA和AB受试者中fc(10%和9%)、TPR(23%和17%)和小牛体积(1.51%和4.04%)分别增加。仅AB组SNS指标升高。与LBNP -30相比,LBNP + ES使PARA组的SV(20%)和Qc(16%)增加,TPR(12%)降低。在所有试验期间,两组的MAP与REST相比没有变化。LBNP -30诱导的直立挑战在PARA和AB受试者中引起了相似的心血管适应。在LBNP -30期间es诱导的肌肉收缩增强了PARA组表现出的心血管反应,可能是通过骨骼肌泵的再激活和静脉回流的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular responses to an orthostatic challenge and electrical-stimulation-induced leg muscle contractions in individuals with paraplegia.

The purpose of this study was to investigate the cardiovascular and haemodynamic responses that occur during moderate orthostatic challenge in people with paraplegia, and the effect of electrical stimulation (ES)-induced leg muscle contractions on their responses to orthostatic challenge. Eight males with complete spinal lesions between the 5th and 12th thoracic vertebrae (PARA) and eight able-bodied individuals (AB) volunteered for this study. Changes in heart rate (fc), stroke volume (SV), cardiac output (Qc), mean arterial pressure (MAP), total peripheral resistance (TPR), limb volumes and indices of neural modulation of fc, [parasympathetic (PNS) and sympathetic (SNS) nervous system indicators] were assessed during: (1) supine rest (REST), (2) REST with lower-body negative pressure at -30 torr (LBNP -30, where 1 torr = 133.32 N/m2), and (3) for PARA only, LBNP -30 with ES-induced leg muscle contractions (LBNP + ES). LBNP -30 elicited a decrease in SV (by 23% and 22%), Qc (by 15% and 18%) and the PNS indicator, but an increase in fc (by 10% and 9%), TPR (by 23% and 17%) and calf volume (by 1.51% and 4.04%) in both PARA and AB subjects, respectively. The SNS indicator was increased in the AB group only. Compared to LBNP -30, LBNP + ES increased SV (by 20%) and Qc (by 16%), and decreased TPR (by 12%) in the PARA group. MAP was unchanged from REST during all trials, for both groups. The orthostatic challenge induced by LBNP -30 elicited similar cardiovascular adaptations in PARA and AB subjects. ES-induced muscle contractions during LBNP -30 augmented the cardiovascular responses exhibited by the PARA group, probably via reactivation of the skeletal muscle pump and improved venous return.

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