title: Is There an Association Between Markers of Cardiovascular Autonomic Dysfunction at Discharge From Rehabilitation and Participation 1 and 5 Years Later in Individuals With Spinal Cord Injury?
abstract: To determine whether physical activity and participation 1 and 5 years after discharge are associated with measures of cardiovascular autonomic function: prevalence of hypotension and reduced peak heart rate at discharge from initial inpatient spinal cord injury (SCI) rehabilitation.
  
  
  
  Prospective cohort study.
  
  
  
  Rehabilitation centers.
  
  
  
  Individuals with SCI (N=146).
  
  
  
  Not applicable.
  
  
  
  We recorded markers of cardiovascular autonomic dysfunction (resting blood pressure and peak heart rate) and personal and lesion characteristics at the time of discharge from rehabilitation. Parameters for participation (social health status dimension of the Sickness Impact Profile) and physical activity (Physical Activity Scale for Individuals with Physical Disabilities [PASIPD]) were measured 1 and 5 years after discharge. Effects of prevalence of cardiovascular autonomic dysfunction were analyzed using linear regression analysis while correcting for possible confounders.
  
  
  
  We found no significant association between hypotension and social health status dimension of the Sickness Impact Profile or PASIPD, either at 1 or at 5 years after discharge. A significant association between peak heart rate and social health status dimension of the Sickness Impact Profile was found at 1 year after discharge, showing poorer participation in individuals with low peak heart rate (ie, cardiovascular autonomic dysfunction). The unadjusted relation between peak heart rate and the social health status dimension of the Sickness Impact Profile was significant at 5 years, but not when adjusted for confounders. We found associations between peak heart rate and PASIPD for both 1 and 5 years after discharge; however, these were not significant after correction for potential confounding factors.
  
  
  
  Autonomic dysfunction after SCI is a crucial factor influencing quality of life. We found that cardiovascular autonomic impairment, assessed from low peak heart rate, was associated with reduced participation after 1 year. The results suggest that peak heart rate at discharge from rehabilitation after SCI should be used to identify those needing additional support to facilitate physical activity and participation after discharge.
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada; International Collaboration On Repair Discoveries, Vancouver, BC, Canada; Research Institute MOVE Amsterdam, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Rianne Ravensbergen
authors.affiliation: Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands; Center for Human Movement Sciences Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: de Groot
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands; Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Marcel W
authors.initials: MW
authors.lastname: Post
authors.affiliation: Rehabilitation Center Adelante, Hoensbroek, The Netherlands.
authors.forename: Helma M
authors.initials: HM
authors.lastname: Bongers-Janssen
authors.affiliation: Center for Human Movement Sciences Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Lucas H
authors.initials: LH
authors.lastname: van der Woude
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada; International Collaboration On Repair Discoveries, Vancouver, BC, Canada. Electronic address: victoria_claydon@sfu.ca.
authors.forename: Victoria E
authors.initials: VE
authors.lastname: Claydon
mesh_terms: D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006304:Health Status; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge; D011446:Prospective Studies; D011788:Quality of Life; D012047:Rehabilitation Centers; D012737:Sex Factors; D058992:Social Participation; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D013997:Time Factors
keywords: Activities of daily living; Rehabilitation; Spinal cord injuries