Abstract
Study design:
Case–control study.
Objectives:
To investigate the level of autonomic nervous system dysfunction in patients with spinal cord injury and to determine its effect on the basal metabolic rate and oxygen consumption during daily living activities.
Setting:
Turkish Armed Forces Rehabilitation Center, Ankara, Turkey.
Methods:
Thirty-six patients with chronic spinal cord injury (SCI) were allocated into two groups according to the presence of autonomic nervous system dysfunction. Autonomic nervous system dysfunction was investigated with the measurements of blood pressure and heart rate during urodynamic examination and several provocative maneuvers (standing at tilt table, forcing deep respiration and Valsalva). Groups were compared in terms of the basal metabolic rate and oxygen consumption during daily living activities. Measurement of the basal metabolic rate was determined by indirect calorimetry under standardized conditions. Total body fat mass and lean tissue mass were measured in all participants using dual-energy X-ray absorptiometry by standard methods. Telemetric intrapulmonary gas exchange analyzer was used to measure oxygen consumption during daily living activities.
Results:
There was no statistically significant difference between the groups in age, time since injury, body mass lean and fat rates, or sensory and motor scores (P>0.05). Basal metabolic rates and oxygen consumption during daily living activities were not different between the groups (P>0.05).
Conclusions:
These results suggest that the presence of autonomic dysfunction does not change oxygen consumption at rest and during daily living activities.
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References
Kocina P . Body composition of spinal cord injured adults. Sports Med 1997; 23: 48–60.
Bauman WA, Adkins RH, Spungen AM, Waters RL . The effect of residual neurological deficit on oral glucose tolerance in persons with chronic spinal cord injury. Spinal Cord 1999; 37: 765–771.
Karlsson AK . Insulin resistance and sympathetic function in high spinal cord injury. Spinal Cord 1999; 37: 494–500.
Maki KC, Briones ER, Langbein WE, Inman-Felton A, Nemchausky B, Welch M et al. Associations between serum lipids and indicators of adiposity in men with spinal cord injury. Paraplegia 1995; 33: 102–109.
Krum H, Howes LG, Brown DJ, Ungar G, Moore P, McNeil JJ et al. Risk factors for cardiovascular disease in chronic spinal cord injury patients. Paraplegia 1992; 30: 381–388.
Berne MR, Levy NM (eds). Physiology 3rd edn. Mosby: New York, NY, USA. 1998.
Guyton CA, Hall EJ (eds). Medical Physiology 10th Turkish edn. Nobel Tıp Press: Istanbul, Turkey. 2001.
Jeon JY, Steadward RD, Wheeler GD, Bell G, McCargar L, Harber V . Intact sympathetic nervous system is required for leptin effects on resting metabolic rate in people with spinal cord injury. J Clin Endocrinol Metab 2003; 88: 402–407.
Saad MF, Alger SA, Zurlo F, Young JB, Bogardus C, Ravussin E . Ethnic differences in sympathetic nervous system-mediated energy expenditure. Am J Physiol 1991; 261: 789–794.
Toubro S, Sorensen TI, Ronn B, Christensen NJ, Astrup A . Twenty-four hour energy expenditure: the role of body composition, thyroid status, sympathetic activity, and family membership. J Clin Endocrinol Metab 1996; 81: 2670–2674.
Acheson KJ, Ravussin E, Schoeller DA, Christin L, Bourquin L, Baertschi P et al. Two-week stimulation or blockade of the sympathetic nervous system in man: influence on body weight, body composition, and twenty four-hour energy expenditure. Metabolism 1988; 37: 91–98.
Buemann B, Astrup A, Madsen J, Christensen NJ . A 24-h energy expenditure study on reduced-obese and nonobese women: effect of beta-blockade. Am J Clin Nutr 1992; 56: 662–670.
Bauman WA, Spungen AM, Wang J, Pierson RN . The relationship between energy expenditure and lean tissue in monozygotic twins discordant for spinal cord injury. J Rehabil Res Dev 2004; 41: 1–8.
Monroe MB, Tataranni PA, Pratley R, Manore MM, Skin-ner JS, Ravussin E . Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects. Am J Clin Nutr 1998; 68: 1223–1227.
Yilmaz B, Yasar E, Goktepe S, Alaca R, Yazicioglu K, Dal U et al. Basal metabolic rate and autonomic nervous system dysfunction in men with spinal cord injury. Obesity 2007; 15: 2683–2687.
Ravits JM . AAEM minimonograph #48: autonomic nervous system testing. Muscle Nerve 1997; 20: 919–937.
Hilz MJ, Dütsch M . Quantitative studies of autonomic function. Muscle Nerve 2006; 33: 6–20.
Hall KM, Cohen ME, Wright J, Call M, Werner P . Characteristics of the functional independence measure in traumatic spinal cord injury. Arch Phys Med Rehabil 1999; 80: 1471–1476.
Craven BC, Morris AR . Modified Ashworth Scale reliability for measurement of lower extremity spasticity among patients with SCI. Spinal Cord 2010; 48: 207–213.
Isbell TR, Klesges RC, Meyers AW, Klesges LM . Measurement reliability and reactivity using repeated measurements of resting energy expenditure with a facemask, mouthpiece, and ventilated canopy. J Parenter Enteral Nutr 1991; 15: 165–168.
Warner JT, Bell W, Webb DK, Gregory JW . Daily energy expenditure and physical activity in survivors of childhood malignancy. Pediatr Res 1998; 43: 607–613.
Firouzbakhsh S, Mathis RK, Dorchester WL, Oseas RS, Groncy PK, Grant KE et al. Measured resting energy expenditure in children. J Pediatr Gastroenterol Nutr 1993; 16: 136–142.
Buchholz AC, McGillivray CF, Pencharz PB . Physical activity levels are low in free-living adults with chronic paraplegia. Obes Res 2003; 11: 563–570.
Popa C, Popa F, Grigorean VT, Onose G, Sandu AM, Popescu M et al. Vascular dysfunctions following spinal cord injury. J Med Life 2010; 3: 275–285.
Garstang SV, Miller-Smith SA . Autonomic nervous system dysfunction after spinal cord injury. Phys Med Rehabil Clin N Am 2007; 18: 275–296.
Abel T, Platen P, Rojas Vega S, Schneider S, Strüder HK . Energy expenditure in ball games for wheelchair users. Spinal Cord 2008; 46: 785–790.
Acknowledgements
The study was supported by the Scientific and Technological Research Council of Turkey (107S165).
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Yilmaz, B., Göktepe, S., Yaşar, E. et al. The effect of autonomic nervous system dysfunction on oxygen consumption during daily living activities in patients with spinal cord injury. Spinal Cord 55, 300–303 (2017). https://doi.org/10.1038/sc.2016.111
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DOI: https://doi.org/10.1038/sc.2016.111


