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1.
Sleep Breath ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748068

RESUMO

PURPOSE: The current study aims to assess the efficacy of the Stop-Bang Questionnaire (SBQ) in screening treatment-required sleep apnoea following Spinal Cord Injury (SCI). Additionally, we explore the performance of combined questionnaires and pulse oximetry to determine the most cost-effective method. METHODS: The study employs a cross-sectional observational design. All patients admitted to in-hospital rehabilitation at the Spinal Cord Injury Centre of Western Denmark from September 2022 to February 2023 were continuously enrolled. Participating patients underwent SBQ screening, a standard sleep questionnaire, and cardiorespiratory monitoring, followed by an individual consultation with a physician. RESULTS: During the study period, 35 SCI patients were admitted, with 24 providing informed consent. Among the 24 included patients, there was a 75% prevalence of mild to severe sleep apnoea, and 46% had treatment-required sleep apnoea. The SBQ missed only one patient with treatment-required sleep apnoea but misclassified eight patients. Combining SBQ with the pulse oximetry demonstrated the best performance in identifying patients with sleep apnoea. CONCLUSION: The study indicates that SBQ alone is insufficient for screening treatment-required sleep apnoea. Exploratory analysis suggests that combining SBQ with a simple pulse oximetry measurement might enhance accuracy.

2.
Spinal Cord Ser Cases ; 7(1): 78, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446698

RESUMO

INTRODUCTION: Spinal cord injury (SCI) disrupts autonomic control of the cardiovascular system, which may lead to autonomic dysfunction. Growing amounts of evidence support the possibility that systemic and cerebral hemodynamic dysfunctions may contribute to cognitive deficits in patients with SCI. CASE PRESENTATION: We present a case of autonomic cardiovascular dysfunction in a 55-year old female patient following non-traumatic cervical SCI. This case illustrates how a simple arithmetic test may elicit fluctuations in blood pressure causing cognitive disturbances. DISCUSSION: Clinical awareness of autonomic dysfunction and cognitive deficits is relevant in neurorehabilitation of patients with SCI. Assessment of autonomic function should be evaluated according to recommendation from International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) [1].


Assuntos
Doenças do Sistema Nervoso Autônomo , Sistema Cardiovascular , Medula Cervical , Traumatismos da Medula Espinal , Sistema Nervoso Autônomo , Doenças do Sistema Nervoso Autônomo/diagnóstico , Doenças do Sistema Nervoso Autônomo/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico
3.
Spinal Cord Ser Cases ; 6(1): 83, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32883956

RESUMO

INTRODUCTION: Blood flow-restricted exercise (BFRE) appears to hold considerable potential in spinal cord injury (SCI) rehabilitation, due to its ability to induce beneficial functional changes and morphological alterations from low-intensity, low-load exercise. However, it remains unclear if this training approach is feasible and safe in individuals with autonomic dysreflexia (AD). CASE PRESENTATION: A 23-year-old male with traumatic, cervical (C6), motor-complete (AIS: B) SCI and diagnosed AD completed eight sessions of BFRE for the upper extremities over 4 weeks. Blood pressure and heart rate recordings and perceptual pain responses were collected repeatedly during exercise. Blood samples were drawn pre- and post-training. Training was carried out in a neurorehabilitation hospital setting with appertaining medical staff readiness, and was supervised by a physiotherapist with expertise in AD in general as well as prior knowledge of the present patient's triggers and symptoms. Four incidences of AD (defined as systolic blood pressure increase >20 mmHg) were recorded across all training sessions, of which one was symptomatic. The patient's blood profile did not change considerably from pre- to post-training sessions. Self-reported average pain during training corresponded from "mild" to "moderate". DISCUSSION: The patient was able to perform 4 weeks of BFRE, but encountered episodes of AD. Similarly, two AD episodes were registered during a single conventional, free-flow resistance training session. Evidence from clinically controlled safety studies is needed in order to establish if and how BFRE can be applied in a rehabilitation strategy in SCI individuals with neurological level of injury at or above T6 level.


Assuntos
Disreflexia Autonômica/terapia , Exercício Físico/fisiologia , Quadriplegia/terapia , Traumatismos da Medula Espinal/terapia , Disreflexia Autonômica/complicações , Disreflexia Autonômica/epidemiologia , Doenças do Sistema Nervoso Autônomo/complicações , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial/efeitos adversos , Frequência Cardíaca/fisiologia , Humanos , Quadriplegia/complicações , Quadriplegia/diagnóstico , Traumatismos da Medula Espinal/complicações , Urodinâmica/fisiologia
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