The circulatory behaviour in complete chronic paraplegia

Abstract

DURING World War II the systematic study of the circulatory problems in para plegia was began by Sir Ludwig Guttmann and continued after the war by him and his colleagues at Stoke Mandeville. The loss of thermoregulatory vasomotor adaptation (Cooper et al., 1957; Guttmann et al., 1958) and the cardiovascular responses to bladder distension (Guttmann & Whitteridge, 1947; Cunningham et al., 1953), were the main results of the first studies. In the following years, studies were made on the behaviour of denervated vessels (after peripheric nerves section or after sympathectomy) during responses to cold (Shepherd

Effect of a pulsating anti-gravity suit on peak exercise performance in individual with spinal cord injuries

“…It has been found that in spinal cord injured (SCI) individuals the function of the muscle pump and the sympathetic nervous system are severely disturbed, causing an impaired ability to redistribute blood (Biart and Maury 1973;Kinzer and Convertino 1989;Furher 1990). It has been shown that this contributes to cardiovascular intolerance during orthostatic challenges and exercise or strenuous activities in daily life (Gass and Camp 1984;Figoni 1993).…”

Postural hypotension and abnormalities of salt and water metabolism in myelopathy patients

“…4,15 The failure of the sympathetic nervous system to protect the circulation against gravity in these patients is evidenced by reduced levels of catecholamines and loss of vasomotor adjustments. 1,7,16,17 A further response to PH is the activation of the reninangiotensin-aldosterone system (RAS), in an attempt to preserve renal blood¯ow by sodium retention, extracellular volume expansion, and possibly increasing mean arterial pressure. 18 ± 20 To the extent that aerents from the sympathetic nervous system are involved in RAS activation, disruption of the sympathetic nervous system may result in inadequate responsiveness by the RAS to the reduction in renal blood and an incomplete compensation for PH.…”

About orthostatic hypotension in tetraplegic individuals reflections and experience

“…Except in those individuals when tilting triggers o strong spasms which help the venous return, 29 tilting upwards usually causes a more unpleasant OH than does the change to a sitting position probably due to the fact that the internal organs are more compressed and that a person who is tetraplegic can lean forwards somewhat when sitting.…”