ABSTRACT
Objective
To assess the recovery of the cardiac autonomic control system (CACS) response to the modified tilt-test during rehabilitation, in children post moderate-severe TBI at the subacute phase post-injury.
Method
Thirty-seven children aged 6-18 years, 14-162 days post moderate-severe TBI, participated in the study. The assessment included CACS values evaluation (heart rate (HR), heart rate variability (HRV) and blood pressure) during the modified tilt-test: five minutes lying supine and five minutes passive standing. Re-assessment was performed after eight weeks of rehabilitation.
Results
In both assessments, only four children reported symptoms associated with orthostatic intolerance during the modified tilt-test. No change was found over time in the HR and HRV values at rest. In response to the modified tilt-test, the systolic blood pressure showed change over time, with a significant interaction effect (p=0.04); while in the first assessment the SBP values showed a hypertension trend in the second assessment the SBP values showed a hypotension trend.
Conclusions
Children post moderate-severe TBI at the sub-acute phase post-injury, have a better systolic blood pressure response during the modified tilt-test after eight weeks of individually tailored rehabilitation program, despite no change in the CACS values at rest.
Clinical trial gov. number
NCT03215082
Acknowledgments
This study was performed in partial fulfillment of the requirements for a Ph.D. degree of Gilad Sorek, Sackler Faculty of Medicine, Tel Aviv University, Israel.
We would like to thank the whole SiMPLy-Rehab team for the partnership, support and knowledge sharing.
Disclosure statement
No potential conflict of interest was reported by the authors.