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Vol. 23. Issue 1.
Pages 27-32 (01 January 2019)
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Vol. 23. Issue 1.
Pages 27-32 (01 January 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.09.001
Damaged cardiovascular autonomic control in wheelchair-using children and adolescents with myelomeningocele: a case–control study
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Marisa Maia Leonardi-Figueiredo, Hugo Celso Dutra de Souza, Emanuela Juvenal Martins, Monalisa Squiaveto, Ana Claudia Mattiello-Sverzut
Corresponding author
acms@fmrp.usp.br

Corresponding author at: University of Sao Paulo, Ribeirao Preto Medical School, Avenida Bandeirantes 3900, 2nd Floor of Building Physiotherapy and Occupational Therapy, CEP 14049-900, Ribeirão Preto, SP, Brazil.
Department of Healthy Sciences, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
Highlights

  • Children and adolescents with myelomeningocele showed higher heart rate at rest.

  • Children and adolescents with myelomeningocele did not show differences in HR and BP variability.

  • Children and adolescents with myelomeningocele showed lower baroreflex sensitivity.

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Tables (2)
Table 1. Clinical characteristics of MMC and Control groups.
Table 2. Blood pressure (BP) and heart rate (HR) at rest, heart rate variability (HRV), blood pressure variability (BPV) and spontaneous baroreflex sensitivity (BRS) for myelomeningocele (MMC) and Control groups.
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Abstract
Background

Cardiovascular autonomic dysfunction is associated with the development of cardiovascular diseases, but little is known about it in children and adolescents with myelomeningocele.

Objective

This study investigated the cardiovascular autonomic function in wheelchair-using children and adolescents with myelomeningocele.

Methods

Twenty-two participants were assigned to one of two groups: myelomeningocele group (n=11) and Control group (n=11). Heart rate variability and systolic blood pressure variability were collected in supine resting position using spectral analyses. Spontaneous baroreflex sensitivity was collected by time-domain through the sequence method.

Results

At rest, heart rate was higher in myelomeningocele group when compared to Control group (mean difference 22.1, 95% CI 4.82–39.40; p=0.01). The heart rate and systolic blood pressure variability parameters did not show differences between groups. However, myelomeningocele showed lower gain mean in baroreflex sensitivity (mean difference −4.5, 95% CI −8.47 to −0.60; p=0.02), when compared to Control.

Conclusion

Wheelchair-using children and adolescents with myelomeningocele presented differences in the autonomic cardiovascular function. This may be associated with hypomobility due to wheelchair dependence, and venous muscle pump insufficiency due to paraplegia.

Keywords:
Autonomic nervous system
Child
Meningomyelocele
Baroreflex
Neurologic gait disorders

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