Intermittent negative pressure applied to the lower limb increases foot macrocirculatory and microcirculatory blood flow pulsatility in people with spinal cord injury

Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.

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Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084219 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4219

Author(s):

Magdalena Mackiewicz-Milewska ◽

Małgorzata Cisowska-Adamiak ◽

Katarzyna Sakwińska ◽

Iwona Szymkuć-Bukowska ◽

Iwona Głowacka-Mrotek

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Heterotopic Ossification ◽

Lower Limb ◽

Bone Fractures ◽

Lower Limbs ◽

University Hospital ◽

Pain Sensation ◽

Vein Thrombosis ◽

Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

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Cerebral Autoregulation during Postural Change in Patients with Cervical Spinal Cord Injury—A Carotid Duplex Ultrasonography Study

Diagnostics ◽

10.3390/diagnostics11081321 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1321

Author(s):

Joo-Hyun Kee ◽

Jun-Hyeong Han ◽

Chang-Won Moon ◽

Kang Hee Cho

Keyword(s):

Blood Pressure ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Blood Flow ◽

Cerebral Autoregulation ◽

Duplex Ultrasonography ◽

Postural Change ◽

Carotid Duplex ◽

Cord Injury ◽

Carotid Duplex Ultrasonography

Patients with a spinal cord injury (SCI) frequently experience sudden falls in blood pressure during postural change. Few studies have investigated whether the measurement of blood flow velocity within vessels can reflect brain perfusion during postural change. By performing carotid duplex ultrasonography (CDU), we investigated changes in cerebral blood flow (CBF) during postural changes in patients with a cervical SCI, determined the correlation of CBF change with presyncopal symptoms, and investigated factors affecting cerebral autoregulation. We reviewed the medical records of 100 patients with a cervical SCI who underwent CDU. The differences between the systolic blood pressure, diastolic blood pressure, and CBF volume in the supine posture and after 5 min at 50° tilt were evaluated. Presyncopal symptoms occurred when the blood flow volume of the internal carotid artery decreased by ≥21% after tilt. In the group that had orthostatic hypotension and severe CBF decrease during tilt, the body mass index and physical and functional scores were lower than in other groups, and the proportion of patients with a severe SCI was high. The higher the SCI severity and the lower the functional score, the higher the possibility of cerebral autoregulation failure. CBF should be assessed by conducting CDU in patients with a high-level SCI.

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The relationships among the severity of spinal cord injury, motor and somatosensory evoked potentials and spinal cord blood flow

Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section ◽

10.1016/0168-5597(89)90055-5 ◽

1989 ◽

Vol 74 (4) ◽

pp. 241-259 ◽

Cited By ~ 172

Author(s):

Michael G. Fehlings ◽

Charles H. Tator ◽

R.Dean Linden

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Blood Flow ◽

Evoked Potentials ◽

Cord Blood ◽

Somatosensory Evoked Potentials ◽

Spinal Cord Blood Flow ◽

Cord Injury

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Influence of physiotherapy on leg blood flow in patients with complete spinal cord injury lesions

Physiotherapy Theory and Practice ◽

10.3109/09593989509022406 ◽

1995 ◽

Vol 11 (2) ◽

pp. 97-107 ◽

Cited By ~ 4

Author(s):

M. Svensson ◽

A. Siösteen ◽

H. Wetterqvist ◽

L. Sullivan

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Blood Flow ◽

Leg Blood Flow ◽

Cord Injury ◽

Complete Spinal Cord Injury

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Increased vascular resistance in paralyzed legs after spinal cord injury is reversible by training

Journal of Applied Physiology ◽

10.1152/japplphysiol.00897.2001 ◽

2002 ◽

Vol 93 (6) ◽

pp. 1966-1972 ◽

Cited By ~ 64

Author(s):

Maria T. E. Hopman ◽

Jan T. Groothuis ◽

Marcel Flendrie ◽

Karin H. L. Gerrits ◽

Sibrand Houtman

Keyword(s):

Blood Pressure ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Blood Flow ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Vascular Resistance ◽

Arterial Blood Flow ◽

Arterial Blood ◽

Cord Injury

The purpose of the present study was to determine the effect of a spinal cord injury (SCI) on resting vascular resistance in paralyzed legs in humans. To accomplish this goal, we measured blood pressure and resting flow above and below the lesion (by using venous occlusion plethysmography) in 11 patients with SCI and in 10 healthy controls (C). Relative vascular resistance was calculated as mean arterial pressure in millimeters of mercury divided by the arterial blood flow in milliliters per minute per 100 milliliters of tissue. Arterial blood flow in the sympathetically deprived and paralyzed legs of SCI was significantly lower than leg blood flow in C. Because mean arterial pressure showed no differences between both groups, leg vascular resistance in SCI was significantly higher than in C. Within the SCI group, arterial blood flow was significantly higher and vascular resistance significantly lower in the arms than in the legs. To distinguish between the effect of loss of central neural control vs. deconditioning, a group of nine SCI patients was trained for 6 wk and showed a 30% increase in leg blood flow with unchanged blood pressure levels, indicating a marked reduction in vascular resistance. In conclusion, vascular resistance is increased in the paralyzed legs of individuals with SCI and is reversible by training.

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