Changes in the cardiac autonomic control system during rehabilitation in children after severe traumatic brain injury

Gilad Sorek, Isabelle Gagnon, Kathryn Schneider, Mathilde Chevignard, Nurit Stern, Yahaloma Fadida, Liran Kalderon, Sharon Shaklai, Michal Katz-Leurer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: One of the sequalae of severe traumatic brain injury (TBI) in children is impaired function of the cardiac autonomic control system (CACS) at rest. The CACS response to conventional autonomic tests is little known. Objective: To examine the CACS response to conventional autonomic tests in children after severe TBI during the rehabilitation period and to compare with typically developing (TD) children. Methods: This study combined a case-control and follow-up design. The severe TBI group (cases) consisted of 33 children aged 9–18 years, 14–142 days after severe TBI who were followed for 8 weeks during rehabilitation. The control group consisted of 19 TD children matched for age and sex. Heart rate (HR) and heart rate variability (HRV) were evaluated with the Polar RS800CX device at rest (sitting), during a handgrip test and during a paced breathing test. Results: At the first assessment, we found lower HRV values at rest and a lower HRV response during the paced breathing and handgrip tests in the TBI group than the TD group (p<0.01). After 8 weeks, HRV values did not change at rest in the TBI group, but the response to the autonomic tests improved significantly, with increased HRV values in response to the paced breathing test (p<0.01) and the handgrip test (p = 0.01). Conclusions: After severe TBI, children exhibited an impaired CACS response to autonomic tests, with parasympathetic suppression and sympathetic arousal. After 8 weeks of rehabilitation, CACS function recovered partially and the response to the autonomic tests improved with no change in CACS function at rest.

Original languageEnglish
Article number101652
JournalAnnals of Physical and Rehabilitation Medicine
Volume66
Issue number2
DOIs
StatePublished - Mar 2023

Funding

FundersFunder number
Network of European Funding for Neuroscience Research13897
Ministry of Health, State of Israel

    Keywords

    • Cardiac autonomic control system
    • Children and adolescents
    • Handgrip test
    • Paced breathing test
    • Traumatic brain injury

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