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. 2017 Mar;40(2):159-169.
doi: 10.1080/10790268.2015.1135556. Epub 2016 Feb 17.

Inter-day reliability of blood pressure and cerebral blood flow velocities in persons with spinal cord injury and intact controls

Jill M Wecht  1   2   3 , Joseph P Weir  4 , William A Bauman  1   5   2   3
Affiliations

Inter-day reliability of blood pressure and cerebral blood flow velocities in persons with spinal cord injury and intact controls

Jill M Wecht et al. J Spinal Cord Med. 2017 Mar.

Abstract

Background: Due to interruption of cardiovascular autonomic control unstable blood pressure (BP) is common in individuals with spinal cord injury (SCI) above the sixth thoracic vertebral level. The impact of unstable BP on cerebral blood flow (CBF) is not well appreciated, but symptoms associated with altered cerebral perfusion are reported, which can negatively impact daily life activities.

Methods: We measured seated BP and CBF in participants with SCI and able-bodied (AB) controls on three laboratory visits to determine the inter-day reliability (intraclass correlation coefficient: ICC). BP was assessed at the finger using photoplethysmography and at the brachial artery with manual sphygmomanometry. CBF velocities (CBFv) were assessed at the middle cerebral artery using transcranial Doppler (TCD) ultrasound.

Results: Data were collected in 15 participants with chronic SCI (C3-T4) and 10 AB controls, the groups did not differ for age, height, weight or BMI; however, brachial BP (P < 0.001), finger BP (P < 0.01) and CBFv (P < 0.05) were significantly lower in the SCI group compared to the controls. The inter-day ICC for brachial BP ranged from 0.51 to 0.79, whereas the ICC for finger BP was not as high (0.17 to 0.47). The inter-day ICC for CBFv ranged from 0.45 to 0.96, indicating fair to substantial reliability.

Conclusions: These data indicate good inter-day reliability of brachial BP and TCD recording of CBFv; however, the assessment of finger BP appears to be somewhat less reliable. In addition, these data confirm reduced resting CBFv in association with hypotension in individuals with SCI compared to matched controls with low BP.

Keywords: Blood pressure; Cerebral blood flow; Paraplegia; Reliability; Tetraplegia.

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Figures

Figure 1.
Figure 1.
Depicts the mean ± SD of [A] brachial and [B] finger SBP, DBP and MAP for the AB (white bars) and SCI (black bars) groups. The main effect for group was significant; *** P < 0.001; ** P < 0.01 versus the AB group.
Figure 2.
Figure 2.
 Depicts the mean ± SD of the SFV, DFV and MFV for the AB (white bars) and SCI (black bars) groups. The main effect for group was significant; * P < 0.05; ** P < 0.01 versus the AB group.
Figure 3.
Figure 3.
Depicts inter-day (visit) variability in SBP at the brachial artery in the SCI (3A) and AB (3B) participants and at the finger in the SCI (3C) and AB (3D) participants. Data reflect the mean of two measurements taken 15 minutes apart on each study visit.
Figure 4.
Figure 4.
Depicts inter-day (visit) variability in DBP at the brachial artery in the SCI (4A) and AB (4B) participants and at the finger in the SCI (4C) and AB (4D) participants. Data reflect the mean of two measurements taken 15 minutes apart on each study visit.
Figure 5.
Figure 5.
Depicts inter-day (visit) variability in SFV, MFV and DFV in the SCI (5A, 5C, 5E) and AB (5B, 5D, 5F) participants.
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