Cardiac autonomic modulation in response to postural transition during a virtual reality task in individuals with spinal cord injury: A cross-sectional study

• Published in: PloS one 2023-04, Vol.18 (4), p.e0283820-e0283820
• Main Authors: Papa, Denise Cardoso Ribeiro, Menezes, Lilian Del Ciello de, Moraes, Íbis Ariana Peña de, Silveira, Ana Clara, Padula, Natalia, Silva, Suellen de Oliveira Veronez, Gaspar, Roberta Caveiro, Dias, Eduardo Dati, Ferreira, Celso, Araújo, Luciano Vieira de, Astorino, Todd A, Dawes, Helen, Monteiro, Carlos Bandeira de Mello, Silva, Talita Dias da
• Format: Article
• Language: English
• Subjects: Adaptation; Analysis; Autonomic Nervous System; Balance; Biology and Life Sciences; Care and treatment; Cognitive ability; Computer and Information Sciences; Computer applications; Cross-Sectional Studies; Diagnosis; Disability; Dysautonomia; Engineering and Technology; Evaluation; Exercise; Group dynamics; Heart; Heart beat; Heart rate; Humans; Intervention; Medicine and Health Sciences; Modulation; Nervous system; Parasympathetic nervous system; Position measurement; Postural Balance - physiology; Posture; Primary Dysautonomias; Rehabilitation; Sitting Position; Spinal cord; Spinal Cord Injuries; Spinal cord injury; Spinal injuries; Variability; Virtual reality
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0283820

The postural transition from sitting to standing is a moment of dysautonomic occurrence in individuals with Spinal Cord Injury (SCI). Different tools can be used to minimize this event, such as virtual reality. Thus, we aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition from the sitting to orthostatism position using a cognitive virtual reality (VR) task. Individuals with and without SCI were positioned on the Easy Stand® device, sitting at rest, at 0° considering the angle between the seat and the floor, elevation at 45°, and orthostatism at 90°, for 5 minutes in each position. Heart rate variability (HRV) measures of sympathovagal balance were collected (heart rate receiver: Polar V800). The groups were subdivided into two groups, one that performed VR as an intervention during the postural angle changes and another group that did not perform VR. We evaluated 76 individuals, 40 with a medical diagnosis of SCI and 36 who composed the able-bodied control group without SCI, matched by age and sex. The HRV results showed that the SCI group who performed the task in VR demonstrated no significant difference in parasympathetic activation and global variability between the sitting versus 90° positions. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90° positions. The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.