Test-retest reliability of the Valsalva maneuver in spinal cord injury

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Spinal cord injury (n=14). Intervention: Valsalva maneuver. Primary outcome: Reproducibility of qualitative waveform analysis.

Q: What does this research mean for the field?

Qualitative waveform analysis and quantitative parameters derived from the Valsalva maneuver are reliable and reproducible, supporting their use in assessing autonomic functions in patients with spinal cord injury. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.ESTABLISHES_NEW_DIRECTION.

Michael Berger; Tristan W. Dorey; Hirmand Nouraei; Andrei V. Krassioukov

doi:10.1080/10790268.2020.1798134

August 14, 2020Journal of Spinal Cord MedicineOpen Access

Test-retest reliability of the Valsalva maneuver in spinal cord injury

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Key result

Qualitative waveform analysis of the Valsalva maneuver was reproducible in 12 of 14 participants with spinal cord injury, supporting its use for assessing autonomic functions.

Study Design

Type

Observational (n=14)

Structured PICO

P

Population

14 individuals with recent (within 3-6 months) traumatic cervical spinal cord injury (C3-C8 neurological level), mean age 41.9 ± 15.5 years, 13 males and 1 female, from a single tertiary rehabilitation center. Excluded: tracheostomy, history of cardiopulmonary disease, severe cognitive dysfunction, or any unstable medical or psychiatric condition.

I

Intervention

Valsalva maneuver (VM) consisting of a 15-second forced expiration maintaining a target pressure of 40 mm Hg, performed at least twice per session across two testing sessions.

O

Outcome

Test-retest reliability of quantitative baroreflex sensitivity (BRS) parameters (Valsalva ratio [VR], pressure recovery time [PRT], vagal baroreflex sensitivity [BRSv], adrenergic baroreflex sensitivity [BRSa1], and total recovery [TR]) assessed by intra-class correlation coefficient (ICC), and qualitative reproducibility (V, N, or M pattern).surrogate

Limitations

Relatively small sample size
Sample reflects the responses of only those with cervical level injuries
Heavily biased toward male sex
VM depends extensively on the amount of effort the participant puts into forced expiration
Trial chosen for analysis was at the discretion of a single author (no interrater reliability tested)
Participants completed testing before medication administration

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Implication

The Valsalva maneuver provides reliable quantitative parameters (Valsalva ratio and Total Recovery) for the non-invasive assessment of cardiovagal and sympathetic adrenergic function in patients with cervical spinal cord injury.

Abstract

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Cite This Study

Berger et al. (2020) conducted an observational in Spinal cord injury (n=14). Valsalva maneuver was evaluated on Reproducibility of qualitative waveform analysis. Qualitative waveform analysis of the Valsalva maneuver was reproducible in 12 of 14 participants with spinal cord injury, supporting its use for assessing autonomic functions.

synapsesocial.com/papers/6a1b0b665aeb978a24c20eab https://doi.org/10.1080/10790268.2020.1798134

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Test-retest reliability of the Valsalva maneuver in spinal cord injury

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Test-retest reliability of the Valsalva maneuver in spinal cord injury

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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