Key result
Children with spastic cerebral palsy lacked the significant increase in low-frequency and decrease in high-frequency heart rate variability seen in normal children during orthostatic stress (p<0.05).
Why the study?
Does orthostatic stress elicit normal autonomic nervous system responses measured by heart rate variability in children with spastic cerebral palsy compared to normal children?
Case-Control (n=24)
Does orthostatic stress elicit normal autonomic nervous system responses measured by heart rate variability in children with spastic cerebral palsy compared to normal children?
p-value: p=< 0.05
Children with spastic cerebral palsy exhibit blunted cardiac autonomic responses, such as vagal withdrawal and sympathetic activation, during orthostatic stress.
Suggests possible autonomic differences in spastic CP; leaves open clinical relevance of tilt HRV pending confirmatory studies.
The purpose of this study was to investigate the function of the autonomic nervous system in children with spastic cerebral palsy (CP) through an analysis of heart rate variability (HRV) occurring with orthostatic stress. Twelve children with spastic CP and twelve normal children participated in this study. The echocardiogram (ECG) signals were recorded for 3 minutes in both the supine and 70 degrees C head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. Two components were measured; a low- frequency (LF) component (0.05 - 0.15 Hz) primarily reflecting sympathetic activity during orthostatic stress and a high-frequency (HF) component (0.15 - 0.4 Hz) reflecting parasympathetic activity. In the supine position, there was no significant difference between any of the HRV components of the two groups. In the head-up tilt position, absolute and normalized LF were significantly increased and absolute HF was significantly decreased in the normal children (p < 0.05), but not in the children with spastic CP. The results of this study suggest that cardiac autonomic functions, such as vagal withdrawal and sympathetic activation which occur during head-up tilt position, are not sufficient to overcome the orthostatic stress arising in spastic CP children.
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Park et al. (2002) conducted a case-control in Spastic cerebral palsy (n=24). Spastic cerebral palsy vs. Normal children was evaluated on Heart rate variability (low-frequency and high-frequency components) in supine and 70 degrees head-up tilt positions (p=< 0.05). Children with spastic cerebral palsy lacked the significant increase in low-frequency and decrease in high-frequency heart rate variability seen in normal children during orthostatic stress (p<0.05).
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