Spinal Cord Injuries Clinical Trial
Official title:
Risk Level Determination of Vascular Complications Due to Autonomic Dysreflexia in Spinal Cord Injured Individuals
Autonomic dysreflexia (AD) is a syndrome of unbalanced response of the sympathetic system to noxious stimuli below the level of spinal cord injury (SCI), characterized by paroxysmal hypertension. Mostly, it is combined with symptoms such as pounding headache, slowed heart rate, and upper body flushing, but it can also be asymptomatic. When resulting in hypertensive crisis, it can be life-threatening and result in seizures, cardiac arrest, retinal or subarachnoid hemorrhages, stroke, and even death. The aim of this study is to determine the risk level of vascular complications in SCI people by correlating the clinical symptoms with their individual perception during AD triggered below the level of injury.
Status | Recruiting |
Enrollment | 40 |
Est. completion date | December 31, 2023 |
Est. primary completion date | November 30, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 70 Years |
Eligibility | Inclusion Criteria: - 18 to 70 years old female and male patients - People in chronic phase (more than 12 months) after traumatic or ischemic spinal cord lesion - People with Neurological Level of Injury C3-T6 and ASIA Impairment Scale A-B according to ISNCSCI - Written informed consent Exclusion Criteria: - People with acute infection or other suddenly incurred complication |
Country | Name | City | State |
---|---|---|---|
Czechia | Department of Rehabilitation and Sports Medicine, University Hospital Motol | Prague |
Lead Sponsor | Collaborator |
---|---|
Assoc. Prof. Jiri Kriz, MD, PhD |
Czechia,
Kriz J, Andel R, Hakova R. Delayed diagnosis of an unsuspected pelvic fracture in a patient with tetraplegia. J Spinal Cord Med. 2014 Jul;37(4):425-8. doi: 10.1179/2045772313Y.0000000178. Epub 2014 Jan 3. — View Citation
Kriz J, Relichova Z. Intermittent self-catheterization in tetraplegic patients: a 6-year experience gained in the spinal cord unit in Prague. Spinal Cord. 2014 Feb;52(2):163-6. doi: 10.1038/sc.2013.154. Epub 2013 Dec 17. — View Citation
Machac S, Radvansky J, Kolar P, Kriz J. Cardiovascular response to peak voluntary exercise in males with cervical spinal cord injury. J Spinal Cord Med. 2016 Jul;39(4):412-20. doi: 10.1080/10790268.2015.1126939. Epub 2015 Dec 28. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Blood pressure monitoring | Continuous blood pressure and heart rate monitoring will be recorded using Finapres device.
The risk level will be determined according to the value of systolic blood pressure (SBP): Low risk - SBP to 150 mmHg Moderate risk - SBP 150-200 mmHg High risk - SBP above 200 mmHg |
During the intervention | |
Secondary | Dermal sweating | Wrist sweating will be monitored using a measure of dermal resistance with range 0-5 M? (difference 0,1 k?, accuracy 0,15 %) and 5-32 M? (difference 10 k?, accuracy 1 %) and sampling frequency 10 second.
Regarding the AD symptoms, level of dermal resistance decrease corresponds to increase of sweating. |
During the intervention | |
Secondary | Assessment of symptoms | Subjective individual symptoms are divided into three groups, according to their severity (minimum value: mild symptoms, maximum: strong symptoms):
Mild symptoms - shivers on the nape or on the back Moderate symptoms - sweating on the forehead, neck or upper extremities Strong symptoms - pounding headache, nausea |
During the intervention | |
Secondary | ADFSCI questionnaire | The ADFSCI (Autonomic Dysfunction Following Spinal Cord Injury) questionnaire provides information about individual symptoms of blood pressure (BP) instability. The ADFSCI is a 24-item questionnaire consisting of four parts: demographics, medication, AD, and hypotension. The AD and hypotension parts include 10 and 7 items, respectively, each using a 5-point scale to score the frequency and severity of hyper- or hypotensive symptoms with a range of 0 ~ 204 (highest BP instability) points. | During the intervention |
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