Abstract
Kirshblum SC, House JG, O'Connor KC. Silent autonomic dysreflexia during a routine bowel program in persons with traumatic spinal cord injury: a preliminary study. Arch Phys Med Rehabil 2002;83:1774-6. Objective: To determine the existence and frequency of silent autonomic dysreflexia in subjects with a complete spinal cord injury (SCI) above the neurologic level of T6. Design: Prospective design. Setting: Blood pressure monitoring of subjects during a routine bowel program. Participants: Ten subjects with chronic (>1y), complete (American Spinal Injury Association Impairment Scale class A) SCI with a neurologic level of injury above T6. Interventions: Not applicable. Main Outcome Measures: An increase in systolic blood pressure (SBP) of greater than 20 to 40mmHg above baseline or an SBP greater than 150mmHg. Results: The mean resting blood pressure for the subject group was 104/65mmHg. During the bowel program, no subject reported experiencing any of the classic symptoms of autonomic dysreflexia. The mean maximum blood pressure recorded during the bowel program was 160/90mmHg. All of the patients had an increase in SBP greater than 20mmHg above baseline, and 70% had an increase in SBP greater than 40mmHg above baseline. Sixty percent of subjects had an increase in SBP greater than 150mmHg, with 40% of subjects reaching an SBP greater than 170mmHg at least once during their bowel program. Conclusion: Silent autonomic dysreflexia occurs frequently in SCI during bowel programs. Further study is recommended to determine whether preventative measures or treatment is needed. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
Published Version
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