Atypical autonomic dysreflexia during robotic-assisted body weight supported treadmill training in an individual with motor incomplete spinal cord injury

This case report describes a man with a spinal cord injury who experienced atypical autonomic dysreflexia (AD) during robotic-assisted body weight-supported treadmill training (BWSTT). AD is a condition characterized by a sudden increase in blood pressure and can be dangerous. The man had no typical symptoms of AD, such as headache or sweating, but his blood pressure rose significantly during the BWSTT sessions. This 'silent' AD was only detected through regular monitoring of his vital signs. The authors suggest that clinicians should be aware of the potential for silent AD during robotic-assisted BWSTT in individuals with motor incomplete spinal cord injury and recommend frequent vital sign assessment.

• 1
  A 41-year-old man with C6 AIS C spinal cord injury developed asymptomatic autonomic dysreflexia (AD) during robotic-assisted body weight-supported treadmill training (BWSTT).
• 2
  The patient exhibited significant increases in blood pressure during BWSTT sessions without concurrent clinical signs of AD, experiencing only exertional fatigue during one session.
• 3
  Removal from the BWSTT device resulted in a rapid return of blood pressure to normal levels, suggesting a direct relationship between the training and the AD episodes.