Cardiac autonomic modulation in response to postural transition during a virtual reality task in individuals with spinal cord injury: A cross-sectional study

PLoS ONE, 2023 · DOI: https://doi.org/10.1371/journal.pone.0283820 · Published: April 13, 2023

Simple Explanation

This study investigates how virtual reality (VR) tasks affect the heart's autonomic nervous system in people with spinal cord injuries (SCI) during postural changes. Individuals with and without SCI were placed on a device that gradually moved them from sitting to standing positions while performing a cognitive VR task. The study found that VR tasks may help improve the balance between the sympathetic and parasympathetic nervous systems, potentially reducing dysautonomia during postural changes in individuals with SCI.

Study Duration

January 2019 and February 2020

Participants

76 individuals (40 with SCI, 36 able-bodied controls)

Evidence Level

Cross-sectional, quasi-experimental study

Key Findings

1
SCI group performing VR showed no significant difference in parasympathetic activation and global variability between sitting and standing positions.
2
Better sympathovagal balance was observed in both SCI and able-bodied groups performing the VR task during postural changes.
3
Individuals with SCI had lower heart rate variability (HRV) compared to able-bodied individuals in all postures.

Research Summary

The study aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition using a cognitive virtual reality (VR) task. The HRV results showed that the SCI group who performed the task in VR demonstrated no significant difference in parasympathetic activation and global variability between the sitting versus 90˚ positions. The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.

Practical Implications

Rehabilitation Strategy

VR tasks can be incorporated into physical rehabilitation programs for SCI individuals to improve autonomic nervous system activity.

Dysautonomia Management

Utilizing motor-cognitive tasks during position changes can increase sympathovagal system activity, potentially mitigating syncope risks.

Personalized Rehabilitation

VR interventions can be tailored to individual needs, increasing patient motivation and engagement in rehabilitation.

Study Limitations

1
Cross-sectional study design limits understanding of long-term effects.
2
Lack of assessment of blood pressure, respiratory rate, and perceived exertion.
3
Use of a laboratory-specific motor-cognitive task limits generalizability to other VR tasks.

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