Vascular health toolbox for spinal cord injury: Recommendations for clinical practice

Over the last half century, the life expectancy for persons with spinal cord injury has increased drastically. Associated with the increased life expectancy, renal, metabolic and respiratory complications have given way to cardiovascular disease as the leading cause of death. Therefore, it is imperative that clinicians have at their disposal non-invasive and practical techniques for tracking cardiovascular disease risk amongst individual patients. This review provides an overview of non-invasive, widely available, and relatively inexpensive technologies for assessing cardiovascular health in persons with spinal cord injury. These technologies include ultrasound, pulse wave velocity and pulse wave analysis. A number of assessments can be conducted using these technologies, which confer acceptable reliability and validity, and are relatively simple to administer. Assessment recommendations for use in clinical practice are provided, and there is sufficient evidence to encourage the use of these techniques as a component of routine serial assessments.