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Pediatric cardio-autonomic response to variable effort after severe traumatic brain injury
Michal Katz-Leurer1,2, Hemda Rotem2, Maayan Shofer2
1a Sackler Faculty of Medicine, School of Health Professions, Physical Therapy Department , Tel-Aviv University , Israel.
Insights
Children with severe traumatic brain injury (TBI) show less efficient cardiac autonomic function at rest and during exercise compared to typically developing peers. This impacts their heart rate and heart rate variability responses.
Area of Science:
- Pediatric neurology
- Cardiovascular autonomic function
- Neurorehabilitation
Background:
- Severe traumatic brain injury (TBI) in children can lead to long-term neurological deficits.
- Cardiac autonomic nervous system (CANS) function is crucial for physiological regulation.
- Limited research exists on CANS function in children during the chronic phase post-TBI.
Purpose of the Study:
- To evaluate resting, exercise, and recovery heart rate (HR) and heart rate variability (HRV) in children with chronic severe TBI.
- To compare HR and HRV parameters between children post-TBI and age-matched typically developed (TD) controls.
Main Methods:
- Participants included 10 children (7-11 years) 3-5 years post-severe TBI and 20 TD controls.
- HR and HRV were measured at rest, during a 3-minute step test, and a 6-minute treadmill walk.
- Measurements were also taken during post-exercise recovery periods.
Main Results:
- Children post-TBI exhibited higher resting mean HR and lower resting HRV than controls (p < 0.05).
- Both groups showed increased HR and decreased HRV during exercise.
- Children post-TBI displayed significantly blunted HR and HRV responses to exercise and recovery cessation compared to controls (p < 0.01).
Conclusions:
- The cardiac autonomic system in children with chronic severe TBI is less efficient at rest.
- Children post-TBI demonstrate reduced autonomic adaptability to physical exertion.
- Findings suggest impaired autonomic regulation following severe TBI in pediatric populations.
Aim:
To assess heart rate (HR) and heart rate variability (HRV) at rest, during exercise and during the recovery phase post-exercise in children at the chronic phase post-severe TBI as compared to age-matched typically-developed (TD) controls.
Setting:
Out-patient clinic.
Participants:
Ten children (two girls, eight boys), 3-5 years post-severe TBI, aged 7-11 years with residual deficits and 20 TD children matched for age.
Interventions:
HR and HRV were determined at rest, during step test for 3 minutes, during walking on a treadmill for 6 minutes and during the recovery periods post-exercise sessions.
Main Outcome Measures:
HR and HRV parameters.
Results:
Children post-TBI demonstrated higher mean HR values and lower HRV at rest compared to controls (p < 0.05). During exercise a significant increase in HR and significant decrease in HRV was noted in both groups. A significant interaction was noted (p < 0.01); HR and HRV parameters in response to exercise and to exercise cessation were significantly lower among children post-TBI as compared to the controls.
Conclusions:
The findings of this study show that, in children, post-severe TBI at the chronic phase, the cardiac autonomic system is less efficient at rest and less adaptive to exercise and activity as compared to TD children.
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