Pediatric cardio-autonomic response to variable effort after severe traumatic brain injury

Brain Inj. 2016;30(10):1239-42. doi: 10.1080/02699052.2016.1179343. Epub 2016 Jun 15.

Abstract

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.

Keywords: Heart rate variability; exercise; traumatic brain injury.

MeSH terms

  • Autonomic Nervous System / physiopathology*
  • Brain Injuries, Traumatic / physiopathology*
  • Case-Control Studies
  • Child
  • Exercise / physiology
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Rest
  • Walking