PLoS ONE (Jan 2023)

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

  • Denise Cardoso Ribeiro Papa,
  • Lilian Del Ciello de Menezes,
  • Íbis Ariana Peña de Moraes,
  • Ana Clara Silveira,
  • Natalia Padula,
  • Suellen de Oliveira Veronez Silva,
  • Roberta Caveiro Gaspar,
  • Eduardo Dati Dias,
  • Celso Ferreira,
  • Luciano Vieira de Araújo,
  • Todd A Astorino,
  • Helen Dawes,
  • Carlos Bandeira de Mello Monteiro,
  • Talita Dias da Silva

DOI
https://doi.org/10.1371/journal.pone.0283820
Journal volume & issue
Vol. 18, no. 4
p. e0283820

Abstract

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PurposeThe postural transition from sitting to standing is a moment of dysautonomic occurrence in individuals with Spinal Cord Injury (SCI). Different tools can be used to minimize this event, such as virtual reality. Thus, we aimed to analyze cardiac autonomic modulation in individuals with SCI during postural transition from the sitting to orthostatism position using a cognitive virtual reality (VR) task.MethodsIndividuals with and without SCI were positioned on the Easy Stand® device, sitting at rest, at 0° considering the angle between the seat and the floor, elevation at 45°, and orthostatism at 90°, for 5 minutes in each position. Heart rate variability (HRV) measures of sympathovagal balance were collected (heart rate receiver: Polar V800). The groups were subdivided into two groups, one that performed VR as an intervention during the postural angle changes and another group that did not perform VR.ResultsWe evaluated 76 individuals, 40 with a medical diagnosis of SCI and 36 who composed the able-bodied control group without SCI, matched by age and sex. 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. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90° positions.ConclusionThe use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.