Damaged cardiovascular autonomic control in wheelchair-using children and adolescents with myelomeningocele: a case-control study

Background: Cardiovascular autonomic dysfunction is associated with the development of cardiovascular diseases, but little is known about it in children and adolescents with myelomeningocele. Objective: This study investigated the cardiovascular autonomic function in wheelchair-using children and adolescents with myelomeningocele. Methods: Twenty-two participants were assigned to one of two groups: myelomeningocele group (n=11) and Control group (n = 11). Heart rate variability and systolic blood pressure variability were collected in supine resting position using spectral analyses. Spontaneous baroreflex sensitivity was collected by time-domain through the sequence method. Results: At rest, heart rate was higher in myelomeningocele group when compared to Control group (mean difference 22.1, 95% CI 4.82-39.40; p=0.01). The heart rate and systolic blood pressure variability parameters did not show differences between groups. However, myelomeningocele showed lower gain mean in baroreflex sensitivity (mean difference -4.5, 95% CI -8.47 to -0.60; p =0.02), when compared to Control. Conclusion: Wheelchair-using children and adolescents with myelomeningocele presented differences in the autonomic cardiovascular function. This may be associated with hypomobility due to wheelchair dependence, and venous muscle pump insufficiency due to paraplegia. (C) 2018 Associacao Brasiteira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved. (AU)