The effect of autonomic nervous system dysfunction on oxygen consumption during daily living activities in patients with spinal cord injury

Study design: Case-control study. Objectives: To investigate the level of autonomic nervous system dysfunction in patients with spinal cord injury and to determine its effect on the basal metabolic rate and oxygen consumption during daily living activities. Setting: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. Methods: Thirty-six patients with chronic spinal cord injury (SCI) were allocated into two groups according to the presence of autonomic nervous system dysfunction. Autonomic nervous system dysfunction was investigated with the measurements of blood pressure and heart rate during urodynamic examination and several provocative maneuvers (standing at tilt table, forcing deep respiration and Valsalva). Groups were compared in terms of the basal metabolic rate and oxygen consumption during daily living activities. Measurement of the basal metabolic rate was determined by indirect calorimetry under standardized conditions. Total body fat mass and lean tissue mass were measured in all participants using dual-energy X-ray absorptiometry by standard methods. Telemetric intrapulmonary gas exchange analyzer was used to measure oxygen consumption during daily living activities. Results: There was no statistically significant difference between the groups in age, time since injury, body mass lean and fat rates, or sensory and motor scores (P>0.05). Basal metabolic rates and oxygen consumption during daily living activities were not different between the groups (P>0.05). Conclusions: These results suggest that the presence of autonomic dysfunction does not change oxygen consumption at rest and during daily living activities.