Spinal Cord Injuries, Slow Breathing
Conditions
Keywords
resonance, yogic, pranayama, spinal cord injury
Brief summary
This research will aid in understanding of slow-breathing and its effect on heart rate and blood pressure in people with a spinal cord injury (SCI). This research will investigate if traditional 'yogic' breathing exercises can be performed by subjects with SCI and its influence on the cardiovascular system.
Detailed description
The relationship between respiratory patterns and cardiovascular variability in healthy persons has been previously studied. However, the impact of SCI on the interrelationships between the respiratory and cardiovascular systems remains relatively unstudied. The loss of autonomic control in SCI may mean that slow breathing has profound effects on cardiovascular variability. Hence, those with SCI may represent a population that could benefit from the potential physiologic effects of numerous yogic-based breathing patterns that can be applied anywhere any time. Hence, it is important to determine if slower breathing patterns can shift the cardiovascular control pattern to-wards important healthful effects. This physiological study will compare the effects of uncontrolled breathing and traditional yogic slow-breathing practices on cardiovascular variability in SCI patients.
Interventions
BEHAVIORALSlow Breathing
On two separate visits (on Day 1 and between Day 7 and 9 of their self-practice) the subject will be coached on yoga breathing techniques. The breathing techniques will be varied in: 1. frequency (between 0.25 and 0.1 Hz) 2. Inspiratory:Expiratory (I:E) ratio or 'Duty Cycle' 3. with and without ujjayi (yogic throat restriction) 4. with and without inspiratory/expiratory breath holding At the end of the first coaching visit the subject will be given a diary to record their own practice of the breathing techniques they were coached on.
Sponsors
Spaulding Rehabilitation Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
This study was a small prospective cohort (N = 12 out of 17 completed) study with a one-time unblinded intervention of 4 differing breathing techniques/ratios compared to spontaneous breathing. Patients will receive instruction on D1 and on D7 lasting about 45 minutes and a diary for self-practice. On D14 the participant will be asked to sequentially perform the directed breathing frequencies and ratios. The lab visit will last approximately 1.5 hours, during which beat-by-beat cardiovascular variables and breath-by-breath respiratory variables will be recorded. The total in-person time commitment (\ 4 hours) over the 14 days.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Age: 18-60 years old 2. Wheelchair user 3. Medically stable \& able to follow directions 4. Body mass index (18.5 - 35 kg/m2)
Exclusion criteria
1. BP \>140/90 mmHg 2. Current use of cardioactive medications (except medication to support blood pressure) 3. Current tobacco use 4. Significant arrhythmia 5. Coronary artery disease 6. Diabetes 7. Renal Disease 8. Cancer 9. Epilepsy or other neurological diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HRV | 7 minutes of paced or unpaced breathing | Heart rate variability assessed in the frequency domain during paced or unpaced breathing via Welch's modified periodogram method. Average power calculated by integrating the power spectral density in the low and high frequency bands. |
| BPV | 7 minutes of paced or unpaced breathing | Systolic blood pressure variability from a Finometer assessed in the frequency domain via Welch's modified periodogram method. Average power calculated by integrating the power spectral density in the low and high frequency bands. |
| SpO2 | 7 minutes of paced or unpaced breathing | Peripheral oxygen saturation during paced or unpaced breathing |
| Expired Carbon Dioxide (CO2) | 7 minutes of paced or unpaced breathing | Expired CO2 from a nasal cannula |
Countries
United States
Participant flow
Recruitment details
All participants had a spinal cord injury and were wheelchair users. After screening and signing an informed consent, participants receive instruction on how to perform the different breathing patterns (arms). After 2 instructional sessions and 2 weeks of practice on their own a study visit was scheduled. Participants completed all arms in a random order in a single study visit.
Pre-assignment details
17 individuals signed an informed consent. 12 completed a study visit. All breathing patterns/milestones were completed by the 12 individuals who completed the study.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 33.25 Years STANDARD_DEVIATION 5.97 |
| Body Mass Index | 26.2 kg/m^2 STANDARD_DEVIATION 4.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 11 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 8 Participants |
| Sex: Female, Male Female | 3 Participants |
| Sex: Female, Male Male | 9 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 17 |
| other Total, other adverse events | 0 / 17 |
| serious Total, serious adverse events | 0 / 17 |
Outcome results
None listed