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

Purpose The 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. Methods Individuals with and without SCI were positioned on the Easy Stand (R) device, sitting at rest, at 0 degrees considering the angle between the seat and the floor, elevation at 45 degrees, and orthostatism at 90 degrees, 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. Results We 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 degrees positions. There was better sympathovagal balance in SCI and able-bodied control groups who performed the VR task between the sitting versus 90 degrees positions. Conclusion The use of a VR task seems to contribute to better sympathovagal balance, with the potential to reduce dysautonomia during postural changes.