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Reactive Hyperemia Response to Pressure-Induced Localized Ischemia in Patients with Multiple Sclerosis

Center for Rehabilitation Technology, Helen Hayes Hospital

Martin Ferguson-Pell

Center for Rehabilitation Technology, Helen Hayes Hospital

Joseph Herbert

Multiple Sclerosis Center, Helen Hayes Hospital, Route 9W, West Haverstraw, New York 10993

Multiple sclerosis (MS) causes severe disability in adults. One of the secondary complications during the course of their illness is the development of pressure sores. This study sought to determine the postischemic response in the skin microcirculation of patients with MS, compared with able-bodied (AB) subjects, with the view to identifying differences that could be linked to their increased risk for pressure sores.

The reactive hyperemia response following five minutes of indentation with a pressure of 150 mmHg was monitored in nine MS patients (EDSS > 7.0) and nine age-and sex-matched AB subjects. The skin blood content and oxygenation during the reactive hyperemia response was measured using reflectance spectrophotometry. This technique is noninvasive, quantifiable for skin redness, and effective for pigmented skin.

A slower rate of increase in blood content following load release, a faster decay in blood content after the peak response, a smaller total reactive hyperemia response and slower rate of reflow following momentary blanching occur in MS patients compared to AB controls. These changes may be a consequence of reduced vascular reactivity due to impaired autonomic control in the skin of patients with multiple sclerosis. Such changes could be important in influencing tissue tolerance to prolonged pressure.

Key Words: Multiple sclerosis • Pressure sores • Skin • Reactive hyperemia • Reflectance spectrophotometry.

Neurorehabilitation and Neural Repair, Vol. 8, No. 4, 193-201 (1994)
DOI: 10.1177/136140969400800404


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