Orthostatic Hypotension, Spinal Cord Injury
Conditions
Keywords
electric stimulation, tilt-table
Brief summary
Background: The presence of orthostatic hypotension (OH) as a consequence of blood volume redistribution during verticalisation in persons with spinal cord injury (SCI) is a common condition. Aims: To investigate the impact of three different types of electric stimulation (ES) (ES of the abdominal muscles versus ES of lower limb muscles versus simultaneously ES of abdominal and lower limb muscles versus control) on blood pressure stabilization and verticalisation-degrees between 0° and 70°. The hypothesis is, that the ES-induced contractions of the muscles cause a stabilisation respectively an increase of the blood pressure during the tilt-table test. Subjects: 20 Women and men, at least 18 years of age, following an acute and traumatic SCI, with a lesion level above T6, an American Spinal Injury Association (AIS) Impairment Scale A,B or C and a diagnosis of OH (by tilt table test) were eligible for the study. Methods: Each patient underwent randomly three different types of ES sessions while being positioned on a tilt-table. The following sessions were planned: A) ES of the abdominal muscles B) ES of the lower limb muscles C) Combination of A and B D) Control session (=diagnostic session) Study type: Intervention Design: Prospective interventional study
Interventions
PROCEDUREES of the abdominal muscles
ES was applied with surface electrodes and fixed stimulation parameters with individual mA, depending on each patients´ sensibility.
PROCEDUREES of the limb muscles
Lower limb muscles were stimulated to produce a milking mechanism from the distal to proximal part of the limb to pump the venous blood from the peripheral to the central part of the body
PROCEDUREES of limbs & abdomen
The combination of the ES of the lower limb muscles and the abdominal muscles.
Sponsors
Swiss Paraplegic Research, Nottwil
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* inpatients * positive diagnosis of OH * acute traumatic SCI * lesion level above T6 * AIS A, B or C
Exclusion criteria
* fractures of the lower limbs * decubitus (NPUAP \>2) * massive psychiatric dysfunction * suicide intention
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| blood pressure [mmHg] | 1 day (single measurement at each arm ) |
Secondary
| Measure | Time frame |
|---|---|
| Heart rate | 1 day (single measurement at each arm ) |
Countries
Switzerland
Outcome results
None listed