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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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ES of the abdominal muscles | Experimental | ES with surface electrodes, fixed stimulation parameters and individual mA |
|
| ES of limbs & abdomen | Experimental | The combination of the ES of the lower limb muscles and the abdominal muscles. |
|
| ES of the limb muscles | Experimental | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ES of the abdominal muscles | Procedure | ES was applied with surface electrodes and fixed stimulation parameters with individual mA, depending on each patients´ sensibility. |
|
| Measure | Description | Time Frame |
|---|---|---|
| blood pressure [mmHg] | 1 day (single measurement at each arm ) |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | 1 day (single measurement at each arm ) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aurelio Tobon, MD | Swiss paraplegic center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Swiss Paraplegic Center | Nottwil | Canton of Lucerne | 6207 | Switzerland |
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| Label | URL |
|---|---|
| Swiss Paraplegic Centre Nottwil | View source |
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| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D007024 | Hypotension, Orthostatic |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
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| ES of the limb muscles | Procedure | 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 |
|
| ES of limbs & abdomen | Procedure | The combination of the ES of the lower limb muscles and the abdominal muscles. |
|
| D014947 | Wounds and Injuries |
| D054971 | Orthostatic Intolerance |
| D054969 | Primary Dysautonomias |
| D001342 | Autonomic Nervous System Diseases |
| D007022 | Hypotension |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |