Effects of thigh and abdominal muscles stimulation and lower limb stockings on the orthostatic hypotension responses in individuals with spinal cord injury
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Abstract
Background: No information comparing the effectiveness of thigh or abdominal muscle stimulation combined with stockings on the orthostatic hypotension responses in patients with spinal cord injury (SCI).
Objective: To compare the effects of three different interventions: lower limb stockings (LLS), thigh muscle stimulation, and a combination of the abdominal muscles stimulation and LLS on mean blood pressure (MBP) and heart rate (HR) during passive standing in patients with SCI.
Methods: A crossover design was used in this study. Thirteen patients with C3 to T1 SCI participated in the study. Participants were randomly tested during passive standing on a tilt table of the following three conditions: (1) the control (CON) using LLS (2) stimulation at the quadriceps and hamstrings (QH), and (3) stimulation at the abdominal muscle combined with LLS (Abd). The MBP and HR were measured at rest, 1 minute, every 3 minutes after tilting-up, and immediately after tilting-down. The tilting time up to 30 minutes was also recorded.
Results: Hypotension and faster HR occurred significantly after tilting-up when compared to resting in all three conditions. However, the MBP (p=0.19) and HR (p=0.43) after tilting up did not differ significantly among the three conditions. There were no significant differences in tilting time when comparing across these conditions (CON=24:06±11:13; QH=19:35±11:53; and Abd=21:08±11:48 minutes:seconds, p=0.96).
Conclusions: Stimulation only at the thigh muscles or the abdominal muscle combined with LLS, or using only LLS does not minimize cardiovascular responses during passive standing in patients with SCI.
Keywords: Blood pressure, Heart rate, Electrical stimulation, Spinal cord injury, Orthostatic hypotension
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