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Functional electrical stimulation effect on orthostatic hypotension after spinal cord injury
E E Sampson1, R S Burnham, B J Andrews
1Division of Physical Medicine & Rehabilitation, Faculty of Medicine, University of Alberta, Edmonton, Canada.
Objective:
To investigate the possibility of using functional electrical stimulation (FES) to control orthostatic hypotension in patients with spinal cord injury (SCI) and to clarify the mechanism of the response.
Design:
Subjects were tilted by 10 degree increments with varying intensities of lower-extremity FES. Stimulation over muscles was compared to stimulation over noncontractile sites.
Setting:
Physical therapy department of a major rehabilitation center.
Patients:
Six patients with SCI above T6 (3 with recent injury recruited consecutively from an inpatient spinal cord rehabilitation unit, and 3 from the community with longstanding injury, recruited as volunteers).
Main Outcome Measures:
Blood pressure, heart rate, and perceived presyncope score recorded at each tilt angle and analyzed using a multivariate analysis of variance statistical methodology.
Results:
Systolic and diastolic blood pressure increased with increasing stimulation intensities (systolic, p = .001; diastolic, p = .0019) and decreased with increasing angle of tilt (p < .001) regardless of the site of stimulation. Subjects tolerated higher angles of incline with electrical stimulation than without (p = .03).
Conclusions:
FES causes a dose-dependent increase in blood pressure independent of stimulation site that may be useful in treating orthostatic hypotension.