Document Detail

The Effects of Patient-Controlled Abdominal Compression on Standing Systolic Blood Pressure in Adults with Orthostatic Hypotension.
MedLine Citation:
PMID:  25448247     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To assess the effects patient-controlled abdominal compression on the postural changes in systolic blood pressure (SBP) associated with orthostatic hypotension (OH). Secondary variables included subject assessments of their preferences and the ease-of-use.
DESIGN: A randomized cross-over trial.
SETTING: An Autonomic Research Laboratory.
PARTICIPANTS: Thirteen adults with neurogenic OH.
MAIN OUTCOME MEASURES.: Primary outcome variable: postural changes in SBP. Secondary outcome variables included subject assessments of their preferences and ease-of-use.
INTERVENTION.: Four maneuvers were performed: 1) moving from supine to standing without abdominal compression; 2) moving from supine to standing with either a conventional or an adjustable abdominal binder in place; 3) application of subject-determined maximal tolerable abdominal compression while standing; and 4) subsequent reduction while still erect of abdominal compression to a level the subject believed would be tolerable for a prolonged period.
RESULTS: Baseline median SBPs in the supine position were not affected by mild (10 mmHg) abdominal compression prior to rising (146 (Inter-quartile Range, 124-164) mmHg without abdominal compression; 145 (129-167) mmHg with the conventional binder and 153 (129-160) mmHg with the adjustable binder. (P=0.85). Standing without a binder was associated with -57 (-40 to -76) mmHg SBP decrease. Ten (10) mmHg levels of compression applied prior to rising with the conventional and adjustable binders blunted these drops to -50 (-33 to -70) P=0.03 and -46 (-34 to -75) mmHg; P=0.01) respectively. Increasing compression to subject-selected maximal tolerance while standing did not provide additional benefit and was associated with drops of -53 (-26 to -71); P=0.64) and -59 (-49 to -76) mmHg; P=0.52 for the conventional and adjustable binders respectively. Subsequent reduction of compression to more tolerable levels tended to worsen OH with both the conventional -61 (-33 to -80) mmHg; P=0.64 and adjustable -67 (-61 to -84) mmHg; P=0.79 binders. Subjects reported no differences in preferences between the binders in terms of preference or ease-of-use.
CONCLUSION: These results suggest that mild (10 mmHg) abdominal compression prior to rising can ameliorate OH but further compression once standing does not result in additional benefit.
Juan J Figueroa; Wolfgang Singer; Paola Sandroni; David M Sletten; Tonette L Gehrking; Jade A Gehrking; Phillip Low; Jeffrey R Basford
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-6
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  -     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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