Moineau Bastien, Brown Andrea, Brisbois Louise, Zivanovic Vera, Miyatani Masae, Kapadia Naaz, Hsieh Jane T C, Popovic Milos R
KITE, Toronto Rehabilitation Institute - University Health Network , Toronto , Ontario , Canada.
Rehabilitation Sciences Institute, University of Toronto , Toronto , Ontario , Canada.
J Spinal Cord Med. 2019 Oct;42(sup1):176-185. doi: 10.1080/10790268.2019.1638129.
: Following spinal cord injury (SCI) at the cervical or upper-thoracic level, orthostatic hypotension (OH) is observed in 13-100% of patients. This study aimed to test the feasibility of conducting a randomized controlled trial combining a dynamic tilt-table (Erigo) and functional electrical stimulation (FES) to mitigate OH symptoms in the subacute phase after SCI. : Pilot study. : A tertiary rehabilitation hospital. : Inpatients who had a C4-T6 SCI (AIS A-D) less than 12 weeks before recruitment, and reported symptoms of OH in their medical chart. : Screening sit-up test to determine eligibility, then 1 assessment session and 3 intervention sessions with Erigo and FES for eligible participants. : Recruitment rate, duration of assessment and interventions, resources used, blood pressure, and Calgary Presyncope Form (OH symptoms). : Amongst the 232 admissions, 148 inpatient charts were reviewed, 11 inpatients met all inclusion criteria, 7 participated in a screening sit-up test, and 2 exhibited OH. Neither of the two participants recruited in the pilot study was able to fully complete the assessment and intervention sessions due to scheduling issues (i.e. limited available time). : This pilot study evidenced the non-feasibility of the clinical trial as originally designed, due to the low recruitment rate and the lack of available time for research in participant's weekday schedule. OH in the subacute phase after SCI was less prevalent and less incapacitating than expected. Conventional management and spontaneous resolution of symptoms appeared sufficient to mitigate OH in most patients with subacute SCI.
在颈髓或胸髓上段损伤(SCI)后,13%-100%的患者会出现体位性低血压(OH)。本研究旨在测试将动态倾斜台(Erigo)和功能性电刺激(FES)相结合进行随机对照试验以减轻SCI亚急性期OH症状的可行性。:初步研究。:一家三级康复医院。:招募前不到12周发生C4-T6 SCI(美国脊髓损伤协会损伤分级A-D级)且病历中有OH症状报告的住院患者。:进行仰卧起坐筛查试验以确定入选资格,然后对符合条件的参与者进行1次评估 session和3次使用Erigo及FES的干预session。:招募率、评估和干预的持续时间、使用的资源、血压以及卡尔加里晕厥前状态量表(OH症状)。:在232例入院患者中,查阅了148份住院病历,11例住院患者符合所有纳入标准,7例参与了仰卧起坐筛查试验,2例表现出OH。由于日程安排问题(即可用时间有限),初步研究中招募的两名参与者均未能完全完成评估和干预session。:由于招募率低且参与者工作日程中缺乏研究可用时间,本初步研究证明了原设计的临床试验不可行。SCI亚急性期的OH比预期的更不常见且致残性更低。在大多数亚急性SCI患者中,常规管理和症状的自发缓解似乎足以减轻OH。