Cardiovascular response to functional electrical stimulation and dynamic tilt table therapy to improve orthostatic tolerance

Chi, Lorne; Masani, Kei; Miyatani, Masae; Thrasher, T. Adam; Johnston, K.Wayne; Mardimae, Alexandra; Kessler, C.; Fisher, Joseph A.; Popović, Miloš R.

doi:10.1016/j.jelekin.2008.08.007

Cited by 27 publications

(28 citation statements)

References 33 publications

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“…These subjects would be considered to be early-stage rather than acute patients. In agreement with previous studies [26][27], head-up tilt was well tolerated during the experiments, with no instances of presyncope or syncope occurring. Some patients, particularly those with inhibited motor function and compromised vasomotor control, would be considered to be at a high risk of orthostatic instability.…”

Section: Discussionsupporting

confidence: 91%

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Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Craven¹,

Gollee²,

Coupaud³

et al. 2013

JRRD

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Abstract-Damage to the spinal cord compromises motor function and sensation below the level of injury, resulting in paralysis and progressive secondary health complications. Inactivity and reduced energy requirements result in reduced cardiopulmonary fitness and an increased risk of coronary heart disease and cardiovascular complications. These risks may be minimized through regular physical activity. It is proposed that such activity should begin at the earliest possible time point after injury, before extensive neuromuscular degeneration has occurred. Robotic-assisted tilt-table therapy may be used during early-stage spinal cord injury (SCI) to facilitate stepping training, before orthostatic stability has been achieved. This study investigates whether such a stimulus may be used to maintain pulmonary and coronary health by describing the acute responses of patients with early-stage (<1 yr) motor-complete SCI (cSCI) and motor-incomplete SCI (iSCI) to passive, active, and electrically stimulated robotic-assisted stepping. Active participation was found to elicit an increased response from iSCI patients. The addition of electrical stimulation did not consistently elicit further increases. Extensive muscle atrophy was found to have occurred in those patients with cSCI, thereby limiting the potential effectiveness of electrical stimulation. Active participation in robotic-assisted tilttable therapy may be used to improve cardiopulmonary fitness in iSCI patients if implemented as part of a regular training program.

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Section: Discussionsupporting

confidence: 91%

“…In both instances, orthostatic instability is counteracted by increased peripheral resistance to the gravitational pooling of blood. A study investigating RATTT augmented by FES concluded that the combination of these therapies was more effective in improving orthostatic tolerance than either intervention individually [26][27].…”

Section: Introductionmentioning

confidence: 99%

Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Craven¹,

Gollee²,

Coupaud³

et al. 2013

JRRD

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“…SCI subjects, in acute stages, are disposed to orthostatic hypotension occurrences while transferred from a horizontal to an upright position due to the lack of sympathetic activity and also leg muscle contractions that finally lead to delay in starting the functional gait training [18,19].…”

Section: Early Gait Rehabilitation Interventions After Spinal Cord Inmentioning

confidence: 99%

“…Therefore, for overcoming of such limitations a novel, robotic tilt table so-called Erigo was designed and developed, which offered a locomotion therapy at a very early stage of rehabilitation. These types of approaches through utilizing a safe mobilization and intensive sensorimotor stimulation, ambulates the lower extremity, and suggests a wide range of positive impacts and functions to enhance early rehabilitation of SCI patients [18][19][20].…”

Section: Early Gait Rehabilitation Interventions After Spinal Cord Inmentioning

confidence: 99%

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Arazpour¹,

Sharifi²,

Mousavi³

et al. 2018

Essentials of Spinal Cord Injury Medicine

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Gait training has an important role in rehabilitation of standing and walking in spinal cord injury (SCI) patients. There were different types of gait training in these subjects.Both the body weight support treadmill training and robotic-assisted and robotic exoskeleton are effective and secure methods for gait training and improving the energy demand and metabolic cost in SCI patients in different level of injury. The powered exoskeletons can provide patients with SCI the ability to walk with the lowest energy consumption.The powered exoskeleton's energy consumption and speed of walking depend on the training duration. Based on different types of gait training methods, training time, and other affected parameters, the aim of this chapter was to evaluate the role of gait training in recovery of standing and walking in SCI patients.

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“…12 Previous investigations have also shown that HR increased when ES was applied to persons with SCI, 13 including during head-up tilt with concomitant ES. 8,9,14 From a survey of the literature, the authors were unable to document a previous study that investigated the outcomes of ES therapy as a weekly training regimen in managing OH in sub-acute SCI patients, especially for maintaining their BP and the HR during orthostatic challenge. This study was a pilot investigation to explore responses to regular ES therapy before undertaking a larger trial.…”

Section: Introductionmentioning

confidence: 99%

Electrical stimulation-evoked contractions blunt orthostatic hypotension in sub-acute spinal cord-injured individuals: two clinical case studies

et al. 2014

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Study design: Prospective study of two cases. Objectives: To describe the effects of electrical stimulation (ES) therapy in the 4-week management of two sub-acute spinal cordinjured (SCI) individuals (C7 American Spinal Injury Association Impairment Scale (AIS) B and T9 AIS (B)). Setting: University Malaya Medical Centre, Kuala Lumpur, Malaysia. Methods: A diagnostic tilt-table test was conducted to confirm the presence of orthostatic hypotension (OH) based on the current clinical definitions. Following initial assessment, subjects underwent 4 weeks of ES therapy 4 times weekly for 1 h per day. Post-tests tilt table challenge, both with and without ES on their rectus abdominis, quadriceps, hamstrings and gastrocnemius muscles, was conducted at the end of the study (week 5). Subjects' blood pressures (BP) and heart rates (HR) were recorded every minute during pretest and post-tests. Orthostatic symptoms, as well as the maximum tolerance time that the subjects could withstand head up tilt at 60°, were recorded.

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Cardiovascular response to functional electrical stimulation and dynamic tilt table therapy to improve orthostatic tolerance

Cited by 27 publications

References 33 publications

Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Electrical stimulation-evoked contractions blunt orthostatic hypotension in sub-acute spinal cord-injured individuals: two clinical case studies

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