Orthostatic Hypotension Clinical Trial
Official title:
Transcranial Electrical Stimulation for Management of Orthostatic Instability in Acute Cervical Spinal Cord Injury
Individuals with acute cervical spinal cord injury (SCI) can suffer from an excessive and
prolonged fall in blood pressure when assuming an upright position, such as transitioning
from lying to sitting or standing, a condition also known as orthostatic hypotension (OH).
Due to a decrease in cerebral oxygenation, affected individuals can develop debilitating
symptoms including lightheadedness, blurred vision, fatigue and even loss of consciousness.
Recent evidence suggests that OH has a negative impact on cognition in individuals with SCI.
Clinical observations suggest that OH can lead to neurological deterioration in individuals
who may otherwise have a stable SCI. The presence of symptomatic OH prevented participation
in 43% of physical therapy treatment sessions in a study of individuals with acute SCI
despite the use of current treatment options. OH is known to adversely affect health, delay
rehabilitation and prolong hospitalization in the acute phase of management of individuals
who display it. Our team found OH was present in 41 of 55 (75%) patients with acute cervical
SCI at our center in 2004.
We plan to research the efficacy of a low-cost, non-invasive device known as transcranial
electrical stimulation (TES) to manage OH in individuals with acute cervical SCI. Previous
studies have shown that this device is safe to use in individuals with SCI, and has improved
blood pressure control in non-SCI individuals.
We hypothesize that in individuals with acute cervical SCI and OH, TES intervention will
elicit an attenuation of the drop in systolic BP (SBP)in response to orthostatic stress.
TES-induced differences will be most pronounced in those individuals with sparing of spinal
autonomic pathways
n/a
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