AbstractBackground: Orthostatic hypotension (OH) occur early following stroke due to impaired venous return, autonomic instability and paretic limb muscles. This orthostatic hemodynamic stress further exacerbates the existing cerebral damage and delayed functional recovery. Aim: To compare effects of Pneumatic abdominal binder (PAB) and Pneumatic Calf Compression (PCC) versus Elastic Compression Bandaging (ECB) for OH during tilt table standing in patients with acute stroke. Methods: 26 (18 male, 8 female) stroke subjects (duration < 4 weeks) with OH as defined by American Academy of Neurology and American Autonomic Society were randomly assigned to receive either experimental- PAB + PCC (n=13) or control- ECB (n=13). Tilt table standing was administered for six consecutive sessions and outcomes were measured pre-post intervention. The hemodynamic responses were measured using OmronTM Digital BP apparatus. The pressure applied using PAB and PCC for the experimental group was maintained at 40 and 30 mm Hg respectively while in the control group ECB was applied to the paretic calf muscles. Primary outcome of percentage of patients who attained orthostatic stability at 600 of tilt was considered for between-group comparison using Z test and modified Rankin Functional Scale (MRS) were compared using Mann-Whitney U test using SPSS.13 Results: Comparison of percentage of subjects who had attained orthostatic stability between the groups was significant on the 3rd and 6th day with p <.05. Pre-Post median scores for MRS and LOS had no significant difference between the groups. Conclusion: Application of pneumatic abdominal binder, calf compression found to be improving orthostatic stability in acute stroke rehabilitation. Further large scale studies with long-term follow-up are warranted and necessary.
Keywords: Orthostatic Hypotension in Stroke; Tilt Table Standing; and Pneumatic Compression bandages.