Comparison of orthostatic reactions of patients still unconscious within the first three months of brain injury on a tilt table with and without integrated stepping. A prospective, randomized crossover pilot trial.
OBJECTIVE
To determine whether passive leg movement during tilt table mobilization reduces the incidence of orthostatic dysfunction in mobilization of patients being comatose or semi-comatose early after brain injury.


METHODS
Randomized crossover pilot trial using sequential testing.


METHODS
Neurorehabilitation hospital.


METHODS
Nine patients still unconscious within the first three months of brain injury (5 men, 4 women; age 51 +/- 20 years).


METHODS
Patients were subjected once to a conventional tilt table and once to a tilt table with an integrated stepping device.


METHODS
The number of syncopes/presyncopes (orthostatic hypotension, tachypnoea, increased sweating) during interventions.


RESULTS
One patient had presyncopes on both devices, six patients had presyncopes on the conventional tilt table but not on the tilt table with integrated stepping, and two patients did not exhibit presyncopal symptoms on either device. There were significantly more incidents on the tilt table without than on the one with an integrated stepping device (P < 0.05) at tilts of 50 or 70 degrees respectively.


CONCLUSIONS
Patients tolerate greater degrees of head-up tilt better with simultaneous leg movement.
Luther
Marianne S
MS
Neurologische Klinik Bad Aibling, Bad Aibling, Germany. Mluther@schoen-kliniken.de
Krewer
Carmen
C
Müller
Friedemann
F
Koenig
Eberhard
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D020207:Coma, Post-Head Injury / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects; D011187:Posture; D011446:Prospective Studies; D055815:Young Adult