title: 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.
abstract: 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.
authors.affiliation: Neurologische Klinik Bad Aibling, Bad Aibling, Germany. Mluther@schoen-kliniken.de
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Luther
authors.forename: Carmen
authors.initials: C
authors.lastname: Krewer
authors.forename: Friedemann
authors.initials: F
authors.lastname: Müller
authors.forename: Eberhard
authors.initials: E
authors.lastname: Koenig
mesh_terms: 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