Orthostatic hypotension following spinal cord injury: impact on the use of standing apparatus.
BACKGROUND
Upright posture confers numerous medical and social benefits to a spinal cord injured (SCI) patient. Doing so is limited by symptoms of orthostatic hypotension. This is a common secondary impairment among tetraplegic sufferers.


OBJECTIVE
Establish the proportion of SCI patients who are restricted from using standing apparatus, such as standing frames and standing wheelchairs, because of inducing symptomatic orthostatic hypotension or the fear of developing these disabling symptoms.


METHODS
Survey conducted by Internet-accessible electronic questionnaire. Questionnaire validated for reliability and accuracy.


RESULTS
293 respondents. Mean age 44.6; 76% male. Median time from injury: 7 years. 38% suffered with orthostatic hypotension; majority were complete injuries and all (except one - T12) were T5 or above level. 52% replied that they were using standing wheelchairs or frames. Of these, 59 (20% of total) stated that orthostatic hypotension symptoms were limiting the use of their upright apparatus. Of those who did not use standing wheelchairs or frames, 16 (5.5% of total) reported that this was because of the fear of worsening their orthostatic hypotension.


CONCLUSIONS
Orthostatic hypotension restricts standing apparatus use in a large proportion (a total of 25.5% of respondents in this survey) of SCI patients.
Chelvarajah
Ramesh
R
Spinal Research Centre, Royal National Orthopaedic Hospital, Stanmore, UK. ramesh.chelvarajah@talktalk.net
Knight
Sarah L
SL
Craggs
Michael D
MD
Middleton
Fred R
FR
D000328:Adult; D005239:Fear; D005260:Female; D006306:Health Surveys; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology* / Q000523:psychology / Q000534:rehabilitation; D020407:Internet; D008297:Male; D009983:Orthopedic Equipment / Q000706:statistics & numerical data*; D010349:Patient Compliance; D011187:Posture / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation*; D014910:Wheelchairs / Q000706:statistics & numerical data