title: Electrical stimulation-evoked contractions blunt orthostatic hypotension in sub-acute spinal cord-injured individuals: two clinical case studies.
abstract: METHODS
  Prospective study of two cases.
  
  
  OBJECTIVE
  To describe the effects of electrical stimulation (ES) therapy in the 4-week management of two sub-acute spinal cord-injured (SCI) individuals (C7 American Spinal Injury Association Impairment Scale (AIS) B and T9 AIS (B)).
  
  
  METHODS
  University Malaya Medical Centre, Kuala Lumpur, Malaysia.
  
  
  METHODS
  A diagnostic tilt-table test was conducted to confirm the presence of orthostatic hypotension (OH) based on the current clinical definitions. Following initial assessment, subjects underwent 4 weeks of ES therapy 4 times weekly for 1 h per day. Post-tests tilt table challenge, both with and without ES on their rectus abdominis, quadriceps, hamstrings and gastrocnemius muscles, was conducted at the end of the study (week 5). Subjects' blood pressures (BP) and heart rates (HR) were recorded every minute during pre-test and post-tests. Orthostatic symptoms, as well as the maximum tolerance time that the subjects could withstand head up tilt at 60°, were recorded.
  
  
  RESULTS
  Subject A improved his orthostatic symptoms, but did not recover from clinically defined OH based on the 20-min duration requirement. With concurrent ES therapy, 60° head up tilt BP was 89/62 mm Hg compared with baseline BP of 115/71 mm Hg. Subject B fully recovered from OH demonstrated by BP of 105/71 mm Hg during the 60° head up tilt compared with baseline BP of 124/77 mm Hg. Both patients demonstrated longer tolerance time during head up tilt with concomitant ES (subject A: pre-test 4 min, post-test without ES 6 min, post-test with ES 12 min; subject B: pre-test 4 min, post-test without ES 28 min, post-test with ES 60 min).
  
  
  CONCLUSIONS
  Weekly ES therapy had positive effect on OH management in sub-acute SCI individuals.
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: N A
authors.initials: NA
authors.lastname: Hamzaid
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: L T
authors.initials: LT
authors.lastname: Tean
authors.affiliation: 1] Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia [2] Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: Davis
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Suhaimi
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Hasnan
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001703:Biophysics; D001794:Blood Pressure / Q000502:physiology; D004558:Electric Stimulation / Q000379:methods*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000150:complications*; D018667:Tilt-Table Test; D055815:Young Adult