title: Robotic tilt table reduces the occurrence of orthostatic hypotension over time in vegetative states.
abstract: The aim of this study is to evaluate the effects of verticalization with or without combined movement of the lower limbs in patients in a vegetative state or a minimally conscious state. In particular, we aimed to study whether, in the group with combined movement, there was better tolerance to verticalization. This was a randomized trial conducted in a neurorehabilitation hospital. Twelve patients with vegetative state and minimally conscious state 3-18 months after acute acquired brain injuries were included. Patients were randomized into A and B treatment groups. Study group A underwent verticalization with a tilt table at 65° and movimentation of the lower limbs with a robotic system for 30 min three times a week for 24 sessions. Control group B underwent the same rehabilitation treatment, with a robotic verticalization system, but an inactive lower-limb movement system. Systolic and diastolic blood pressure and heart rate were determined. Robotic movement of the lower limbs can reduce the occurrence of orthostatic hypotension in hemodynamically unstable patients. Despite the small number of patients involved (only eight patients completed the trial), our results indicate that blood pressures and heart rate can be stabilized better (with) by treatment with passive leg movements in hemodynamically unstable patients.
authors.affiliation: aRehabilitation Institute, Habilita, Zingonia bRehabilitation Institute, Habilita, Sarnico cNeurosurgery Unit, Spedali Civili dMechanical and Industrial Engineering Department, University of Brescia, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taveggia
authors.forename: Ivana
authors.initials: I
authors.lastname: Ragusa
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Trani
authors.forename: Daniele
authors.initials: D
authors.lastname: Cuva
authors.forename: Cristina
authors.initials: C
authors.lastname: Angeretti
authors.forename: Marco
authors.initials: M
authors.lastname: Fontanella
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Panciani
authors.forename: Alberto
authors.initials: A
authors.lastname: Borboni
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001930:Brain Injuries / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology / Q000517:prevention & control*; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D000066530:Neurological Rehabilitation / Q000295:instrumentation*; D018458:Persistent Vegetative State / Q000503:physiopathology / Q000534:rehabilitation*; D012371:Robotics / Q000295:instrumentation*