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Orthostatic Hypotension

Whole-Body Vibration in Management of OH

Whole-body vibration (WBV) exercise is performed on a platform that generates vertical sinusoidal vibrations, stimulating muscle spindles and resulting in muscle contractions. The effect of WBV exercise on muscle activity is elicited through reflex muscle activation (Bongiovanni et al. 1990) and muscle twitch potentiation (Cochrane et al. 2010).

Author Year; Country
Score
Research Design
Total Sample Size
 Methods Outcome
Yarar-Fisher 2013; USA
PEDro=6
RCT (matched)
N=21

Population: 11 men with SCI (mean age: 49±7 years; C4-T6; AIS A or B; ³1 year post-injury) and 10 able-bodied men age: 48±8 years.
Treatment: Randomly assigned to 30, 40 and 50 Hz synchronous-vertical whole body vibration (WBV) with an amplitude (peak to peak) of ≈2 mm on three separate days.
Outcome measures: Heart rate, mean arterial pressure (MAP), stroke volume, cardiac output, oxygen consumption (VO2), relative changes in oxygenated, deoxygenated and total heme groups.
  1. Both groups demonstrated small but significant increase in VO2, oxygenated heme and total heme groups; increases were larger in the SCI compared to the control group.
  2. Significant decrease in deoxygenated heme in the SCI group.
  3. No frequency effect was observed.
  4. WBV responses did not appear sufficient to induce cardiovascular benefits in the SCI group.
  5. WBV maintained mean arterial pressure levels above the pre-WBV standing values.

Discussion

There is one RCT (n=21) by Yarar-Fisher et al. (2013) examined the effect of whole-body vibration (WBV) on blood pressure while standing, and found that lower limb peripheral blood flow improved post-WBV. However, the clinical application of WBV in preventing orthostatic hypotension has not yet been studied.

Conclusion

There is level 1 evidence (Yarar-Fisher et al. 2013) that whole-body vibration increases standing mean arterial pressure in individuals with SCI.

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