Systematic Review

As the body of knowledge is growing in the field of OH management for SCI, it is becoming increasingly important to review the literature and ensure that the information used both in research and clinical practice is current and evidence based. The aim of this section of the OH chapter is to provide an overview of the current systematic reviews available for in areas related to OH management in SCI population.

Discussion

We found only one systematic review on OH management for individuals with SCI by Krassioukov et al. (2009). Although the authors found that the overall quality of the literature was poor and that higher quality research assessing the treatments for OH in the SCI population is needed, there is level 2 evidence that pressure from elastic stockings and abdominal binders may improve cardiovascular physiologic responses during submaximalupper-extremity exercises. In addition, FES is an important adjunct treatment to minimize cardiovascular changes during postural orthostatic stress and that simultaneous upper-extremity exercises may increase orthostatic tolerance during a progressive tilt exercise in subjects with paraplegia.