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Orthostatic Hypotension

Patient Information

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Introduction

Systematic Review

Pharmacological Management of OH in SCI

Non-pharmacological Management of OH in SCI

Key Points:

  • Midodrine hydrochloride should be included in the management protocol of OH in individuals with spinal cord injury.
  • There is limited evidence that fludrocortisone is effective for the management of OH in SCI.
  • There is limited evidence that ergotamine is effective for the management of OH in SCI.
  • There is little evidence that ephedrine is effective for the management of OH in SCI.
  • There is limited evidence that L-DOPS is effective for the management of OH in SCI.
  • There is limited evidence that L-NAME is effective for the management of OH in SCI
  • The benefits of salt loading have not been sufficiently proven in individuals with SCI.
  • There is insufficient evidence that elastic stockings or abdominal binders have any beneficial effect on cardiovascular responses in SCI
  • The use of FES is an effective adjunct treatment to minimize cardiovascular responses to changes in position.
  • Simultaneous arm exercise during a tilt test is not effective for improving orthostatic tolerance.
  • There is limited evidence that regular physical activity may improve orthostatic tolerance during a tilt test.
  • There is limited evidence that active stand training improves the response to orthostatic stress in cervical SCI.
  • The benefits of body-weight supported treadmill training for management of OH have not been sufficiently proven in SCI.

Krassioukov A, Wecht JM, Teasell RW, Eng JJ (2018). Orthostatic Hypotension Following Spinal Cord Injury. In: Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, Sproule S, McIntyre A, Querée M, editors. Spinal Cord Injury Rehabilitation Evidence. Version 6.0. Vancouver: p. 1-31.

Patient Information on Orthostatic hypotension after SCI.