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Peer-reviewedCC BYSpinal cord series and cases

Abdominal functional electrical stimulation and binder to reduce orthostatic hypotension in individuals with a subacute spinal cord injury.

  • Chiettha Prajnadewie1,2,3
  • Lynn Blecher4
  • Keith Md McNaughton1,2
  • Claire L Boswell-Ruys1,2,3,4
  • Billy L Luu2,3
  • Harrison T Finn1,2
  • Elizabeth A Bye1,2,3,4
  • Bonsan B Lee1,4
  • Jane E Butler1,2,3
  • Anne E Palermo5,6,7,8
  • Euan J McCaughey1,2,9,10
10 affiliations
  1. 1University of New South Wales, Sydney, NSW, Australia.
  2. 2Neuroscience Research Australia, Sydney, NSW, Australia.
  3. 3The Kolling Institute and School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
  4. 4Prince of Wales Hospital, Sydney, NSW, Australia.
  5. 5University of New South Wales, Sydney, NSW, Australia. [email protected].
  6. 6Neuroscience Research Australia, Sydney, NSW, Australia. [email protected].
  7. 7The Kolling Institute and School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. [email protected].
  8. 8TIRR, Memorial Hermann, Houston, USA. [email protected].
  9. 9Queen Elizabeth National Spinal Injuries Unit, Queen Elizabeth University Hospital, Glasgow, Scotland, G514TF, UK.
  10. 10College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, G128QQ, UK.
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Abstract

Study design

Repeated measures comparative study.Objectives

Compare acute effects of 4 treatment conditions: (i) abdominal binder (Binder), (ii) abdominal functional electrical stimulation (AFES), (iii) AFES and binder (AFES-Binder), and (iv) no intervention (Control), on signs of orthostatic hypotension (OH) and blood pressure (BP) maintenance in individuals with acute and subacute spinal cord injury (SCI).Setting

Spinal injury inpatient ward.Methods

Eleven participants with SCI (C3-T5) with at least one sign or symptom of OH underwent a passive sit-up test on 4 days with the 4 treatment conditions. Non-invasive continuous recordings of systolic BP, diastolic BP and calculated mean arterial pressure (MAP) were measured during 4 periods: (1) supine without treatment (5 min); (2) supine with treatment (5 min); (3) upright with treatment (up to 15 min); and (4) supine post-treatment (10 min).Results

Largest drops in BP still resulted in OH in all conditions (p < 0.001), with the largest instantaneous change in MAP in the Binder condition (-41 mmHg [95% CI, -47 to -34]). AFES-Binder condition maintained mean upright MAP relative to supine (-1 mmHg [95% CI, -5 to 2], p = 0.291). Mean upright MAP decreased in all other conditions [Control: (-4 mmHg [95% CI, -7 to -1], p = 0.002); Binder: (-7 mmHg [-10 to -4], p < 0.001); AFES: (-6 mmHg [95% CI, -9 to -2], p < 0.001)]. Mean upright MAP was highest in the AFES-Binder condition.Conclusions

No single treatment condition prevented OH completely. While AFES with abdominal binder does not eliminate OH, it shows potential to mitigate BP instability during postural transitions in acute and subacute SCI.

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Cite

BibTeXRIS
BibTeX
@article{prajnadewie2026abdominal,
  title = {{Abdominal functional electrical stimulation and binder to reduce orthostatic hypotension in individuals with a subacute spinal cord injury.}},
  author = {Chiettha Prajnadewie and Lynn Blecher and Keith Md McNaughton and Claire L Boswell-Ruys and Billy L Luu and Harrison T Finn and Elizabeth A Bye and Bonsan B Lee and Jane E Butler and Anne E Palermo and Euan J McCaughey},
  journal = {Spinal cord series and cases},
  year = {2026},
  month = oct,
  doi = {10.1038/s41394-026-00757-x},
  url = {https://europepmc.org/article/MED/42897136},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Abdominal functional electrical stimulation and binder to reduce orthostatic hypotension in individuals with a subacute spinal cord injury.
AU  - Chiettha Prajnadewie
AU  - Lynn Blecher
AU  - Keith Md McNaughton
AU  - Claire L Boswell-Ruys
AU  - Billy L Luu
AU  - Harrison T Finn
AU  - Elizabeth A Bye
AU  - Bonsan B Lee
AU  - Jane E Butler
AU  - Anne E Palermo
AU  - Euan J McCaughey
PY  - 2026
DA  - 2026/10/19
JO  - Spinal cord series and cases
DO  - 10.1038/s41394-026-00757-x
UR  - https://europepmc.org/article/MED/42897136
AB  - Study design  Repeated measures comparative study.Objectives  Compare acute effects of 4 treatment conditions: (i) abdominal binder (Binder), (ii) abdominal functional electrical stimulation (AFES), (iii) AFES and binder (AFES-Binder), and (iv) no intervention (Control), on signs of orthostatic hypotension (OH) and blood pressure (BP) maintenance in individuals with acute and subacute spinal cord injury (SCI).Setting  Spinal injury inpatient ward.Methods  Eleven participants with SCI (C3-T5) with at least one sign or symptom of OH underwent a passive sit-up test on 4 days with the 4 treatment conditions. Non-invasive continuous recordings of systolic BP, diastolic BP and calculated mean arterial pressure (MAP) were measured during 4 periods: (1) supine without treatment (5 min); (2) supine with treatment (5 min); (3) upright with treatment (up to 15 min); and (4) supine post-treatment (10 min).Results  Largest drops in BP still resulted in OH in all conditions (p < 0.001), with the largest instantaneous change in MAP in the Binder condition (-41 mmHg [95% CI, -47 to -34]). AFES-Binder condition maintained mean upright MAP relative to supine (-1 mmHg [95% CI, -5 to 2], p = 0.291). Mean upright MAP decreased in all other conditions [Control: (-4 mmHg [95% CI, -7 to -1], p = 0.002); Binder: (-7 mmHg [-10 to -4], p < 0.001); AFES: (-6 mmHg [95% CI, -9 to -2], p < 0.001)]. Mean upright MAP was highest in the AFES-Binder condition.Conclusions  No single treatment condition prevented OH completely. While AFES with abdominal binder does not eliminate OH, it shows potential to mitigate BP instability during postural transitions in acute and subacute SCI.
SN  - 2058-6124
ER  -