Abstract:
OBJECTIVE:To review systematically the evidence for the management of orthostatic hypotension (OH) in patients with spinal cord injuries (SCIs). DATA SOURCES:A key word literature search was conducted of original and review articles as well as practice guidelines using Medline, CINAHL, EMBASE, and PsycInfo, and manual searches of retrieved articles from 1950 to July 2008, to identify literature evaluating the effectiveness of currently used treatments for OH. STUDY SELECTION:Included randomized controlled trials (RCTs), prospective cohort studies, case-control studies, pre-post studies, and case reports that assessed pharmacologic and nonpharmacologic intervention for the management of OH in patients with SCI. DATA EXTRACTION:Two independent reviewers evaluated the quality of each study, using the Physiotherapy Evidence Database score for RCTs and the Downs and Black scale for all other studies. Study results were tabulated and levels of evidence assigned. DATA SYNTHESIS:A total of 8 pharmacologic and 21 nonpharmacologic studies were identified that met the criteria. Of these 26 studies (some include both pharmacologic and nonpharmacologic interventions), only 1 pharmacologic RCT was identified (low-quality RCT producing level 2 evidence), in which midodrine was found to be effective in the management of OH after SCI. Functional electrical stimulation was one of the only nonpharmacologic interventions with some evidence (level 2) to support its utility. CONCLUSIONS:Although a wide array of physical and pharmacologic measures are recommended for the management of OH in the general population, very few have been evaluated for use in SCI. Further research needs to quantify the efficacy of treatment for OH in subjects with SCI, especially of the many other pharmacologic interventions that have been shown to be effective in non-SCI conditions.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Krassioukov A,Eng JJ,Warburton DE,Teasell R,Spinal Cord Injury Rehabilitation Evidence Research Team.doi
10.1016/j.apmr.2009.01.009subject
Has Abstractpub_date
2009-05-01 00:00:00pages
876-85issue
5eissn
0003-9993issn
1532-821Xpii
S0003-9993(09)00121-Xjournal_volume
90pub_type
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journal_title:Archives of physical medicine and rehabilitation
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journal_title:Archives of physical medicine and rehabilitation
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更新日期:2001-12-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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doi:10.1016/j.apmr.2003.08.108
更新日期:2004-08-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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更新日期:2005-04-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
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doi:
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章
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更新日期:2000-01-01 00:00:00
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更新日期:2000-09-01 00:00:00
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更新日期:2010-03-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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doi:
更新日期:1985-07-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2014-09-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2005-12-01 00:00:00
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更新日期:2015-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:1998-07-01 00:00:00
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doi:
更新日期:1980-02-01 00:00:00
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更新日期:2001-11-01 00:00:00
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更新日期:2014-10-01 00:00:00
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更新日期:2008-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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