Safety, Feasibility, and Efficacy of Transcutaneous Spinal Cord Stimulation on Stabilizing Blood Pressure for Acute Inpatients With Spinal Cord Injury
Jill M. Wecht, Ed.D.
Summary
Current forms of pharmacologic and non-pharmacologic treatments for hypotension and orthostatic hypotension (OH) remain inadequate during acute inpatient rehabilitation (AIR) following a traumatic spinal cord injury (SCI). A critical need exists for the identification of safe, practical, and effective treatment options that stabilize blood pressure (BP) after traumatic SCI. Recent published evidence suggests that transcutaneous Spinal Cord Stimulation (TSCS) can be used to raise seated BP, and mitigate the falls in BP during orthostatic repositioning in individuals with chronic SCI. This site-specific project will focus on the use of TSCS to stabilizing seated BP and mitigate the fall in BP during orthostatic repositioning during AIR following traumatic SCI.
Description
Based on available evidence, TSCS may have advantages over current pharmacological approaches to the treatment of hypotension and OH: (1) does not exacerbate polypharmacy, (2) can be activated/deactivated rapidly, and (3) can be applied in synergy with physical exercise. TSCS represents an alternate approach to epidural SCS, with far greater potential to reach large numbers of individuals, thus providing for a greater likelihood of clinical implementation with fewer risk. We are asking several key questions: (1) what are the effects of TSCS on seated BP and BP changes during an orthostatic cha…
Eligibility
- Age range
- 14–100 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Newly injured patients with traumatic SCI * Admitted to Acute Inpatient Rehabilitation at Mount Sinai * Within one year of SCI * Seated hypotension (systolic BP ≤ 110 mmHg for males or ≤ 100 mmHg for females) * Orthostatic hypotension (fall in systolic BP ≥ 20 mmHg and/or a fall in diastolic BP ≥ 10 mmHg within 10 minutes of assuming an upright position) * Daily fluctuation in systolic BP ≥ 20 mmHg and/or fluctuation in diastolic BP ≥ 10 mmHg * At least 14 years old Exclusion Criteria: * Implanted brain/spine/nerve stimulators * Cochlear implants * Cardiac pacemaker/de…
Interventions
- DeviceDigitimer
transcutaneous spinal cord stimulation for blood pressure control following spinal cord injury.
Location
- The Icahn School of Medicine at Mount SinaiNew York, New York