Effects of Intermittent Pneumatic Compression on Leg Vascular Function in People with Spinal Cord Injury: A Pilot Study

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2017.1360557 · Published: September 1, 2019

Spinal Cord Injury Cardiovascular Science

Simple Explanation

This study investigates whether intermittent pneumatic compression (IPC) can improve blood flow and vascular health in the legs of people with spinal cord injury (SCI). IPC involves using inflatable cuffs around the legs to simulate muscle contractions and increase blood flow. The study found that IPC increased blood flow-induced shear stress in the legs within 15 minutes and improved vascular endothelial function after 60 minutes in people with SCI. These findings suggest that IPC may be a useful therapy for improving vascular health in the paralyzed legs of individuals with SCI, potentially reducing their risk of cardiovascular disease.

Study Duration

Not specified

Participants

Eight adults with SCI (injury level: T3 and below; ASIA class A-C; age: 41±17 yrs)

Evidence Level

Pilot Study

Key Findings

1
Peak shear rate in the experimental leg increased significantly at 15 minutes during IPC (215±137 to 285±164 s−1 at 15 mins; +39±29%, P = 0.03), while no change occurred in the control leg.
2
Flow-mediated dilation (FMD) significantly increased in the experimental leg after IPC (Pre IPC: 0.36±0.14 vs. Post IPC: 0.47±0.17 mm; P = 0.011, d = 0.66), but no change occurred in the control leg.
3
Resting FMD (mm) was similar between legs at rest.

Research Summary

This pilot study aimed to determine if intermittent pneumatic compression (IPC) could increase leg blood flow and enhance vascular endothelial function in individuals with spinal cord injury (SCI). The study found that a 60-minute IPC session acutely increased leg shear stress within 15 minutes and improved vascular endothelial function after 60 minutes in the experimental leg compared to the control leg. The researchers concluded that IPC therapy might be an effective strategy for improving endothelial function in the paralyzed legs of people with SCI.

Practical Implications

Therapeutic Potential

IPC therapy may offer a non-invasive method to improve vascular health in SCI patients, potentially reducing the risk of cardiovascular complications.

Clinical Application

The findings support the use of IPC as an adjuvant therapy to traditional treatments for improving cardio-metabolic health in individuals with SCI.

Further Research

Future studies should investigate the optimal IPC protocol, the underlying mechanisms of the response, and the chronic effects of IPC therapy on cardio-metabolic outcomes in SCI patients.

Study Limitations

1
Small sample size (n=8)
2
Heterogeneous SCI group (varied age, injury level, SCI duration, and classification)
3
Lack of comparative data to able-bodied individuals to denote any apparent endothelial dysfunction and/or increased vascular stiffening

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