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

J Spinal Cord Med. 2019 Sep;42(5):586-594. doi: 10.1080/10790268.2017.1360557. Epub 2017 Aug 3.

Abstract

Objective: The purpose of this pilot study was to determine whether 60 mins of intermittent pneumatic compression therapy (IPC) could acutely increase leg blood flow-induced shear stress and enhance vascular endothelial function in persons with spinal cord injury (SCI). Design: Pretest with multiple posttests, within subject randomized control design. Setting: University of Southern Mississippi, Spinal Cord Injury Research Program within the School of Kinesiology, recruiting from the local community in Hattiesburg, Jackson, and Gulfport, MS. Participants: Eight adults with SCI (injury level: T3 and below; ASIA class A-C; age: 41±17 yrs). Interventions: A 60-min IPC session was performed in one leg (experimental leg; EXP), with the other leg serving as a control (CON). Outcomes Measures: Posterior-tibial artery shear rate (Doppler-ultrasound) was examined at rest, and at 15 and 45 mins during IPC. Endothelial function was assessed using the flow-mediated dilation (FMD) technique, before and after IPC. Results: Resting FMD (mm) was similar between legs at rest. A two-way repeated measures ANOVA (leg x time) revealed that during IPC, peak shear rate increased in the EXP leg (215±137 to 285±164 s-1 at 15 mins; +39±29%, P = 0.03), with no change occurring in the CON. In addition, FMD significantly increased in the EXP leg (Pre IPC: 0.36±0.14 vs. Post IPC: 0.47±0.17 mm; P = 0.011, d = 0.66), with no change occurring in the CON leg. Conclusion: These preliminary findings suggests that IPC therapy may acutely increase leg shear stress within 15 mins, with a resultant moderate-large improvement in vascular endothelial function after 60 mins in people with SCI.

Keywords: Compression Therapy; Endothelial Function; Spinal Injury.

MeSH terms

  • Adult
  • Aged
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Intermittent Pneumatic Compression Devices
  • Leg / blood supply*
  • Leg / physiopathology
  • Male
  • Middle Aged
  • Neurological Rehabilitation / instrumentation
  • Neurological Rehabilitation / methods*
  • Pilot Projects
  • Regional Blood Flow*
  • Spinal Cord Injuries / rehabilitation*