Effects of compression stockings on sympathetic activity and heart rate variability in individuals with spinal cord injury

J Spinal Cord Med. 2012 Mar;35(2):81-8. doi: 10.1179/2045772311Y.0000000054. Epub 2012 Feb 4.

Abstract

Objective: To investigate whether wearing graduated compression stockings (GCS) could affect the sympatho-adrenergic and heart rate variability (HRV) responses at rest and after a strenuous wheelchair exercise in individuals with spinal cord injury (SCI).

Design: Crossover trial.

Setting: Department of Physical Medicine and Rehabilitation, Saint Etienne, France.

Participants: Nine men with SCI (five with low paraplegia: LP, four with high paraplegia: HP).

Interventions: Two maximal wheelchair exercise tests: with and without GCS (21 mmHg).

Main outcome measures: HRV measurements: high frequency (HF), low frequency (LF), and LF/HF ratio. Norepinephrine (NOR) and epinephrine (EPI), at rest and post-exercise. Secondary measures were: blood pressure, heart rate, maximal power output, oxygen uptake, stroke volume, cardiac output, at rest, during and after exercise.

Results: When wearing GCS: LFnu(wavelet-post) significantly increased and HFnu(wavelet-post) significantly decreased (P < 0.05) in SCI subjects, leading to an enhance ratio of LF(wavelet)/HF(wavelet) and a significantly increased in NOR(rest) (P < 0.05).

Conclusions: GCS induces an enhanced sympathetic activity in individuals with paraplegia, regardless of the level of the injury. Enhanced post-exercise sympathetic activity with GCS may help prevent orthostatic hypotension or post-exercise hypotension.

MeSH terms

  • Adult
  • Blood Pressure / physiology*
  • Cross-Over Studies
  • Electrocardiography
  • Epinephrine / blood
  • Exercise
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Norepinephrine / blood
  • Spinal Cord Injuries / blood
  • Spinal Cord Injuries / physiopathology*
  • Spinal Cord Injuries / rehabilitation*
  • Stockings, Compression*
  • Sympathetic Nervous System / physiopathology*
  • Wheelchairs
  • Young Adult

Substances

  • Norepinephrine
  • Epinephrine