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OI and G-suit Research Articles

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OI and G-suit Research Articles

These are excerpts of research that show successful use of compression garments (g-suit, MAST) for Orthostatic Intolerance (OI). To read more of the research articles, please click the links provided.

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  • Faces of CFS - Case Histories of Chronic Fatigue Syndrome by David S. Bell, MD, FAAP

    Lyndonville, New York, August 15, 2000, Chapter 9 "Andrea's Revolver", pages 71-75

    I [Dr. David S. Bell] began working with Dr. David Streeten, an endocrinologist who had worked extensively with "orthostatic intolerance", the inability of the body to tolerate the upright position. . . I met Dr. Streeten for the first time in February 1994 when I accompanied Andrea Thompson to his offices in order to observe his evaluation of her first hand. . . When the CFS patient is lying down, the symptoms are improved, although not gone entirely. The disability of CFS has to do with the fact that we spend our non-sleeping lives in the upright position. . . When the CFS patient would become ill during standing, he would inflate their MAST trousers [military anti-shock trousers]. . . He hypothesized that the pressure on Andrea's legs and abdomen by the MAST trousers had forced a more vigorous blood flow through Andrea's brain, and that this increased blood flow stopped the pain. Andrea wanted to buy a pair of MAST trousers for home use. (Later on we actually tried this, but it turns out to be impossible to walk around with these things on which sort of cancels out the purpose.) . . . I began testing CFS patients in my office for changes in pulse and blood pressure when they stand quietly, and found that the vast majority have abnormalities. This is the reason that people with CFS may look healthy to outsiders, but they are unable to stand at the check-out counter of the grocery store. In fact, on occasion, some of them faint, or come very close to fainting, presumably because they cannot maintain good blood flow to the brain.
    Read more.

    See below for more of Dr. David H. Streeten's work with Orthostatic Intolerance (OI) and MAST trousers.

    David S. Bell, MD, FAAP, is a primary care physician in pediatrics and family practice in Lyndonville, New York. Dr. Bell is the author of CFIDS, The Disease of a Thousand Names (1991), The Doctor's Guide to Chronic Fatigue Syndrome (1994), and A Parents' Guide to CFIDS How to Be an Advocate for Your Child with Chronic Fatigue Immune Dysfunction Syndrome (1999).

    Copyright © David S. Bell MD, 2000

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  • Postural hypotension and the anti-gravity suit by Dr. Wilfrid H. Brook - full article
    Also available to view as PDF/Adobe Acrobat format. (1.5 MB)

    Australian Family Physician Vol. 23, No. 10, October 1994, pages 1945-1949

    An air force anti-gravity suit, as used by fighter pilots to prevent loss of consciousness, has been successfully employed to treat severe postural hypotension in a patient with Shy-Drager syndrome. The definition of postural hypotension is reviewed, and reference is made to the previous use of the anti-gravity suit in the treatment of this condition.
    Read more.

    Wilfrid H. Brook RFD, MB, BS(Melb), MS(Mon), FRCSEd, FICA, is a senior lecturer in the Department of Anatomy, Monash University, in Melbourne and senior medical officer, No 21 (City of Melbourne) Squadron, RAAFAR. [Dr. Wilfrid H. Brook is currently retired.]

    Copyright © 1994 by Australian Family Physician and Dr. Wilfrid H. Brook

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  • Application of USAF G-Suit Technology for Clinical Orthostatic Hypotension: A Case Study - full article
    Also available to view as PDF/Adobe Acrobat format. (1.6 MB)

    Lori L. Elizondo, B.S., Donald F. Doerr, B.S.E.E., Mark A. Sims, M.D., G. Wyckliffe Hoffler, M.D., and Victor A. Convertino, Ph.D.

    Aviation, Space, and Environmental Medicine - Vol. 67, No. 4 - April 1996 pages 344-350

    Introduction: The purpose of this study was to determine the effectiveness of a USAF anti-gravity suit (G-suit) on the stability of a patient with chronic orthostatic hypotension. Methods: A 37-yr-old female with a history of insulin-dependent diabetes mellitus (IDDM) and symptomatic orthostasis was evaluated and the results were compared with those of non-diabetic controls, matched for age, height, and weight. . . Blood pressures and heart rate were measured during three 5-min stand tests to assess orthostatic responses: a) without G-suit; b) with noninflated G-suit; and c) with inflated G-suit (50 mm Hg). . . Conclusion: These results demonstrate successful application of Air Force technology as a useful alternative to pharmacologic intervention in the treatment of a patient with autonomic dysfunction leading to supine hypertension and orthostatic hypotension.
    Read more.

    This research (paper) received a United States Air Force Scientific Achievement Award.

    From the Physiology Research Branch, Clinical Science Division, Brooks Air Force Base, TX (L. L. Elizondo, V. A. Convertino); Biomedical Operations Office, NASA-Kennedy Space Center, FL (D. F. Doerr, G. W. Hoffler); and Jupiter Hospital, Jupiter, FL (M. A. Sims).

    Reprint & Copyright © 1996 by Aerospace Medical Association, Alexandria, VA.

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  • Efficacy of compression of different capacitance beds in the amelioration of orthostatic hypotension - full article
    Also available to view as PDF/Adobe Acrobat format. (1.4 MB)

    J.-C. Denq MD, T.L. Opfer-Gehrking, M. Giuliani MD, J. Felten, V.A. Convertino PhD, and P.A. Low MD

    Clinical Autonomic Research - Vol. 7 - 1997 pages 321-326

    Orthostatic hypotension (OH) is the most disabling and serious manifestation of adrenergic failure, occurring in the autonomic neuropathies, pure autonomic failure (PAF) and multiple system atrophy (MSA). No specific treatment is currently available for most etiologies of OH. A reduction in venous capacity, secondary to some physical counter maneuvers (e.g., squatting or leg crossing), or the use of compressive garments, can ameliorate OH. . . We therefore evaluated the efficacy of compression of specific compartments (calves, thighs, low abdomen, calves and thighs, and all compartments combined), using a modified antigravity suit, on the end-points of orthostatic blood pressure, and symptoms of orthostatic intolerance. . . The abdomen was the only single compartment whose compression significantly reduced OH (p < 0.005). . . Compression of all compartments is the most efficacious, followed by abdominal compression, whereas leg compression alone was less effective, presumably reflecting the large capacity of the abdomen relative to the legs. . . Venous compression by a G suit positive pressure of 40 mmHg improves OH.
    Read more.

    From the Department of Neurology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Republic of China (J.-C. Denq MD); Autonomic Disorders Research Center, Department of Neurology, Mayo Clinic, Rochester, Minnesota (T.L. Opfer-Gehrking, J. Felten, P.A. Low MD); Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania (M. Giuliani MD); and Physiology Research Branch, Clinical Sciences Division, Brooks Air Force Base, Texas, USA (V.A. Convertino PhD).

    0959-9851 © 1997 Rapid Science Publishers

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  • Some of Dr. David H. Streeten's Abstracts Regarding Orthostatic Intolerance (OI)

    Streeten DH, Anderson GH Jr., Auchincloss JH Jr., Richardson RL, Thomas FD, Miller JW

    These are some examples of Orthostatic Intolerance (OI) being corrected with an inflatable pressure suit (MAST - military anti-shock trousers) providing lower body (abdomen and legs) compression of 45-50 mm Hg pressure.
    • Delayed Orthostatic Intolerance.
      This delayed orthostatic hypotension could be corrected with inflation of a pressure suit to 45 mm Hg.
    • Orthostatic Hypertension. Pathogenetic Studies.
      An inflated pressure suit over the pelvis and lower limbs prevented the excessive fall in cardiac output and significantly reduced (p less than 0.02) the excessive rise in standing DBP [diastolic blood pressure] in orthostatic hypertensive patients.
    • Abnormal Orthostatic Changes in Blood Pressure and Heart Rate in Subjects with Intact Sympathetic Nervous Function: Evidence for Excessive Venous Pooling.
      The orthostatic disorders of blood pressure and heart rate identified in the 34 patients were significantly reduced, almost always into the normal range, by external pressure of 45 to 50 mm Hg applied through an inflatable pressure suit.
    • Vascular Responsiveness to Norepinephrine in Sympathicotonic Orthostatic Intolerance.
      Sympathicotonic orthostatic intolerance (hypotension, tachycardia, or both) is associated with normal or excessive orthostatic increases in plasma norepinephrine concentration and is reversible by the inflation of a military anti-shock trouser suit enveloping the lower limbs and abdomen.
    • Pathogenesis of Hyperadrenergic Orthostatic Hypotension. Evidence of Disordered Venous Innervation Exclusively in the Lower Limbs.
      Correction of the abnormal orthostatic changes by an inflated pressure suit (MAST) confirmed previous evidence of excessive gravitational pooling of blood in the leg veins.
    • Mechanisms of Orthostatic Hypotension and Tachycardia in Patients with Pheochromocytoma.
      The pathophysiological importance of the subnormal venous responses to the orthostatic hypotension and tachycardia in the patients were supported by the finding that the orthostatic changes were corrected by lower body compression to 45 mm Hg with a MAST pressure suit.
      Read more.

      Copyright © 1985, 1988, 1990, 1992, 1996 by Dr. David H. Streeten

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  • Guidelines for the Clinician for Development of Fitness Programs for Individuals with Spinal Cord Injury by Sarah A. Morrison, PT - full article
    Also available to view as PDF/Adobe Acrobat format. (3.9 MB)

    RRDS Physical Fitness: A Guide for Individuals with Spinal Cord Injury - Chapter Three, pages 33-44

    Lower body positive pressure suits are placed over the lower extremities and abdomen area. Pressures in the suit fluctuate in an attempt to mimic the muscle pump activities of the lower body musculature. Similar to the use of CFESLE [computerized functional electrical stimulation to the lower extremities], the medical goal of utilizing the lower body positive pressure suits is decreasing leg venous pooling and increasing circulating blood volumes during exercise. The first studies that evaluated the effectiveness of the lower body positive pressure suits were done by Vallbona and Huang. The results of their studies revealed that orthostatic hypotension could be prevented in persons with tetraplegia through the use of leg and abdominal pneumatic devices. Hopman took this idea one step further and researched the effects of an anti-G suit on cardiovascular responses to upper limb exercise in persons with paraplegia. Results of this study showed that there was an increase in pre-exercise blood pressure and decreased heart rate at similar submaximal workloads.

    Research results of a lower body positive pressure suit testing study by Pitetti showed increased oxygen consumption, increased pulmonary ventilation, increased stoke volume at 50 percent peak oxygen consumption, decreased submaximal heart rate, and a higher recovery of mean arterial blood pressure response. The results of this study suggest that for individuals with SCI [spinal cord injury], lower body positive pressure enhances the exercise capacity by preventing venous pooling in the lower extremities during upper limb exercise.
    Read more.

    Sarah A. Morrison, Physical Therapist, is manager of outpatient physical therapy at Shepherd Center, Atlanta, Georgia. She served as principal investigator of the recently completed 5-year study [1990-1995] entitled: "Cardiorespiratory Responses to Prolonged Exercise in the Spinal Cord Injured Population," supported by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. [Sarah A. Morrison, PT, is currently the Program Director for Spinal Cord Injury Services at the Shepherd Center in Atlanta, Georgia.]

    Copyright © Sarah A. Morrison, PT

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  • Additional Short Research

    William G. Crook, M.D., ImmuneSupport.com; Dr. Peter Del Fante; a taskforce of South Australian clinicians and others with experience in ME/CFS; Commission on Physical Sciences, Mathematics, and Applications (CPSMA), Space Studies Board (SSB); Victor A. Convertino, Ph.D., Craig A. Reister, M.S., David A. Ludwig, Ph.D., Joan Vernikos, Ph.D., Charles E. Wade, Ph.D.

    More examples of the use of pressure garments (g-suit, MAST) for Orthostatic Intolerance (OI).

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  • Important Points from Research Articles

    David S. Bell, MD, FAAP; Wilfrid H. Brook RFD, MB, BS(Melb), MS(Mon), FRCSEd, FICA; Lori L. Elizondo, B.S., Donald F. Doerr, B.S.E.E., Mark A. Sims, M.D., G. Wyckliffe Hoffler, M.D., and Victor A. Convertino, Ph.D.; J.-C. Denq MD, T.L. Opfer-Gehrking, M. Giuliani MD, J. Felten, and P.A. Low MD

    These are points from some of the above research that I thought were important when I read them.

Information in brackets has been added.

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