A Portable, Active Abdominal Compression Binder for Orthostatic Intolerance: Design and Evaluation in Healthy Subjects, 2026, Stephen Juraschek et al

[Mij]

Abstract

Purpose
Orthostatic intolerance is a category of disorders characterized by inadequate hemodynamic compensation upon standing. In this study, we developed a portable, active abdominal compression binder intended for individuals with orthostatic intolerance. We present proof-of-concept evidence in healthy volunteers demonstrating the binder’s ability to provide consistent abdominal compression, reduce tachycardic response upon standing, and maintain user comfort.

Methods
We designed and fabricated a novel active binder that applies motor-driven abdominal compression upon the detection of standing. Twenty healthy volunteers (ages 18–50 years) completed three randomized supine-to-standing trials: no binder, a commercial passive binder, and the novel active binder. Throughout each trial, compression pressure, heart rate, and respiration were continuously monitored and comfort was assessed via post-trial Likert-scale survey.

Results
The active binder achieved a higher mean compression pressure (≈ 11 mmHg) with significantly lower intersubject variability (standard deviation (SD) ≈ 1 mmHg) than the passive binder (mean ≈ 8 mmHg; SD ≈ 3 mmHg). Active compression reduced the standing heart rate by 4.4 bpm compared to control (p < 0.05) vs. a 1 bpm reduction with the passive binder (p > 0.05). Neither the active nor the passive abdominal binders impeded respiration. Survey responses demonstrated that the active binder was at least as comfortable as the passive and was rated easier to don.

Conclusion
These findings suggest that active abdominal compression may serve as a more efficacious, consistent, and user-friendly alternative to passive binders for mitigating orthostatic intolerance.
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[Mij]

Revolutionary Compression Binder for Orthostatic Intolerance Tested

The results of the study have generated significant interest within the medical community. Leading experts in cardiovascular health and biomedical engineering are anticipating more comprehensive clinical trials to assess long-term benefits and effects of the binder on individuals with chronic conditions. Engagement from the scientific community is crucial for validating the device’s potential, which could lead to further refinements and innovations in design.

 

[Jonathan Edwards]

I think it pretty unlikely that orthostatic intolerance in ME/CFS s mediated by splanchnic blood pooling. Pooling in the legs seems a bit more plausible. I would worry that abdominal compression might easily make that worse. I am not sure of the logic of trying this on healthy people and an extra 3.4 beats per minute is pretty pathetic.

 

[Verity]

I think it pretty unlikely that orthostatic intolerance in ME/CFS s mediated by splanchnic blood pooling. Pooling in the legs seems a bit more plausible. I would worry that abdominal compression might easily make that worse. I am not sure of the logic of trying this on healthy people and an extra 3.4 beats per minute is pretty pathetic.

I was recommended abdominal compression for my orthostatic intolerance, and it did indeed make me feel worse.

Pooling in the legs seems more plausible to me too.

 

[wabi-sabi]

I find waist compression makes me a tiny bit better, but I have to be well enough to be vertical in the first place for it to be useful.

 

[dratalanta]

It’s definitely leg pooling for me. Waist compression makes no difference.

Back when I was moderate I found that thick tights and high heels kept blood from pooling in my feet and helped me to stay upright for longer - at a cost though. Reducing the OI didn’t (much) reduce the PEM caused by the upright activity itself, a point which needs to be remembered when alleviating symptoms.

Wearing heels had the secondary benefit of providing a socially acceptable explanation for not walking anywhere.

For me, compression was in the same group of tools as caffeine - a method for me to get through today and pay the price tomorrow.

When I am in PEM I raise my knees in my sleep to stop blood pooling in my feet. If I don’t do it in my sleep I wake up in pain and have to elevate my legs to drain the blood.

 

[Evergreen]

Since I can't handle waistbands, I'm pretty sure abdominal compression would create gastrointestinal problems for me that would make it unusable, even if it were effective.

Had to use a back brace recently, just for 5-10 mins at a time, and it caused a lot of pain at the front and GI issues. It was effective for putting me back together, so it was worth it, but definitely not something I could do daily.

 

[wabi-sabi]

Reducing the OI didn’t (much) reduce the PEM caused by the upright activity itself, a point which needs to be remembered when alleviating symptoms.

This is very interesting to hear.

For me, reducing OI does reduce (but not eliminate) PEM. It doesn't make activities innocuous, but it certainly makes them less harmful. I wear compression stockings and a waist squeezer when I need to be vertical and they help a little bit. If I'm not well enough to be vertical, but have to do it anyway for some reason, then they help less. I think of them as my armor.

 

[Kitty]

Pooling in the legs seems more plausible to me too.

Me too, specially as compression clearly alleviates OI. I can stand for several times longer using prescription compression hosiery, although being able to stand for ten minutes instead of two isn't enough of a gain to persuade me to wear tights that hurt my legs because I have lipoedema.

Sometimes when it's cold I put on extra layers, and am reminded that even mild compression helps. I'm currently wearing woolly tights, long thick socks and chunky knit legwarmers, and microwaving my dinner was much easier than usual. But it took a lot of physical effort to get them on, it'll take longer than usual to get to bed because I have to lever them off again, and I'm definitely not going to be wearing them in June.