Compression Stockings Improve Cardiac Output and Cerebral Blood Flow during Tilt Testing in (ME/CFS)Patients: A Randomized Crossover Trial, 2021,Rowe

Discussion in 'ME/CFS research' started by Sly Saint, Dec 30, 2021.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Compression Stockings Improve Cardiac Output and Cerebral Blood Flow during Tilt Testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Patients: A Randomized Crossover Trial

    Abstract

    Background and Objectives: Orthostatic intolerance (OI) is a clinical condition in which symptoms worsen upon assuming and maintaining upright posture and are ameliorated by recumbency. OI has a high prevalence in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Limited data are available to guide the treatment of OI in ME/CFS patients. We and others have previously described patient-reported subjective improvement in symptoms using compression stockings. We hypothesized that these subjective reports would be accompanied by objective hemodynamic improvements.

    Materials and Methods: We performed a randomized crossover trial in 16 ME/CFS patients. Each underwent two 15-min head-up tilt table tests, one with and one without wearing knee-high compression stockings that provided 20–25 mm Hg compression. The order of the tests was randomized. We measured heart rate and blood pressure as well as cardiac output and cerebral blood flow (CBF) using extracranial Doppler of the internal carotid and vertebral arteries.
    Results: There were no differences in supine measurements between the 2 baseline measurements. There were no differences in heart rate and blood pressure at either end-tilt testing period. Compared to the test with the stockings off, the mean percentage reduction in cardiac output during the test with compression stockings on was lower, 15 (4)% versus 27 (6)% (p < 0.0001), as was the mean percentage CBF reduction, 14 (4)% versus 25 (5)% (p < 0.0001).

    Conclusion: In ME/CFS patients with orthostatic intolerance symptoms, cardiac output and CBF are significantly reduced during a tilt test. These abnormalities were present without demonstrable heart rate and blood pressure changes and were ameliorated by the use of compression stockings.

    https://www.mdpi.com/1648-9144/58/1/51
     
    Ash, ahimsa, Barry and 18 others like this.
  2. Wits_End

    Wits_End Senior Member (Voting Rights)

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    Be aware that if you're in the UK and pay for your prescriptions, you get charged per stocking, even though there are two stockings per pack. So getting on for £20 for one pair :(
     
    Ash, Barry, Yvonne and 7 others like this.
  3. Kitty

    Kitty Senior Member (Voting Rights)

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    Bloody hell! They're £13 on Amazon for a pair of Activa thigh-highs, which is the brand you get on prescription if you wear Class 1 or 2 stockings.
     
    Ash, Yvonne, MEMarge and 6 others like this.
  4. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    It's M.E. Linda, Ash, Grigor and 7 others like this.
  5. Milo

    Milo Senior Member (Voting Rights)

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    Here in Canada, a pair of knee high, fitted, prescription compression stockings goes for 120$, so more expensive than you guys.

    i’d believe it is because people are more willing to wear a knee high stocking than a waist high contraption that would be really hard to put on and drop when you go to the washroom. Even knee high, they are hard to put on, and you have to be careful not to tear them. They (knee high) are also too hot for summer, or someone like me, from March to November.
     
    TigerLilea, Wits_End, Kitty and 2 others like this.
  6. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    The study I linked wasn't using the sort of seamless compression garment that you roll up your body, it instead used separate bindings - much easier to put on and actually live with. There's some pics in the video presentation on that link:)

    N=1 but I spend most of my day wearing an abdominal binder now and it seems more effective and far more comfortable/less prone to overheating than compression tights.
     
    Binkie4, Ash, Grigor and 9 others like this.
  7. ahimsa

    ahimsa Senior Member (Voting Rights)

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    Any recommendations?

    I've seen some of these garments online that attach with velcro (so they are adjustable) but I don't know what I should be looking for.

    Thanks!
     
    Ash, Trish, Kitty and 1 other person like this.
  8. Ash

    Ash Senior Member (Voting Rights)

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    I second this request for any recommendations or advice on wined around type?

    I will wrap up my whole body spa treatments style if necessary. I am absolutely desperate not to feel like I will going to puke every time I stand/sit up.
     
    Peter Trewhitt, Binkie4 and Wonko like this.
  9. Wits_End

    Wits_End Senior Member (Voting Rights)

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    That's not the ones I got - either length-wise or brand-wise. Mine just looked like thick pop-sox. The GP told me the prescription ones would be custom-made. Total rubbish.
     
    cfsandmore, Trish, Ash and 2 others like this.

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