Efficacy of Jobst Compression Garments to Prevent Orthostatic Intolerance for up to Three Days following 14 Days of Bed Rest

Aims: 1. To determine whether subjects wearing breast-high, graded compression garments become orthostatically intolerant after 14 days of head-down tilt bed rest (Groups 1 and 2). Measures of efficacy will be presyncope-free survival to 80° head-up tilt testing and responses in blood pressure, heart rate, stroke volume, and cardiac output. 2. To determine the time course of cardiovascular readaptation during the first three days of post-bed rest (BR) recovery after using compression garments for a short period of time on BR+0 (Group 1). The brief usage of high compression garments on BR+0 models the use of the anti-G suit (AGS) among Space Shuttle crewmembers. Readaptation will be measured by responses of blood pressure, heart rate, stroke volume, cardiac output, and presyncope-free survival time to 15-minute head-up tilt tests on BR+1 and BR+3 as well as measures of plasma volume each day of recovery. 3. To determine the effect of wearing graded compression garments on the time course of cardiovascular readaptation during the first three days of post-bed rest recovery (Group 2). Readaptation will be measured by responses of blood pressure, heart rate, stroke volume, cardiac output, and presyncope-free survival time to 15-minute head-up tilt tests on BR+1 and BR+3 as well as measures of plasma volume each day of recovery.

Findings from this study have the potential to impact treatment of patients who are hypotensive and/or suffer from episodes of orthostatic intolerance. Commercially-available knee-high and thigh-high compression garments, while easy to don and convenient to wear, have limited effectiveness as previously tested in our laboratory. The commercially-available breast-high garment, while an effective protection against orthostatic intolerance, can be difficult to don, uncomfortable, and/or inconvenient to remove to urinate or defecate. In contrast, the three-piece garment developed for this project provides the same amount of coverage as the commercially-available breast-high garment but provides greater levels of compression than the commercially-available breast-high garment, is an effective countermeasure to orthostatic intolerance, is easy to don and doff, and can be more easily adjusted for comfort. The improvements to the wear and comfort realized in the development of the three-piece garments should enhance compliance with long-term wearing of compression garments, reduce hypotensive episodes, and improve the lifestyle of patients with orthostatic intolerance. A cardiologist who treats these types of patients has complimented the investigator team on the design of the test garment, and the manufacturer of the modified garment has applied for a US patent.

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