Postural Sway and Counterpressure Maneuvers for Pediatric Syncope

MI-összefoglaló

A vizsgálat saját részvételi feltételeiből. Gép olvasta ki az oldalon álló regiszterszövegből, ezért tévedhet. Hogy ki vehet részt, azt a lenti regiszterszöveg és a vizsgálat csapata dönti el.

The trial is looking for English-speaking children and teens who faint again and again, from a vasovagal cause or linked to POTS. It tests simple leg and body muscle movements.

Életkor

6 to 18 years

Nem

All sexes

A betegség stádiuma

Recurrent fainting: at least two episodes of fainting or near-fainting in the last year. The cause must be vasovagal or linked to postural orthostatic tachycardia syndrome (POTS), as found by a paediatric cardiologist.

Korábbi kezelés

People cannot join if they take any heart or blood-vessel medicines, or medicines for fainting on standing (e.g. fludrocortisone, slow-release sodium chloride, β-blockers, midodrine). Full COVID-19 vaccination under Health Canada guidelines is needed, with proof.

A részvétel fő kizáró okai

• Known or suspected heart rhythm problem (e.g. Wolff-Parkinson-White, Long QT) or structural heart disease
• Head injury, new seizures or return of epilepsy, overdose or intoxication
• Heart or blood-vessel disease, including high blood pressure, diabetes or kidney disease, or low blood sugar
• Physical or mental disability that affects doing the tests
• Being pregnant or thinking you might be

A regiszter feltételei, szó szerint

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• 6 és 18 év között vagy?IgenNem

Mit akar kideríteni a vizsgálat

The investigators are interested in whether discrete counterpressure maneuvers, or muscle movements in the lower body, will boost blood pressure and cardiovascular control in children who faint. We will record cardiovascular responses to maneuvers of exaggerated sway, leg crossing, crouching, and gluteal muscle tensing in children who faint (N=20), as well as their height, weight, muscularity, and pubertal (Tanner) stage. Autonomic cardiovascular control will be measured using a Valsalva manoeuvre (expiration against a closed airway for 20 seconds) and a supine-stand test. The primary outcomes are noninvasive measures of cardiovascular responses to the maneuvers (blood pressure, cerebral blood flow, and stroke volume (volume of blood pumped per heartbeat). Comparisons will be made across levels of sex, diagnosis, Tanner stage, muscularity, height, and degree of autonomic control.

A vizsgálat 2 csoportja

• Counterpressure ManeuversA vizsgált kezelés

  Counterpressure maneuver (CPM) trials will be performed in front of a neutral wall in silence to ensure that visual or auditory stimuli do not affect movement. CPM: * Leg crossing and muscle tensing: Legs are crossed while upright and lower body musculature is isometrically contracted (clinical) * Crouching: Participant crouches down resting weight on the balls of their feet, pressing calves against the back surface of the thighs (clinical) * Exaggerated anterior-posterior sway: Participant sways back and forth with feet planted on ground at a pace/amplitude that is comfortable (discrete) * Gluteal clenching: Participant rhythmically tenses and relaxes the gluteal muscles at a pace/duration that is comfortable (discrete) Participants serve as their own controls and complete both testing arms.

  Kezelés: Counterpressure Maneuvers és Baseline Stand

• Baseline StandSzínlelt kezelés, összehasonlításként

  Participants will perform a sit-stand test, followed by 5-minutes of baseline (quiet) standing trial on a force platform while cardiorespiratory responses are recorded. Sit-stand test: following 5-minutes of supine rest, the participant will be passively moved into the seated position. They will then be asked to actively move into the standing position. Baseline stand: immediately following the sit-stand test, the baseline trial will begin. Participants will stand quietly on the force platform for 5-minutes. This trial will be performed in front of a neutral wall in silence to ensure that visual or auditory stimuli do not affect their movement. Participants serve as their own controls and complete both testing arms.

  Kezelés: Counterpressure Maneuvers és Baseline Stand