RecruitingNot ApplicableNCT05633693

Postural Sway and Counterpressure Maneuvers for Pediatric Syncope

Impact of Postural Sway on Cardiovascular Control in Pediatric Patients With Syncope

Sponsor

Simon Fraser University

Enrollment

30 participants

Start Date

Apr 17, 2023

Study Type

INTERVENTIONAL

Conditions

Postural Orthostatic tachycardia Syndrome Orthostatic intolerance Syncope, Vasovagal

Summary

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.

Eligibility

Min Age: 6 YearsMax Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This clinical trial is studying a behavioral approach called Baseline Stand and a behavioral approach called Counterpressure Maneuvers for people with orthostatic intolerance, postural orthostatic tachycardia syndrome, and other related conditions. The study is currently recruiting participants at 1 location. People eligible for this study include aged 6 Years to 18 Years.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALCounterpressure Maneuvers

Movements that can aid in delaying or preventing syncope by recruiting skeletal muscle pumping (via compression of major veins by contracting muscle to eject blood through cardiovascular circuit) and increased sympathetic drive (via sustaining an isometric muscle contraction). In this trial, we will be evaluating two clinically recommended isometric maneuvers (crouching, and leg crossing with muscle tensing) and two novel dynamic maneuvers that comprise discrete movement that the investigators have identified in prior work (exaggerated anterior-posterior postural sway, rhythmic gluteal clenching).

BEHAVIORALBaseline Stand

Participants will stand quietly for 5-minutes on a force platform to allow the investigators to assess their typical response to orthostasis.