Hopman et al. 1998b; Netherlands
PEDro = 5
RCT
N=9

Population: 9 males, 5 with tetraplegia, 4 with paraplegia; 8 complete, 1 incomplete
Treatment: 5 conditions as above, except submaximal exercise at 20, 40 and 60% of maximum power output.
Outcome measures: Oxygen uptake (VO2), carbon dioxide output, respiratory parameters, HR, BP, stroke volume, cardiac output

1. Tetraplegia: ↑ VO2, cardiac output, stroke volume, BP and stroke volume with FES; ↑ cardiac output, ↑ stroke volume and ↓ HR with binders and stockings; ↓ HR and ↑ BP with anti-G suit.
2. Paraplegia: ↑ VO2 and ↓ HR with FES; ↓ VO2 and ↓ HR with anti-G suit; ↓ VO2 with stockings and binders.
3. Results suggest that FES had greater effect on subjects with tetraplegia than in subjects with paraplegia and that stockings and binder provide an effect for subjects with tetraplegia but not for paraplegia.

Hopman et al. 1998a; USA
PEDro=4
RCT
N=9

Population: 9 males, 5 with tetraplegia, 4 with paraplegia; 1 incomplete and 8 complete injuries (same subjects as above study).
Treatment: 5 discontinuous maximal exercise arm ergometer tests on different days while: 1) sitting, 2) supine, 3) sitting plus an anti-G suit, 4) sitting plus stockings and abdominal binder, and 5) sitting plus FES of the leg muscles.
Outcome Measures: Oxygen uptake (VO2), carbon dioxide output, respiratory parameters, HR, BP, stroke volume, cardiac output

1. The supine posture increased VO2 peak in subjects with tetraplegia, but reduced HR in subjects with paraplegia compared to sitting.
2. The anti-G suit, stockings plus abdominal binder or FES did not have any effect on VO2, HR, ventilatory exchange or power output. The anti-G suit did significantly reduce the perceived exertion for subjects with tetraplegia only.
3. Results suggested that stockings and abdominal binders, FES or anti-G suitdo not provide hemodynamic benefits.

Krassioukov & Harkema 2006;
Canada
Downs & Black=12
Prospective Controlled Trial
N=20

Population: 6 subjects with complete tetraplegia; 5 with complete paraplegia; AIS A; 9 able-bodied controls.
Treatment: With and without harness for locomotor training during supine, sitting and standing (within subject analysis).
Outcomes measures: Blood pressure, heart rate.

1. Orthostatic stress significantly decreased arterial blood pressure only in individuals with cervical SCI (P<0.05).
2. Harness application had no effect on cardiovascular parameters in able-bodied individuals, whereas diastolic blood pressure was significantly increased in those with SCI.
3. Orthostatic changes in cervical SCI when sitting were ameliorated by harness application. However, while standing with harness, individuals with cervical SCI still developed orthostatic hypotension.

Kerk et al. 1995; USA
Downs & Black=11
Prospective Controlled Trial
N=6

Population: Chronic complete paraplegia.
Treatment: Cross-over design: abdominal binder (experimental condition) or not wearing (the control condition).
Outcome Measures: BP, HR, VO2max, respiratory parameters, and wheelchair propulsion.

1. 5/6 subjects demonstrated a mean increase of 31 % in forced vital capacity with binder compared to without. No statistical significance but this may be because the sixth subject showed an 18% decrease in forced vital capacity when wearing the binder.

Rimaud et al. 2008;
France
Downs & Black=14
Pre-Post
N = 9

Population: 9 men with chronic traumatic SCI, were divided into 2 groups: high paraplegia with lesion levels between T4 and T6 (n = 4), and low paraplegia with lesion levels between T10 and L1 (n = 5)
Treatment: Graduated compression knee-length stockings (GCS) at rest.
Outcome Measures: venous capacitance (VC); venous outflow (VO); heart rate; blood pressure.

1. No significant difference in heart rate and blood pressure for either group or either experiment
2. In both groups, VC values were lower with GCS than without
3. VO values did not differ significantly with or without GCS