Muscle techniques may help reduce dizziness when standing up, new study finds

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A new study explores muscle techniques to help decrease dizziness upon standing up, a common condition due to initial orthostatic hypotension (IOH).

The study, led by researchers at the University of Calgary and published in the Heart Rhythm, the journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, offered two muscle techniques to help reduce the symptoms of IOH.

Researchers investigated physical maneuvers before or after standing and their efficacy in reducing a drop in blood pressure, as well as the most common symptoms seen in IOH patients upon standing.

The study’s participants included 22 young women between the ages of 25 and 38 years with a history of fainting immediately after standing with more than four episodes of presyncope or syncope per month. Participants were required to have a significant drop in systolic blood pressure of at least 40mmHg upon standing to fulfill the diagnostic criteria of IOH on the study day.

Participants completed three sit-to-stand maneuvers including a stand with no intervention and two interventions. Continuous heart rate and beat-to-beat blood pressure were measured. Stroke volume and cardiac output were then estimated from these results, according to the study.

Researchers found that pre-activating the thighs through repeated knee raises prior to standing (PREACT) and tensing the thighs and buttock muscles through leg crossing and tensing immediately after standing (TENSE) effectively improved the blood pressure drop. This led to a reduction in symptoms upon standing. They found that the PREACT maneuver accomplished this by increasing cardiac output, while the TENSE maneuver did so by increasing stroke volume.

“Our study provides a novel and cost-free symptom management technique that patients with IOH can use to manage their symptoms,” said the study’s first author Nasia A. Sheikh, MSc, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary. “Since it is a physical maneuver, it simply requires the lower body limbs, which patients can utilize at any time and from anywhere to combat their symptoms.”

IOH symptoms including fainting, lightheadedness, dizziness, or loss of consciousness and affects more than 40 percent of the general population.

Integrative practitioners can incorporate these techniques into treatment plans for their patients who suffer from IOH to help manage their symptoms.