TASKMASTER: TArgeting the SKeletal Muscle pump to Aid Standing in Elders with postuRal hypotension
Principal Investigator: Dr James Frith
This study aims to develop an efficacious and acceptable new therapy; ultimately aiming to improve the quality of life of older people with Orthostatic Hypotension (OH) without increasing their medication burden.
When we stand upright, gravity pulls blood down into our legs, leading to a drop in blood pressure (BP). As we get older this can become severe, leading to a condition called Orthostatic Hypotension (OH), where not enough blood reaches the brain when standing up.
One way to pump the blood out of the legs and up towards the brain is to squeeze the leg muscles – the skeletal muscle pump.
This study wants to find out if making the leg muscles stronger will make the skeletal muscle pump better at pumping blood back up towards the head. As this is a novel concept we must examine whether this idea has the potential to work, before investing in a large clinical trial.
The study will deliver an 8 week exercise programme to 15 older people with OH to increase the strength of their leg muscles. It will measure how much blood is pumped out of the muscles by using a specialised pressure cuff around the calf (similar to a normal BP cuff) before and after the exercise programme. It will also see if this improves BP and symptoms. Study participants will be asked whether the exercise programme was acceptable and how it could be improved.
If the results show that the skeletal muscle pump can be improved, Dr Frith will apply for more money to perform a larger clinical trial.
If this study detects a ‘signal of efficacy’ an application will be made to NIHR Effiacy and Mechanism Evaluation Programme to evaluate the efficacy of the intervention in detail. Having previously contacted the EME Programme, their advice was to perform a case series study to generate proof of concept data to inform a future application. This would include costings to support the research assistant to continue working in this field on the EME study.