Around 30% of older adults experience a dangerous drop in blood pressure every time they stand up—a condition called orthostatic hypotension (OH) that doubles the risk of falls and hospitalisation. This matters because current treatments are inadequate. Drugs often fail, and existing abdominal binders—which work by compressing the abdomen to prevent blood from pooling in the legs—are uncomfortable, passive, and poorly tolerated. OH-related hospitalisations in the UK more than doubled between 2008 and 2017, and falls alone cost the NHS over £2.3 billion annually. The research team aims to replace these static binders with a smart, wearable device that uses motion sensors to detect when the wearer stands and automatically adjusts compression in real time. If successful, the device could reduce falls, prevent hospital admissions, and help older adults—particularly those with Parkinson’s disease—remain independent for longer. The project also includes co-design sessions with older adults to ensure the device is comfortable and easy to use, and a commercialisation strategy to bring it to market through either direct sales or the NHS. The result would be a cost-effective, non-pharmacological tool for a growing ageing population.
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BACKGROUND Orthostatic hypotension (OH), defined as a significant drop in blood pressure upon standing, affects approximately 30% of older adults and is particularly prevalent in individuals with neurodegenerative diseases such as Parkinson’s. OH contributes to cerebral hypoperfusion, dizziness, falls, cognitive decline, and mortality. It is a major driver of hospital admissions and long-term care placement, with OH-related hospitalizations more than doubling from 2008 to 2017. Falls alone cost the NHS over £2.3 billion annually. Current pharmacological treatments are inadequate, and while abdominal binders show promise, existing designs are passive, uncomfortable, and poorly tolerated, limiting both adherence and effectiveness. OBJECTIVE This project aims to prototype and evaluate an adaptive, wearable abdominal compression device to manage OH in older adults. The device will integrate motion sensing and responsive compression to regulate blood pressure in real time, improving functional outcomes and reducing fall risk, while addressing health inequalities through inclusive innovation. METHODS The project consists of four work packages (WPs): WP1: Prototype Development. In partnership with Kinneir Dufort, we will advance development of a user-centred, functional prototype featuring integrated motion sensors and a responsive compression system. The design will accommodate cognitive and physical impairments and will be iteratively refined through testing. WP2: Co-Design with Older Adults. Three facilitated co-design sessions with older adults living with OH will guide the development process. Participants will engage in discussions, interactive testing, and usability feedback activities to ensure the technology is accessible, acceptable, and tailored to user needs. Insights will inform final design decisions, with contingency planning for B2C vs. B2B viability. WP3: Feasibility Testing. A controlled feasibility study will assess safety, tolerability, and physiological performance during simulated postural changes. Older adult volunteers will test various compression modes under clinical observation, with safety protocols in place to mitigate risks including falls, syncope, and skin damage. WP4: Commercialisation Strategy. In collaboration with the NIHR i4i THRIVE programme and the University of Bristol’s Technology Transfer Office, we will conduct market research, health economic modelling, and IP protection activities. We will define pricing strategies for both B2B and B2C models and consult regulatory experts to guide translational planning. CONCLUSION This project addresses a critical unmet clinical and health system need through the development of an intelligent, user-responsive wearable device for OH management. By integrating inclusive design and robust engineering with real-world usability and translational planning, this work aims to reduce falls, improve independence, and deliver a cost-effective solution for an ageing global population.
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