M.L. Espinoza-Espinoza1, D.H. Méndez-Alfaro1, J.P. Bustamante-Aguirre1, Y.C. Espinoza-Valdés1, R.J. Córdova-Arellano1, N.A. Zelada-Astudillo2, A. Herrera-Santelices2, A.R. Zamunér1
1Universidad Católica del Maule, Laboratory of Clinical Research in Kinesiology - Department of Kinesiology, Talca, Chile, 2Universidad Católica del Maule, Departamento de Ciencias de la Actividad Fïsica, Talca, Chile

Background: Parkinson's disease (PD) is a neurodegenerative disorder, characterized by motor and non-motor dysfunctions. Among the non-motor ones, is noteworthy mentioning the autonomic dysfunction, also known as dysautonomia. Automatic mechanical peripheral stimulation (AMPS) has been proposed as a new effective therapy for improving gait parameters and with a potential effect for improving dysautonomia in this population. However, the studies are still incipient.

Purpose: To assess the acute effects of AMPS on cardiac autonomic control and functional capacity in patients with PD.

Methods: This study was approved by the Ethical Committee from the Universidad Católica del Maule under protocol number 183/2018. Eighteen volunteers of both sexes, with idiopathic PD, with a score of 1-3 on the Hoehn and Yhar scale took part in the study. All the volunteers underwent 2 sessions of AMPS: 1) active AMPS and 2) simulated AMPS (sham). The first intervention was determined by randomization, which was performed by a staff member blinded to the study protocol. A 2-week washout period was performed between each session. Before and after the intervention all participants had their RR intervals recorded in supine and standing postures using a Polar V800. Power spectrum analysis of heart rate (HR) variability provided the low frequency (LF) and high frequency (HF) power and LF/HF ratio as an index of the cardiac sympatho-vagal modulation. Moreover, the participants performed the Timed Up and Go and the 10-meter walk test. A two-way repeated measure analysis of variance (ANOVA) was used to check for Time*Condition interaction. Bonferroni's post hoc analysis was performed for the pairwise comparisons. Significance level was set at 5%.

Results: There was a significant increase in the balance item of the Tinetti mobility test (p = 0.03; d = 0.33) and in the walking speed (p = 0.049; d = 0.31) after the active AMPS. Regarding the spectral analysis, the indices LF (p = 0.049; d = 2.18) and LF/HF (p = 0.049; d = 2.14) were significantly higher than the values post sham procedure. In addition, the LF/HF increase from supine to standing was lower post AMPS compared to the post sham procedure (p = 0.01; d = 2.31).

Conclusion(s): One AMPS session was effective in improving, acutely, functional capacity and in increasing cardiac sympathetic modulation at rest in patients with PD. Future studies should address the long-term effects on both motor and cardiovascular parameters.

Implications: This study propose a new non-pharmacological approach, the AMPS, for improving functional capacity and cardiac autonomic control in patients with PD. The results showed that the AMPS was effective in improving functional capacity and increasing cardiac sympathetic control. AMPS might be an interesting non-pharmacological and non-time-consuming intervention for patients with PD.

Funding, acknowledgements: This study was supported by the FONDECYT de iniciación, Grant #11180310 (Fondo Nacional de Desarrollo Científico y Tecnológico, Chile).

Keywords: Rehabilitation, Autonomic Nervous System, Heart Rate Variability

Topic: Neurology: Parkinson's disease

Did this work require ethics approval? Yes
Institution: Universidad Católica del Maule, Talca, Maule, Chile
Committee: Comité de Ética de la Universidad Católica del Maule (CEC UCM)
Ethics number: 183/2018

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