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  4. Effect of Lower Limb vs. Abdominal Compression on Mobility in Orthostatic Hypotension: A Single-Blinded, Randomized, Controlled, Cross-Over Pilot Study in Parkinson's Disease
 
research article

Effect of Lower Limb vs. Abdominal Compression on Mobility in Orthostatic Hypotension: A Single-Blinded, Randomized, Controlled, Cross-Over Pilot Study in Parkinson's Disease

Paschen, Steffen
•
Hansen, Clint
•
Welzel, Julius
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January 1, 2022
Journal Of Parkinsons Disease

Background: Orthostatic hypotension (OH) in Parkinson's disease (PD) is frequent and associated with impairments in quality of life and reduced activities of daily living. Abdominal binders (AB) and compression stockings (CS) have been shown to be effective non-pharmacological treatment options. Objective: Here, we investigate the effect of AB versus CS on physical activity using a digital mobility outcome (sit to stand [STS] frequency) collected in the usual environment as a primary endpoint. Methods: We enrolled 16 PD patients with at least moderate symptomatic OH. In a randomized, single-blinded, controlled, crossover design, participants were assessed without OH treatment over 1 week (baseline), then were given AB or CS for 1 week and subsequently switched to the other treatment arm. The primary outcome was the number of reallife STS movements per hour as assessed with a lower back sensor. Secondary outcomes included real-life STS duration, mean/systolic/diastolic blood pressure drop (BPD), orthostatic hypotension questionnaire (OHQ), PD quality of life (PDQ39), autonomic symptoms (SCOPA-AUT), non-motor symptoms (NMSS), MDS-UPDRS, and activities of daily living (ADL/iADL). Results: Real-life STS frequency on CS was 4.4 +/- 4.1 per hour compared with 3.6 +/- 2.2 on AB and 3.6 +/- 1.8 without treatment (p = 1.0). Concerning the secondary outcomes, NMSS showed significant improvement with CS and AB. OHQ and SCOPA-AUT improved significantly with AB but not CS, and mean BPD drop worsened with CS but not AB. Mean STS duration, PDQ-39, MDS-UPDRS, ADL, and iADL did not significantly change. Conclusion: Both AB and CS therapies do not lead to a significant change of physical activity in PD patients with at least moderate symptomatic OH. Secondary results speak for an effect of both therapies concerning non-motor symptoms, with superiority of AB therapy over CS therapy.

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Type
research article
DOI
10.3233/JPD-223406
Web of Science ID

WOS:000903412100021

Author(s)
Paschen, Steffen
Hansen, Clint
Welzel, Julius
Albrecht, Judith
Atrsaei, Arash  
Aminian, Kamiar  
Zeuner, Kirsten E.
Romijnders, Robbin
Warmerdam, Elke
Urban, Paul Peter
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Date Issued

2022-01-01

Publisher

IOS PRESS

Published in
Journal Of Parkinsons Disease
Volume

12

Issue

8

Start page

2531

End page

2541

Subjects

Neurosciences

•

Neurosciences & Neurology

•

abdominal binder

•

compression stockings

•

orthostatic hypotension

•

parkinson's disease

•

sit-to-stand

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blood pressure drop

•

blood-pressure recovery

•

nonmotor symptoms scale

•

validation

•

movement

•

falls

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LMAM  
Available on Infoscience
January 30, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/194422
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