Objective: To investigate the short-term efficacy of ankle pump exercise combined with automated compression abdominal belts on orthostatic hypotension (OH) and orthostatic intolerance symptoms in patients with Parkinson’s disease (PD).

Background: Orthostatic hypotension is a common and disabling non-motor manifestation of PD, resulting from autonomic dysfunction and impaired sympathetic cardiovascular responses. OH increases the risk of falls, syncope, cognitive impairment, and reduced quality of life. Pharmacological treatments may worsen supine hypertension, underscoring the importance of non-pharmacological interventions. Although ankle pump exercise and abdominal compression have shown benefits individually, evidence for their combined effect in PD-related OH remains limited.

Method: In this open-label randomized controlled trial, 92 PD patients with neurogenic OH were randomized (1:1:1:1) to ankle pump exercise, compression abdominal belt, combined intervention, or routine care for 10 days. Blood pressure was assessed supine and at 1, 3, and 5 minutes after standing. The primary outcome was change in systolic blood pressure (SBP) drop at 3 minutes. Secondary outcomes included BP changes at other time points and symptom severity measured by OHSA, OHDAS, and OGS. Analyses used mixed-effects models adjusted for baseline variables.

Results: Baseline characteristics were comparable across groups. After 10 days, the combined intervention significantly improved SBP drop at 3 minutes compared with control (adjusted mean difference −12.1 mmHg, 95% CI −20.8 to −3.5; P = 0.03), with a similar effect at 5 minutes (−11.9 mmHg, 95% CI −20.7 to −3.2; P = 0.04). No significant BP improvement was observed in single-intervention groups. Orthostatic symptom scores improved in all intervention groups, with the greatest improvement observed in the combined group, particularly on OGS.

Conclusion: Ankle pump exercise combined with automated compression abdominal belts suggests a potential to effectively reduce orthostatic hypotension and alleviate symptoms of orthostatic intolerance in patients with Parkinson’s disease. However, given the small sample size, these findings are preliminary and require further trials.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-randomized-controlled-trial-evaluating-ankle-pump-combined-with-compression-abdominal-belts-on-orthostatic-hypotension-in-patients-with-parkinsons-disease/