Intervention en téléréadaptation et caractérisation de la dysautonomie cardiovasculaire dans la maladie de Parkinson

Introduction: The prevalence of Parkinson's disease (PD), which primarily affects the elderly, is constantly increasing. PD causes non-motor symptoms, such as cardiovascular dysautonomia (CD). Still underdiagnosed in clinics, CD poses risks to patients' health. Physical activity could improve CD and practicing it via telerehabilitation (TR) could reach a larger population. The objectives are 1) to assess the feasibility, acceptability, and explore the potential effects of a TR program on CD; and 2) to characterize CD in PD through objective and self-reported symptom measurements. Methods: 30 individuals with PD were contacted, of whom 16 underwent an active orthostatic hypotension (OH) test to detect CD (OH and/or supine hypertension-SH). Characterization was further complemented by heart rate variability (HRV) testing, galvanic skin response (GSR) and self-reported symptom questionnaires. Participants who tested positive for CD were invited to participated in a 12week hybrid (supervised/unsupervised) TR program. Feasibility (recruitment, retention and adherence rates, and safety), acceptability (satisfaction questionnaire and semi-structured interviews) and potential effects (HRV, GSR, self-reported symptoms, 24-hour ambulatory blood pressure monitoring, 6-minute walk test (6MWT)) were evaluated. Results: CD was detected in 5 out of 16 screened participants. No significant differences were observed between the groups with (CD+) and without (CD-) dysautonomia, and no clear trends emerged. Exploratory analyses identified different profiles within the CD+ group, including a more pronounced CD for patients with SH. The TR program had a low recruitment rate (10%) but good retention (100%) and adherence (91%) rates for the 3 participants who completed it. The intervention did not present any adverse events and acceptability was good according to the participants' perspective. The potential effects showed no trend on DC, while 6MWT indicated an improvement of cardiovascular capacity. Conclusion: The active OH test appears to be useful in identifying CD in PD. Different profiles among patients with CD may be identified. Despite a low recruitment rate, the TR program seems appropriate and responsive to the needs individuals with CD in PD. However, it seems necessary to improve accessibility strategies to reach a larger portion of the population and thus demonstrate the potential effects of such a RT program.

Name thesis:degree_name

M. Sc.

Level thesis:degree_level

Maîtrise

Discipline thesis:degree_discipline

Réadaptation

Grantor dc:publisher

Université de Sherbrooke

Year dc:date.issued

2024

Author dc:creator

• Crépin, Léo

Advisors dc:contributor.advisor

• Léonard, Guillaume
• Pinheiro Carvalho, Livia

• Maladie de Parkinson
• Téléréadaptation
• Dysautonomie
• Cardiovasculaire
• Parkinson’s disease
• Telerehabilitation
• Dysautonomia
• Cardiovascular

Language dc:language.iso

fr, en

Handle dc:identifier.uri

http://hdl.handle.net/11143/21832

OAI identifier oai:identifier

oai:usherbrooke.scholaris.ca:11143/21832