Objective: Orthostatic hypotension (OH) in Parkinson’s disease (PD) is frequent and associated with reduced 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. Here, we investigate the effect of AB versus CS on physical activity using a digital parameter (sit to stand [STS] frequency) collected in the usual environment as a primary endpoint.

Background: Up to date, most PD patients with OH are treated with lower limb CS and AB.  Both treatments were shown to be effective in reducing blood pressure drop and associated symptoms, such as dizziness and presyncopes. To date it is unclear whether one of the two forms of therapy is more effective.

Method: We enrolled 16 PD patients with at least moderate symptomatic OH. In a randomized, single-blinded, controlled, crossover design, participants were assessed without 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 real-life STS movements per hour as assessed with a lower back sensor. Secondary outcomes included real-life sit to stand duration, mean/systolic/diastolic blood pressure drop (BPD), orthostatic hypotension questionnaire (OHQ), PD quality of life (PDQ-39), 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 2.9 ± 1.4 (SD) per hour compared with 3.5 ± 2.0 on AB and 3.7 ± 1.8 without treatment (p=.20). 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 MAP 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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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-lower-limb-vs-abdominal-compression-on-mobility-in-orthostatic-hypotension-a-single-blinded-randomized-controlled-cross-over-study-in-parkinsons-disease/