Effetti della stimolazione meccanica plantare ripetuta sul profilo autonomico, sui parametri cardiovascolari e di movimento nei pazienti affetti da malattia di Parkinson

Introduction: Parkinson’s disease (PD) is spread worldwide; the incidence rapidly increases over the age of 60 years. The cause for the neuronal degeneration tipical of Parkinson disease is not known, nor there are any effective treatment; at the moment only symptomatic treatments are available. Among them there is foot mechanical stimulation which, in a preliminary study, showed an improvement of motor function and performance, enhancement of vagal modulation and reduction of sympathetic modulation, with a concurrent reduction of clinostatic blood pressure after one session of stimulation. The purpose of this study was to evaluate the effects of repeated foot mechanical stimulation on the autonomic, hemodinamic and motor assesment in patients affected by idiopathic PD Material and methods: We enrolled 23 patients with idiopatic PD, from 50 and 80 years old. Each patient underwent a cardiovascular assessment, autonomic status, neurologic and motor profile assessment on the first day, on the second day and on the sixteenth day (the last day of the study). Foot mechanical stimulation was performed the first day, the second day and three times per 72 hours distance. Data were then collected and analyzed. Results: Our study showed how repeated foot stimulation on two specific points on the sole of the foot can lead to a significant reduction of sympathetic modulation and to an enhancement, albeit not statistically significant, of vagal modulation - revealed by both spectral analysis and by symbolic analysis. Moreover, between the start and the end of the study, there was a statistically significant reduction of both SAP and DAP measured in clinostatic position and a clear motor improvement. Conclusions: Repeated foot stimulation may be used in patients affected by Parkinson disease, coupled with the usual treatments, to improve motor function (and so patients’ quality of life), and to treat clinostatic hypertension. That can lead to a reduction in pharmacological antihypertensive therapies and to a better management of orthostatic hypotension, reducing the risk of falls and of disabilities.