THE EFFECT OF REHABILITATION ON HEART RATE VARIABILITY IN PATIENTS WITH PARKINSON'S DISEASE

BACKROUND: Parkinson's disease includes disorders of the motor and autonomic functions (Oka et al., 2006). It is necessary to influence both systems to improve the health state of the patients. The effects of rehabilitation on the autonomic nervous system (ANS) are not clear yet. OBJECTIVE: The aim of this study was to evaluate differences in the autonomic nervous system (ANS) regulation following a rehabilitation programme in patients with Parkinson's disease (PD) with the use of spectral analysis of heart rate variability (SAHRV) in a supine-standing-supine test. We wanted to compare findings in patients with PD prior to a rehabilitation programme with age-matched healthy controls. METHODS: The group under study involved ten subjects (mean age 69.2 +/- 5.9 years) with Parkinson's disease (9.2 +/- 3.0 points according to the Webster scale), with a disease duration mean 3.3 +/- 1.2 years. All patients used L-Dopa. We used the VarCor PF7 diagnostic system for the assesment of SAHRV. The findings in patients with PD before the rehabilitation programme were compared with those in a group of age-matched healthy subjects in a control group (n = 40; mean age 64.0 +/- 7.4 years). RESULTS: Significantly lower values of the LF (low frequency) and HF (high frequency) components were found in patients with PD in a repeated supine position, in comparison with those in a group of control subjects. The value of Total power in the same position was significantly lower in the group of patients with PD, too. Spectral parameter Power HF increased significantly and the Ratio LF/HF decreased significantly in patients with PD after rehabilitation programme. CONCLUSIONS: A decrease of the activity of the autonomic nervous system, which evidences disturbances of cardiovascular regulation, was found with the use of SAHRV in patients with PD. The value of the spectral parameter Power HF was significantly higher and the Ratio LF/HF was significantly lower in patients with PD after rehabilitation programme in comparison with their initial values. It could reflect positive changes in autonomic regulation in these patients.