title: Exercise and the multidisciplinary holistic approach to adolescent dysautonomia.
abstract: OBJECTIVE
  To determine whether an eight-week strength training programme as part of a multidisciplinary approach would minimise symptoms and improve quality of life in patients with dysautonomia.
  
  
  METHODS
  Adolescents referred to a tertiary-level cardiology service from May 2014-December 2015 with symptoms of dysautonomia were eligible. Participants completed an exercise test and a quality of life (QoL) questionnaire (PedsQL) prior to the intervention. Participants were asked to complete exercises five times per week. After eight weeks, participants returned for follow-up testing. Parents completed a proxy report of their child's QoL at both time points.
  
  
  RESULTS
  A total of 17 participants completed the study protocol with an adherence rate of up to 50%. Post-intervention, QoL scores improved across all levels in the participants [total 65.2 (50.4-74.7) vs 48.9 (37.5-63.0); p = 0.006; psychosocial 65.8 (56.1-74.6) vs 50.0 (41.7-65.8); p = 0.010; physical 62.5 (37.5-76.6) vs 43.8 (25-68.5); p = 0.007] and their parent proxy reports [total 63.5 (48.7-81.3) vs 50.0 (39.3-63.0); p = 0.004; psychosocial 62.1 (52.1-81.3) vs 50.0 (39.6-59.2); p = 0.001; physical 62.5 (51.6-80.0) vs 50.0 (27.5-70.3); p = 0.003]. Treadmill time also improved (9.1 vs 8.0 minutes; p = 0.005).
  
  
  CONCLUSIONS
  Following an eight-week strength training programme, dysautonomia patients report a significant improvement in both their quality of life and endurance time.
authors.affiliation: Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada.|Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: K R
authors.initials: KR
authors.lastname: Armstrong
authors.affiliation: Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: De Souza
authors.affiliation: Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.|Department of Psychology, BC Children's Hospital, Vancouver, BC, Canada.
authors.forename: P L
authors.initials: PL
authors.lastname: Sneddon
authors.affiliation: Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada.|Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: J E
authors.initials: JE
authors.lastname: Potts
authors.affiliation: Department of Biomedical Physiology and Kinesiology, Cardiovascular Physiology Laboratory, Simon Fraser University, Burnaby, BC, Canada.
authors.forename: V E
authors.initials: VE
authors.lastname: Claydon
authors.affiliation: Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada.|Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Sanatani
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D054969:Primary Dysautonomias / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training; D016896:Treatment Outcome
keywords: Autonomic nervous system; Dysautonomia of adolescence; Exercise; Quality of life