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ICC Sydney

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Assessment and management of dysautonomia in Post-COVID syndrome and related chronic medical conditions

Session outline

Dysautonomia or Autonomic Dysfunction is a well-recognised phenomenon seen in Post-COVID syndrome PCS) affecting up to 67% of individuals, and plays a pivotal role in symptom generation and perpetuation. The management of PCS in the UK and emerging global evidence has helped us recognise the condition, understand mechanisms, set up integrated management pathways, develop condition-specific patient-reported outcome measures (PROMs) and test rehabilitation intervention programmes.

In this workshop, we will share investigations for dysautonomia, including the use and efficacy of the NASA Lean test for dysautonomia, as well as of a home test called the aAP (adapted Autonomic Profile) which allows a comprehensive and dynamic assessment of autonomic function in PCS. We will discuss the role of heart rate variability as an indirect marker of dysautonomia and share the findings of the HEARTLOC research study detailing a heart rate variability (HRV) biofeedback programme using a diaphragmatic breathing intervention which has demonstrated early efficacy in PCS. Lastly, we will cover other medical and rehabilitation treatments for dysautonomia in PSC and other related conditions such as Fibromyalgia and Myalgic Encephalitis/ Chronic Fatigue Syndrome. We will share our experience of assessing and managing dysautonomia from the NIHR LOCOMOTION study, the largest platform of specialist NHS PCS clinics managing more than 4000 individuals with the condition.

Learning outcomes

  • Attendees get to know how to assess dysautonomia, investigate and make differential diagnosis
  • Attendees will gain knowledge on how to interpret findings of NASA lean test and diagnose the different Orthostatic Intolerance syndromes
  • Attendees will explore how to use the aAP protocol and work with patients at home
  • Attendees get to do some hands-on work with the HRV biofeedback equipment
  • Attendees get to understand dysautonomia pathways in different countries from the delegates and commissioning challenges and opportunities
  • Attendees can discuss ways of collaboration on developing standardised frameworks for rehabilitation staff willing to work in this area

Target audience

  • Rehabilitation physicians
  • Allied Health Professionals
  • Medical practitioners
  • Students
  • Trainees
  • Nursing staff
  • Administrators
  • Policy makers

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