P-159: Comparison of hand dexterity in geriatric and non-geriatric patients with Parkinson's disease

Background. Hand functionality and finger dexterity are impaired in patients with Parkinson’s disease (PD). These disturbances lead to a dependency in activities of daily living (ADL) and poor quality of life (QoL). Objective. We aimed to evaluate whether a specific occupational therapy (OT) program is effective in improving finger and hand dexterity and its impact on ADL in PD patients. Methods. We retrospectively studied PD patients, hospitalized for a 4-week multidisciplinary intensive rehabilitation treatment (MIRT) between January 2015 and June 2018. All patients underwent 1 h/day OT treatment, 5 days a week. The primary outcome measure was the O’Connor finger dexterity test; secondary outcome measures were the Minnesota dexterity test, UPDRS II, and Self-Assessment Parkinson’s Disease Disability Scale (SPDDS). These measures were assessed at admission (T0) and discharge (T1). Results. Based on the Hoehn and Yahr scale (H&Y), patients were divided into two groups: 262 subjects in H&Y stage <3 (early-stage PD patients) and 220 in H&Y stage ≥3 (medium-advanced stage PD patients). As expected, at baseline, all measures were worse in higher H&Y stages. After treatment, both groups experienced significant improvements in all outcomes. Significant differences between early-stage and medium-advanced stage PD patients were observed only for the changes in UPDRS II, with a better improvement in patients in H&Y stage ≥3. Conclusions. We showed that PD patients who underwent a rehabilitation protocol including OT experienced improvements in finger dexterity and hand functionality. Our results underline the relevance of OT in improving autonomy and QoL in PD patients.

Download Full-text

Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462009000100010 ◽

2009 ◽

Vol 31 (1) ◽

pp. 39-42 ◽

Cited By ~ 12

Author(s):

Beatriz Azevedo dos Anjos Godke Veiga ◽

Vanderci Borges ◽

Sonia Maria César de Azevedo Silva ◽

Fabrício de Oliveira Goulart ◽

Maysa Seabra Cendoroglo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Major Depression ◽

Beck Depression Inventory ◽

Geriatric Patients ◽

Rating Scale ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Yahr Scale ◽

Disease Rating

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

Download Full-text

Fatigue in a cohort of geriatric patients with and without Parkinson's disease

Brazilian Journal of Medical and Biological Research ◽

10.1590/s0100-879x2009000800014 ◽

2009 ◽

Vol 42 (8) ◽

pp. 771-775 ◽

Cited By ~ 15

Author(s):

F.O. Goulart ◽

B.A. Godke ◽

V. Borges ◽

S.M.C. Azevedo-Silva ◽

M.F. Mendes ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Geriatric Patients

Download Full-text

Improvement of hand dexterity induced by stimulation of the peduncolopontine nucleus in a patient with advanced Parkinson’s disease and previous long-lasting bilateral subthalamic DBS

Acta Neurochirurgica ◽

10.1007/s00701-011-1051-0 ◽

2011 ◽

Vol 153 (8) ◽

pp. 1587-1590 ◽

Cited By ~ 4

Author(s):

Angelo Franzini ◽

Giuseppe Messina ◽

Edvin Zekaj ◽

Luigi Romito ◽

Roberto Cordella

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Advanced Parkinson’S Disease ◽

Hand Dexterity ◽

Stimulation Of

Download Full-text

Wuqinxi Exercise Improves Hand Dexterity in Patients with Parkinson’s Disease

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8352176 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Tian Wang ◽

Guiping Xiao ◽

Zhenlan Li ◽

Kuncheng Jie ◽

Mengyue Shen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Standing Position ◽

Dominant Hand ◽

Emotional Wellbeing ◽

Single Session ◽

Training Interventions ◽

Hand Dexterity ◽

Before And After

Objective. This study was designed to evaluate the effect of Wuqinxi after one session and 12-week intervention on hand dexterity in patients with Parkinson’s disease (PD). Methods. Forty-six elderly participants with mild-to-moderate PD were randomly assigned to the groups trained with Wuqinxi (n = 23) or stretching (n = 23). All participants practiced 60 min session of either of these exercises, 2 sessions a week for 12 weeks in standing position. The score of Purdue Pegboard Test (PPT) and time for Soda Pop Test (SPT) were performed to assess hand dexterity and motor function along assessing the 39 items of Parkinson’s Disease Questionnaire before and after 12-week interventions. In addition, the PPT scores were compared before vs. after one session of either of these two exercise modes. Results. Single session with either Wuqinxi or stretching exercise tended to improve PPT scores in PD patients. Furthermore, the improved SPT time was significant ( P < 0.01 ) following 12-week training interventions with Wuqinxi (−1.32 ± 0.38 sec) or stretching (−0.89 ± 0.16 sec), which showed no group difference ( P = 0.734 ). However, only the participants in Wuqinxi group significantly improved the PPT scores of the dominant hand (+0.61 ± 1.34), both hand (+1.83 ± 3.13) and assemble (+2.04 ± 3.44) performance after 12-week training intervention. In parallel with improved hand dexterity and motor function, 12-week Wuqinxi training also significantly improved the patient’s emotional wellbeing. Conclusion. The Wuqinxi intervention could be safely and effectively applied to improve hand dexterity following single-session exercise or 12-week training, which were accompanied by improved quality of life in patients with mild-to-moderate PD.

Download Full-text

Cardiac Changes in Parkinson’s Disease: Lessons from Clinical and Experimental Evidence

International Journal of Molecular Sciences ◽

10.3390/ijms222413488 ◽

2021 ◽

Vol 22 (24) ◽

pp. 13488

Author(s):

Lorena Cuenca-Bermejo ◽

Pilar Almela ◽

Javier Navarro-Zaragoza ◽

Emiliano Fernández Villalba ◽

Ana-María González-Cuello ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Orthostatic Hypotension ◽

Side Effect ◽

Geriatric Patients ◽

Hospital Admissions ◽

Negative Inotropic Effect ◽

Nerve Fibers ◽

Motor Symptom ◽

Cardiac Damage

Dysautonomia is a common non-motor symptom in Parkinson’s disease (PD). Most dysautonomic symptoms appear due to alterations in the peripheral nerves of the autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. The degeneration of sympathetic nerve fibers and neurons leads to cardiovascular dysfunction, which is highly prevalent in PD patients. Cardiac alterations such as orthostatic hypotension, heart rate variability, modifications in cardiogram parameters and baroreflex dysfunction can appear in both the early and late stages of PD, worsening as the disease progresses. In PD patients it is generally found that parasympathetic activity is decreased, while sympathetic activity is increased. This situation gives rise to an imbalance of both tonicities which might, in turn, promote a higher risk of cardiac damage through tachycardia and vasoconstriction. Cardiovascular abnormalities can also appear as a side effect of PD treatment: L-DOPA can decrease blood pressure and aggravate orthostatic hypotension as a result of a negative inotropic effect on the heart. This unwanted side effect limits the therapeutic use of L-DOPA in geriatric patients with PD and can contribute to the number of hospital admissions. Therefore, it is essential to define the cardiac features related to PD for the monitorization of the heart condition in parkinsonian individuals. This information can allow the application of intervention strategies to improve the course of the disease and the proposition of new alternatives for its treatment to eliminate or reverse the motor and non-motor symptoms, especially in geriatric patients.

Download Full-text