scholarly journals How COVID-19 will boost remote exercise-based treatment in Parkinson’s disease: a narrative review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Agnes Langer ◽  
Lucia Gassner ◽  
Anna Flotz ◽  
Sebastian Hasenauer ◽  
Jakob Gruber ◽  
...  

AbstractThe lack of physical exercise during the COVID-19 pandemic-related quarantine measures is challenging, especially for patients with Parkinson’s disease (PD). Without regular exercise not only patients, but also nursing staff and physicians soon noticed a deterioration of motor and non-motor symptoms. Reduced functional mobility, increased falls, increased frailty, and decreased quality of life were identified as consequences of increased sedentary behavior. This work overviews the current literature on problems of supplying conventional physiotherapy and the potential of telerehabilitation, allied health services, and patient-initiated exercise for PD patients during the COVID-19 period. We discuss recent studies on approaches that can improve remote provision of exercise to patients, including telerehabilitation, motivational tools, apps, exergaming, and virtual reality (VR) exercise. Additionally, we provide a case report about a 69-year-old PD patient who took part in a 12-week guided climbing course for PD patients prior to the pandemic and found a solution to continue her climbing training independently with an outdoor rope ladder. This case can serve as a best practice example for non-instructed, creative, and patient-initiated exercise in the domestic environment in difficult times, as are the current. Overall, many recent studies on telemedicine, telerehabilitation, and patient-initiated exercises have been published, giving rise to optimism that facilitating remote exercise can help PD patients maintain physical mobility and emotional well-being, even in phases such as the COVID-19 pandemic. The pandemic itself may even boost the need to establish comprehensive and easy-to-do telerehabilitation programs.

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Giovanni Mirabella ◽  
Paolo De Vita ◽  
Michele Fragola ◽  
Silvia Rampelli ◽  
Francesco Lena ◽  
...  

Conventional medical treatments of Parkinson’s disease (PD) are effective on motor disturbances but may have little impact on nonmotor symptoms, especially psychiatric ones. Thus, even when motor symptomatology improves, patients might experience deterioration in their quality of life. We have shown that 3 years of active theatre is a valid complementary intervention for PD as it significantly improves the well-being of patients in comparison to patients undergoing conventional physiotherapy. Our aim was to replicate these findings while improving the efficacy of the treatment. We ran a single-blinded pilot study lasting 15 months on 24 subjects with moderate idiopathic PD. 12 were assigned to a theatre program in which patients underwent “emotional” training. The other 12 underwent group physiotherapy. Patients were evaluated at the beginning and at the end of their treatments, using a battery of eight clinical and five neuropsychological scales. We found that the emotional theatre training improved the emotional well-being of patients, whereas physiotherapy did not. Interestingly, neither of the groups showed improvements in either motor symptoms or cognitive abilities tested by the neuropsychological battery. We confirmed that theatre therapy might be helpful in improving emotional well-being in PD.


2019 ◽  
Author(s):  
Jéssica Moratelli ◽  
Kettlyn Hames Alexandre ◽  
Alessandra Swarowsky ◽  
Clynton Lourenço Corrêa ◽  
Ana Cristina Tillmann ◽  
...  

BACKGROUND People with Parkinson's disease constantly have low levels of physical activity, so dancing has become increasingly important for the treatment of the disease and can help improve balance, gait, reduce falls, and improve quality of life. However, there has been no research on the effects of binary and quaternary rhythms on the symptoms of people living with Parkinson's disease, so the study may provide a new treatment option for this population. OBJECTIVE To propose a 12-week protocol of binary and quaternary rhythms for individuals with Parkinson’s disease and to evaluate their effectiveness on motor (balance, gait, functional mobility), and non-motor symptoms (quality of life, sleep, sleepiness during daytime, fatigue) through a randomized clinical trial. METHODS Sixty individuals with idiopathic Parkinson’s disease, will be enrolled in the study. The participants will be allocated to either the intervention arm (binary rhythm (dance) or quaternary rhythm (dance) 2x/week for 12 weeks). The binary and quaternary rhythm dance classes will be divided into three stages: warm-up and stretching; the main stage and relaxation. Measurements of study outcomes will take place at baseline and post-intervention. RESULTS The primary outcome is balance measured by a balance test score (Mini-Bestest). Secondary outcomes include gait, functional mobility, quality of life, sleep, sleepiness during daytime and fatigue. CONCLUSIONS Considering the high prevalence of individuals with Parkinson's disease, implementing a specific protocol for binary and quaternary rhythms is important considering the need to improve the quality of life, motor and non-motor symptoms of your life. The study will provide critical information on the efficacy and effects of binary-rhythm interventions on motor and non-motor symptoms of individuals with Parkinson's disease in order to help guide and plan future studies. This is an innovative protocol, being an important tool for the reduction of motor and non-motor symptoms in individuals with Parkinson’s disease. CLINICALTRIAL The trial was registered on Clinical Trials number: NCT03235453.


2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.


2021 ◽  
Vol 11 (6) ◽  
pp. 771
Author(s):  
Fany Chuquilín-Arista ◽  
Tania Álvarez-Avellón ◽  
Manuel Menéndez-González

Parkinson’s disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson’s Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 890-890
Author(s):  
JuHee Lee ◽  
Yujin Suh ◽  
Yielin Kim

Abstract Smart phone-based technology for people with Parkinson’s disease has been developed worldwide. Unmonitored non-motor symptoms decrease quality of life of people with Parkinson’s disease, so the needs for technology to manage non-motor symptoms are increasing. The technology is needed to detect subtle changes in non-motor symptoms by healthcare professional. There is no mobile app which manage comprehensive symptoms of Parkinson’s disease including non-motor symptoms. It is necessary to develop a new tracking system that can effectively manage non-motor symptoms as well as motor symptoms of Parkinson’s disease. We developed a prototype of mobile app for Android smartphones, with cooperation with Mazelone company. we also have shaped functions for monitoring of motor symptoms and medication adherence. It also provided a section for caregivers to use on behalf of people with Parkinson’s disease who have difficulty to use app due to hand tremor. Through Delphi technique, we obtained content validity from eight medical and nursing experts on the contents of the application. We provided regular telephone counseling to improve and encourage their app usage. Fifteen participants used the app for 6 weeks. To evaluate usability of mobile app, we provided constructed questionnaire and conducted individual telephone interview. A mobile app for tracking non-motor symptoms demonstrated high usability and satisfaction. We learned lessons about facilitators and barriers when implementing an app such as perception and acceptance of mobile technology. The mobile app will improve continuum of care. Future studies need to improve the contents and refine technical approach for people with Parkinson’s disease.


2012 ◽  
Vol 18 ◽  
pp. S18
Author(s):  
D. Joshi ◽  
P. Chatterjee ◽  
B. Kumar ◽  
A.Z. Ansari ◽  
V.N. Mishra ◽  
...  

2018 ◽  
Vol 11 (4) ◽  
pp. 867-874 ◽  
Author(s):  
Haidar Salimi Dafsari ◽  
Luisa Weiß ◽  
Monty Silverdale ◽  
Alexandra Rizos ◽  
Prashanth Reddy ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Michal Lubomski ◽  
Ryan L. Davis ◽  
Carolyn M. Sue

Objectives: Cognitive impairment impacts negatively on Parkinson's disease (PD) patient and caregiver quality of life (QoL). We examined cognitive impairment in PD patients and their caregivers to determine if caregiver cognition affected their PD relative.Methods: Validated cognition and clinical outcome measures were assessed in 103 PD patients and 81 caregivers.Results: PD patients showed more cognitive impairment than their carers, with 48.6% having possible Mild Cognitive Impairment (MCI) and 16.5% having PD dementia. Increasing age, male gender, lower education level, various non-motor symptoms and certain therapies, associated with poorer cognition in PD. Eighteen and a half percent of caregivers were found to have MCI, in association with a lower physical and mental QoL. This reflected in lower QoL and mood for the respective PD patients.Conclusion: Impaired cognition and QoL in caregivers was associated with decreased QoL and mood for respective PD patients, suggesting MCI in caregivers is an important consideration for the management of PD.


2022 ◽  
Author(s):  
Manoela de Paula Ferreira ◽  
Adriano Zanardi da Silva ◽  
Bruna Yamaguchi ◽  
Sunita Mathur ◽  
Taina Ribas Melo ◽  
...  

BACKGROUND Many people with Parkinson’s disease (PD) have never received rehabilitation care due to lack of accessibility and transportation and high therapy costs for in-person rehabilitation. Home-based dance exercise is an innovative, low-cost therapy that may reduce accessibility barriers to exercise. Especially since the COVID-19 pandemic, home-exercise programs are a highly relevant, alternative approach for people with PD OBJECTIVE This clinical trial protocol aims to explore the effects of a Home-Based contemporary dance exercise program for people with moderate Parkinson’s Disease (PD), focusing on balance, functional mobility, quality of life (QOL), cognitive function, and depression. METHODS This protocol is for a non-randomized clinical trial for adults with moderate PD divided into control group (CG) and Experimental Group (EG). Participants from the EG will perform video-dances of the contemporary dance, delivered in a DVD format. The video-dances will be executed 16 weeks, three times per week, 30 minutes each day at home, with exercise intensity controlled by the BORG scale. Participants from the CG will not receive any new exercise therapy. As primary outcomes, the signs and symptoms of the PD assessed by the Unified Parkinson’s Disease Rating Scale – UPDRS II and III, Hoehn and Yahr for the PD severity, and health-related quality of life (HRQL), measured by the Parkinson’s Disease Questionnaire – PDQ-39) will be tested. Secondary outcomes include cognitive function by the Montreal Cognitive Assessment – MoCA, balance by the Mini-BESTest, functional mobility by the Timed “Up and Go” test – TUG and depression by the Geriatric Depression Scale – GDS. All outcomes will be assessed in an in-person evaluation by a blinded assessor before and after the 16 weeks of the program. RESULTS This protocol has a pilot study that included 10 participants (5 in each group). It was observed positive results favoring the EG over cognitive function (p = 0.034). In addition, HRQL, balance, and depression were improved after the pilot program in the EG, however, without significant difference. CONCLUSIONS This clinical trial has the potential to be a safe alternative exercise approach under COVID restrictions and travel-free therapy with effects on PD symptoms. CLINICALTRIAL RBR-58T68W (Brazilian Clinical Trials Registry)


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