scholarly journals Impact of Mézières Rehabilitative Method in Patients with Parkinson’s Disease: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
Teresa Paolucci ◽  
Federico Zangrando ◽  
Giulia Piccinini ◽  
Laura Deidda ◽  
Rossella Basile ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Controlled Trial ◽  
Group Home ◽  
Berg Balance Scale ◽  
Home Exercise ◽  
Control Group ◽  
Trunk Flexion ◽  
Trunk Flexibility

The aim of this study was to assess the efficacy of Mézières method in improving trunk flexibility of the back muscles and balance in patients with Parkinson’s disease (PD). Materials and Methods. Thirty-six patients were randomized into 2 groups: the Mézières treatment group and the control group (home exercise group). The primary outcome was the improvement in balance per the Berg Balance Scale (BBS) and the trunk flexibility of the back for the anterior flexion trunk test. Also, we evaluated pain, gait balance for the Functional Gait Assessment (FGA), disease-related disability for the Modified Parkinson’s Activity Scale and the Unified Parkinson’s Disease Rating Scale (UPDRS), the quality of life, and the functional exercise capacity. All the measures were evaluated at baseline (T0), at the end of the rehabilitative program (T1), and at the 12-week follow-up (T2). Results. In the Mézières group, the BBS (p<.001) and trunk flexion test (p<.001) improved significantly at T1 and remained the same at T2. Between groups, significant changes were reported in FGA (p=.027) and UPDRS Total (p=.007) at T1 and in FGA (p=.03) at T2. Conclusion. The Mézières approach is efficacious in improving the flexibility of the trunk and balance in PD patients.

Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study

2014 ◽  
Vol 28 (12) ◽  
pp. 1210-1217 ◽  
Author(s):  
Daniele Volpe ◽  
Maria Giulia Giantin ◽  
Roberto Maestri ◽  
Giuseppe Frazzitta
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measures ◽  
Rating Scale ◽  
Controlled Trial ◽  
Berg Balance Scale ◽  
Secondary Outcome ◽  
Balance Confidence ◽  
Balance Scale ◽  
Confidence Scale

Objective: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson’s disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. Design: A randomized single-blind controlled trial. Setting: Outpatients. Subjects: Thirty-four patients with Parkinson’s disease in Hoehn-Yahr stage 2.5–3. Intervention: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). Main measures: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson’s Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson’s Disease Questionnaire-39. Results: Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (−5.9 SD4.8 vs. −1.9 SD1.4, p = 0.003), Parkinson’s Disease Quetionnaire-39 (−18.4 SD12.9 vs. −8.0 SD7.0, p = 0.006) and falls diary (−2.4 SD2.2 vs. −0.4 SD0.5, p = 0.001). Conclusion: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.

scholarly journals A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Agnes Langer ◽  
Sebastian Hasenauer ◽  
Anna Flotz ◽  
Lucia Gassner ◽  
Rochus Pokan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Controlled Trial ◽  
Drop Out ◽  
Control Group ◽  
Class Iii ◽  
Yahr Stage ◽  
Sport Climbing ◽  
Randomised Controlled

AbstractPhysical activity is of prime importance in non-pharmacological Parkinson’s disease (PD) treatment. The current study examines the effectiveness and feasibility of sport climbing in PD patients in a single-centre, randomised controlled, semi-blind trial. A total of 48 PD patients without experience in climbing (average age 64 ± 8 years, Hoehn & Yahr stage 2–3) were assigned either to participate in a 12-week sport climbing course (SC) or to attend an unsupervised physical training group (UT). The primary outcome was the improvement of symptoms on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III). Sport climbing was associated with a significant reduction of the MDS-UPDRS-III (−12.9 points; 95% CI −15.9 to −9.8), while no significant improvement was to be found in the UT (−3.0 points; 95% CI −6.0 to 0.1). Bradykinesia, rigidity and tremor subscales significantly improved in SC, but not in the unsupervised control group. In terms of feasibility, the study showed a 99% adherence of participants to climbing sessions and a drop-out rate of only 8%. No adverse events occurred. This trial provides class III evidence that sport climbing is highly effective and feasible in mildly to moderately affected PD patients.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

2021 ◽  
pp. 154596832110231
Author(s):  
Kishoree Sangarapillai ◽  
Benjamin M. Norman ◽  
Quincy J. Almeida
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Randomized Controlled Trial ◽  
Repeated Measures ◽  
Rating Scale ◽  
Controlled Trial ◽  
Motor Symptoms ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Double Blinded

Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson’s disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.

scholarly journals Feasibility Aspects of Exploring Exercise-Induced Neuroplasticity in Parkinson’s Disease: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Hanna Johansson ◽  
Malin Freidle ◽  
Urban Ekman ◽  
Ellika Schalling ◽  
Breiffni Leavy ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Trial Design ◽  
Controlled Trial ◽  
Recruitment Rate ◽  
Blood Sampling ◽  
Assessment Process ◽  
Control Group ◽  
Exercise Induced

Background. Recent studies indicate that exercise can induce neuroplastic changes in people with Parkinson’s disease (PwPD). Reports of feasibility outcomes from existing pilot trials however are, of date, insufficient to enable replication by others in larger definitive trials. Objective. To evaluate trial design for a definitive trial by exploring process and scientific feasibility. Methods. The trial design was a parallel-group RCT pilot with a 1 : 1 allocation ratio to either HiBalance or an active control group (HiCommunication). Both groups received one-hour sessions twice weekly, plus home exercises weekly, for 10 weeks. Participants with mild-to-moderate Parkinson’s disease (PD) were recruited via advertisement. Assessment included physical performance, structural and functional MRI, blood sampling, neuropsychological assessment, and speech/voice assessment. Process and scientific feasibility were monitored throughout the study. Process feasibility involved recruitment, participant acceptability of assessments and interventions, assessment procedures (focus on imaging, blood sampling, and dual-task gait analysis), and blinding procedures. Scientific feasibility involved trends in outcome response and safety during group training and home exercises. Data are presented in median, minimum, and maximum values. Changes from pre- to postintervention are reported descriptively. Results. Thirteen participants were included (4 women, mean age 69.7 years), with a recruitment rate of 31%. Attendance rates and follow-up questionnaires indicated that both groups were acceptable to participate. Image quality was acceptable; however, diplopia and/or sleepiness were observed in several participants during MRI. With regard to dual-task gait performance, there appeared to be a ceiling effect of the cognitive tasks with seven participants scoring all correct answers at pretest. Blinding of group allocation was successful for one assessor but was broken for half of participants for the other. Conclusions. The overall trial design proved feasible to perform, but further strengthening ahead of the definitive RCT is recommended, specifically with respect to MRI setup, cognitive dual-tasks during gait, and blinding procedures. This trial is registered with NCT03213873.

scholarly journals The Add-On Effect of Lactobacillus plantarum PS128 in Patients With Parkinson's Disease: A Pilot Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chin-Song Lu ◽  
Hsiu-Chen Chang ◽  
Yi-Hsin Weng ◽  
Chiung-Chu Chen ◽  
Yi-Shan Kuo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lactobacillus Plantarum ◽  
Outcome Measures ◽  
Rating Scale ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Motor Deficits ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Background:Lactobacillus plantarum PS128 (PS128) is a specific probiotic, known as a psychobiotic, which has been demonstrated to alleviate motor deficits and inhibit neurodegenerative processes in Parkinson's disease (PD)-model mice. We hypothesize that it may also be beneficial to patients with PD based on the possible mechanism via the microbiome-gut-brain axis.Methods: This is an open-label, single-arm, baseline-controlled trial. The eligible participants were scheduled to take 60 billion colony-forming units of PS128 once per night for 12 weeks. Clinical assessments were conducted using the Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr scale, and change in patient “ON-OFF” diary recording as primary outcome measures. The non-motor symptoms questionnaire, Beck depression inventory-II, patient assessment of constipation symptom, 39-item Parkinson's Disease Questionnaire (PDQ-39), and Patient Global Impression of Change (PGI-C) were assessed as secondary outcome measures.Results: Twenty-five eligible patients (32% women) completed the study. The mean age was 61.84 ± 5.74 years (range, 52–72), mean disease duration was 10.12 ± 2.3 years (range, 5–14), and levodopa equivalent daily dosage was 1063.4 ± 209.5 mg/daily (range, 675–1,560). All patients remained on the same dosage of anti-parkinsonian and other drugs throughout the study. After 12 weeks of PS128 supplementation, the UPDRS motor scores improved significantly in both the OFF and ON states (p = 0.004 and p = 0.007, respectively). In addition, PS128 intervention significantly improved the duration of the ON period and OFF period as well as PDQ-39 values. However, no obvious effect of PS128 on non-motor symptoms of patients with PD was observed. Notably, the PGI-C scores improved in 17 patients (68%). PS128 intervention was also found to significantly reduce plasma myeloperoxidase and urine creatinine levels.Conclusion: The present study demonstrated that PS128 supplementation for 12 weeks with constant anti-parkinsonian medication improved the UPDRS motor score and quality of life of PD patients. We suggest that PS128 could serve as a therapeutic adjuvant for the treatment of PD. In the future, placebo-controlled studies are needed to further support the efficacy of PS128 supplementation.Clinical Trial Registration:https://clinicaltrials.gov/, identifier: NCT04389762.

scholarly journals The PIT: SToPP Trial—A Feasibility Randomised Controlled Trial of Home-Based Physiotherapy for People with Parkinson's Disease Using Video-Based Measures to Preserve Assessor Blinding

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Emma Stack ◽  
Helen Roberts ◽  
Ann Ashburn
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Video Data ◽  
Video Production ◽  
Control Group ◽  
Group Participant ◽  
Home Based ◽  
Randomised Controlled

Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding.Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balancein situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case.Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention.

Stereopsis Deficits in Parkinson’s Disease and Their Clinical Implications

2020 ◽  
Author(s):  
Fang Ba ◽  
Tina T. Sang ◽  
Jaleh Fatehi ◽  
Wenjing He ◽  
Emanuel Mostofi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Severity ◽  
Rating Scale ◽  
Disease Status ◽  
Cognitive Status ◽  
Control Group ◽  
Motor Disorder ◽  
Healthy Control ◽  
Stereo Acuity

Abstract Background: Parkinson's disease (PD) is not exclusively a motor disorder. Among non-motor features, PD patients possess sensory visual dysfunctions. Stereopsis deficit can significantly impact patients' motor performance. However, it is not routinely tested, and its significance is under-investigated. Studying stereopsis using reliable 3D stimuli may help determine its implications in disease status in PD.The objective of the study is to investigate stereopsis abnormalities in PD with reliable and more physiological tools, and their correlation with indicators of PD severity. Methods: Twenty-four healthy control and 20 PD participants were first evaluated for visual acuity, visual field, contrast acuity, and stereoperception with 2D and Titmus stereotests, followed by the assessment with the 3D active shutter system. The correlation between stereopsis and disease severity, Unified Parkinson’s disease rating scale motor scores (UPDRS-III), levodopa equivalent daily dose (LEDD), course of disease and cognitive status were evaluated using univariate regression models. Results: Screening visual tests did not reveal any differences between PD and control group. With the 3D active shutter system, PD patients demonstrated significantly worse stereopsis (i.e p=0.002, 26 seconds of arc). There was a trend that UPDRS-III and LEDD negatively correlate with the stereo acuity, suggesting poorer stereoperception is related to disease severity. Preserved cognitive function correlated with more intact stereo acuity. Conclusion: With more reliable and physiological tools, PD patients exhibit poorer stereopsis. These deficits reflected PD motor and cognitive status. How stereopsis relates to gait, fall risks and navigation warrants more investigations in the future.

scholarly journals A Randomized Controlled Trial of Chinese Medicine on Nonmotor Symptoms in Parkinson’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ka-Kit Chua ◽  
Adrian Wong ◽  
Kam-Wa Chan ◽  
Yin-Kei Lau ◽  
Zhao-Xiang Bian ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Chinese Medicine ◽  
Rating Scale ◽  
Controlled Trial ◽  
Nonmotor Symptoms ◽  
Double Blind ◽  
Term Administration ◽  
Post Hoc ◽  
Chinese Medicine Theory

Nonmotor symptoms (NMS) of Parkinson’s disease (PD) have devastating impacts on both patients and their caregivers. Jiawei-Liujunzi Tang (JLT) has been used to treat some NMS of PD based on the Chinese medicine theory since Qing dynasty. Here we report a double-blind, randomized, placebo-controlled, add-on clinical trial aiming at evaluating the efficacy and safety of the JLT in treating NMS in PD patients. We randomly assigned 111 patients with idiopathic PD to receive either JLT or placebo for 32 weeks. Outcome measures were baseline to week 32 changes in Movement Disorder Society-Sponsored Revision of Unified PD Rating Scale (MDS-UPDRS) Parts I–IV and in NMS assessment scale for PD (NMSS). We observed improvements in the NMSS total score (p=0.019), mood/cognition (p=0.005), and reduction in hallucinations (p=0.024). In addition, post hoc analysis showed a significant reduction in constipation (p<0.001). However, there was no evidence of improvement in MDS-UPDRS Part I total score (p=0.216) at week 32. Adverse events (AEs) were mild and comparable between the two groups. In conclusion, long-term administration of JLT is well tolerated and shows significant benefits in improving NMS including mood, cognition, and constipation.

Effects of a core stabilization training program on balance ability in persons with Parkinson’s disease: a randomized controlled trial

2020 ◽  
Vol 34 (6) ◽  
pp. 764-772
Author(s):  
Irene Cabrera-Martos ◽  
Ana Teresa Jiménez-Martín ◽  
Laura López-López ◽  
Janet Rodríguez-Torres ◽  
Araceli Ortiz-Rubio ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Controlled Trial ◽  
Core Stability ◽  
Control Group ◽  
Balance Confidence ◽  
Balance Ability ◽  
Experimental Group

Objective: To explore the effects of an eight-week core stability program on balance ability in persons with Parkinson’s disease. Design: Randomized controlled trial. Setting: A local Parkinson’s association. Subjects: A total of 44 participants with a clinical diagnosis of Parkinson’s disease were randomly assigned to an experimental ( n = 22) or control group ( n = 22). Intervention: The experimental group received 24 sessions of core training, while the control group received an intervention including active joint mobilization, muscle stretching, and motor coordination exercises. Main measures: The primary outcome measure was dynamic balance evaluated using the Mini-Balance Evaluation Systems Test. Secondary outcomes included the balance confidence assessed with the Activities-specific Balance Confidence Scale and standing balance assessed by the maximal excursion of center of pressure during the Modified Clinical Test of Sensory Interaction on Balance and the Limits of Stability test. Results: After treatment, a significant between-group improvement in dynamic balance was observed in the experimental group compared to the control group (change, 2.75 ± 1.80 vs 0.38 ± 2.15, P = 0.002). The experimental group also showed a significant improvement in confidence (change, 16.48 ± 16.21 vs 3.05 ± 13.53, P = 0.047) and maximal excursion of center of pressure in forward (change, 0.86 ± 1.89 cm vs 0.17 ± 0.26 cm, P = 0.048), left (change, 0.88 ± 2.63 cm vs 0.07 ± 0.48 cm, P = 0.010), and right (change, 1.63 ± 2.82 cm vs 0.05 ± 0.17 cm, P = 0.046) directions of limits of stability compared to the control group. Conclusion: A program based on core stability in comparison with non-specific exercise benefits dynamic balance and confidence and increases center of mass excursion in patients with Parkinson’s disease.

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