scholarly journals Physiotherapy in Parkinson’s Disease: Building ParkinsonNet in Czechia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ota Gal ◽  
Martin Srp ◽  
Romana Konvalinkova ◽  
Martina Hoskovcova ◽  
Vaclav Capek ◽  
...  

Objective. We conducted a questionnaire survey to investigate the availability and quality of physiotherapy (PT) for Parkinson’s disease (PD). Background. Despite evidence about the benefits of PT, there is no data regarding its use in Czechia. Methods. Questionnaires were sent to 368 PD patients seen in a single movement disorders centre within two years (inclusion criteria: idiopathic PD, Hoehn and Yahr stage <5, and residence in Prague) and to 211 physical therapists (PTs) registered in Prague. The patient questionnaire evaluated limitations in 6 core areas and in activities of daily living and inquired about experience with PT. The PTs questionnaire evaluated knowledge about PD, number of PD patients treated yearly, and details of therapy. Results. Questionnaires were returned by 248 patients and 157 PTs. PT was prescribed to 70/248 patients. The effects were satisfactory in 79% and lasted >3 months in 60/64. About half of the PTs have no experience with PD patients, 26% reported <3, and 5% see >10 yearly. The most widely used techniques were neurodevelopmental treatments. Conclusion. Present PD healthcare model in Czechia is suboptimal (low PT prescription, non-evidence-based PT). Implementation of European PT Guidelines for PD and the introduction of an efficient model of care are needed.

2020 ◽  
Vol 7 (6) ◽  
pp. 1732-1739
Author(s):  
Susan G Klappa ◽  
Julie A I Thompson ◽  
Stuart Blatt

The purpose of this study was to investigate grit, exercise, and quality of life (QOL) among individuals diagnosed with Parkinson’s disease (PD). A sample of convenience was used. A survey which included the grit scale, QOL scale, and open-ended questions was distributed to participants (n = 101, 51 male and 50 female) who are members of online PD support groups across the United States. Data were analyzed by SPSS 25. Grit values averaged 3.65 ± 0.51 for participants (n = 101). When divided into groups, mean grit score for community-based exercisers was 3.78 ± 0.42 and 3.10 ± 0.48 for home-based exercisers. Grit was positively correlated to higher QOL on the Parkinson’s disease quality of life (PDQL; r = +0.293, P = .004). Grit was positively correlated to the emotional component of the PDQL ( r = +0.462, P < .001). Participants with higher grit levels had higher emotional coping responses after being diagnosed with PD, exercised more, and were more willing to self-advocate. With limited rehabilitation visits allowed, physical therapists should be aware of community-based programs to redefine participation roles after diagnosis.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Tino Prell ◽  
Denise Schaller ◽  
Caroline Perner ◽  
Otto W. Witte ◽  
Julian Grosskreutz

Background. Frequently used nonmotor scales do not cover all aspects of dysautonomia in Parkinson’s disease (PD). This study explores the association between autonomic symptoms and sicca symptoms with other nonmotor symptoms and health-related quality of life (QoL) in PD. Methods. Autonomic symptoms (Survey of Autonomic Symptoms, SASs), motor function (Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale III, MDS-UPDRS III), nonmotor symptoms (nonmotor symptoms questionnaire, NMS-Quest), and QoL (PD Questionnaire-39, PDQ-39) were analysed in 93 PD patients without dementia. Multivariable and multivariate analyses were performed to study the association between clinical parameters and PDQ-39 domains. Results. Among the autonomic symptoms, sicca symptoms (xerostomia and dry eyes) were the most commonly reported (69%), followed by sexual dysfunction in men, leaking of urine, vasomotor dysfunction, constipation, sudomotor dysfunction, and orthostatic symptoms. The autonomic symptom burden (SAS total) correlated with the NMS-Quest and Hoehn and Yahr stage, but not with age, levodopa equivalent daily dose, disease duration, and the MDS-UPDRS III. The SAS total score was an independent predictor of the PDQ-39 summary index and mainly affected the PDQ-39 cognition and emotional well-being domains. Sicca symptoms were not associated with age, MDS-UPDRS III, disease duration, Hoehn and Yahr stage, and levodopa equivalent daily dose but aggravated the PDQ-39 domains: cognition, emotional well-being, bodily discomfort, and mobility. Sicca symptoms frequently occur together with other nonmotor symptoms, namely, urine urgency, orthostatic problems, and concentration problems. Overall, 75% of the subjects took at least one drug that can cause sicca symptoms (anti-PD medication, antidepressant drugs, antihypertensive drugs, antipsychotic drugs, antimuscarinic drugs, and analgesic drugs). Conclusion. Sicca symptoms are common in PD and negatively influence QoL. The observed association between sicca symptoms and other nonmotor symptoms provides further preliminary evidence for the growing recognition of different nonmotor clusters in PD.


2013 ◽  
Vol 31 (2) ◽  
pp. 235-238 ◽  
Author(s):  
Dhananjay Vijay Arankalle ◽  
Pradeep M K Nair

A 56-year-old man diagnosed in 2003 as having Hoehn & Yahr stage III Parkinson's disease (PD) came to our clinic in 2012 with slurred speech, right-sided bradykinesia, erectile dysfunction, rigidity, emotional instability and depression. His PD showed progressive signs with postural instability, moderate bilateral signs, and he rated 80% on the Schwab & England Activities of Daily Living Scale. A modified protocol of electroacupuncture was administered for a period of 5 weeks, six times per week, with each session lasting for 30 min. Assessments were based on the Berg Balance Scale (BBS) and Parkinson's Disease Questionnaire-39 (PDQ-39) items, a disease-specific measure of subjective health status. He showed improvement on the BBS, suggesting improved functional status. His quality of life showed improvement particularly on the ‘activities of daily living’, ‘cognition’ and ‘communication’ dimensions of the PDQ-39. Acupuncture treatments in animal experiments have generated valuable mechanistic insights that could be relevant to PD, for example, demonstrating its neuroprotective potential from stimulation of various neuroprotective agents. The literature also suggests acupuncture may play a role in the improvement of motor function and quality of life in PD. Acupuncture is tolerated well by individuals with PD and should be considered as an integrative approach for their symptomatic management.


2012 ◽  
Vol 25 (3) ◽  
pp. 659-666 ◽  
Author(s):  
Ana Paula Cunha Loureiro ◽  
Cristiane Gonçalves Ribas ◽  
Talita Gianello Gnoato Zotz ◽  
Rebeca Chen ◽  
Flávia Ribas

INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six volunteers, diagnosed to be in Stages II and III of PD (Hoehn and Yahr Scale), were recruited for this study. Patients (65 ± 13 years old) participated in activities involving Wii Fit, for a total of twelve interventions, twice per week. Clinical and qualitative methods were used for the data collection for the initial and final evaluations: Borg's Scale, Berg Functional Balance Scale, Time Up and Go, anterior and lateral functional reach and Nottingham's Scale were performed during the study. Penguin Slide, Ski Slalom, Soccer Heading and Table Tilt were the Wii games selected as a form of virtual therapy. RESULTS: The collected data were analyzed using the Wilcoxon test. Motor skill, functional capacities and quality of life were analyzed as variables of the patients' balance. Statistically significant differences were found in the following tests: Borg's Scale (p = 0.0464), Berg Functional Balance Scale (p = 0.0277), lateral functional reach to the right (p = 0.0431*) and lateral functional reach to the left (p = 0.0277). CONCLUSION: It is believed that exercises with virtual reality therapy can be a useful tool to improve the balance in PD patients.


2017 ◽  
Vol 48 (3-4) ◽  
pp. 131-137 ◽  
Author(s):  
Kingston Rajiah ◽  
Mari Kannan Maharajan ◽  
Si Jen Yeen ◽  
Sara Lew

Aim: This study focused on the impact of the clinical features on the quality of life (QoL) of Parkinson's disease (PD) patients and of their caregivers. Methods: This study included PD patients along with their caregivers and was undertaken at the Malaysian Parkinson's Disease Association from June 2016 to November 2016. Clinical features of PD patients were assessed using the Movement Disorder Society revised Unified Parkinson Disease Rating Scale; the Hoehn and Yahr stage and the Schwab and England Activities of Daily Living Scale were used to assess the severity and the ability of PD patients respectively. QoL of PD patients was measured using the Parkinson's Disease Questionnaire-39 (PDQ-39). The revised version of the Zarit Burden Interview assessed caregiver burden. Results: At least one of the clinical features affected PD patients' QoL, and at least one of the QoL domains affected the caregivers' burden. Clinical features “saliva and drooling” and “dyskinesia” explained 29% of variance in QoL of PD patients. The QoL domains “stigma,” along with “emotional well-being” explained 48.6% of variance in caregivers' burden. Conclusions: The clinical features “saliva and drooling” and “dyskinesia” impacted the QoL of PD patients, and the QoL domains “stigma” and “emotional well-being” of PD patients impacted their caregivers' burden.


2019 ◽  
Author(s):  
Danielle Pessoa Lima ◽  
Samuel Brito de Almeida ◽  
Janine de Carvalho Bonfadini ◽  
João Rafael Gomes de Luna ◽  
Madeleine Sales de Alencar ◽  
...  

ABSTRACTBackgroundSarcopenia is a complex and multifactorial geriatric condition seen in several chronic degenerative diseases. This study aimed to screen for sarcopenia and fall risk in a sample of Parkinson’s disease (PD) patients and to investigate demographic and clinical factors associated.MethodsThis is a cross-sectional study. We evaluated 218 PD patients at the Movement Disorders Clinic in Fortaleza, Brazil, and collected clinical data including experiencing falls in the six months prior to their medical visit. Probable sarcopenia diagnosis was confirmed by using a sarcopenia screening tool (SARC-F questionnaire) and the presence of low muscle strength.ResultsOne hundred and twenty-one patients (55.5%) were screened positive for sarcopenia using the SARC-F and 103 (47.4%) met the criteria for probable sarcopenia. Disease duration, modified Hoehn and Yahr stage, Schwab and England Activities of Daily Living Scale score, levodopa equivalent dose, probable sarcopenia and positive SARC-F screening were all associated with experiencing falls in the prior six months. Disease duration, lower quality of life and female gender were independently associated with sarcopenia. Experiencing falls in the prior six months was significantly more frequent among patients screened positive in the SARC-F compared to those screened negative.ConclusionsSarcopenia and PD share common pathways and may affect each other’s prognosis and patients’ quality of life. Since sarcopenia is associated with lower quality of life and increased risk of falls, active case finding, diagnosis and proper management of sarcopenia in PD patients is essential.


2021 ◽  
Author(s):  
Jori Fleisher ◽  
Serena Hess ◽  
Brianna Sennott ◽  
Erica Myrick ◽  
Ellen Klostermann Wallace ◽  
...  

BACKGROUND Current understanding of advanced Parkinson’s disease (PD) and its treatment is largely based on data from outpatient visits. The most advanced and disabled individuals become disconnected from both care and research. A previous pilot study among older, multimorbid patients with advanced PD demonstrated the feasibility of interdisciplinary home visits to reach the target population, improve care quality, and potentially avoid institutionalization. OBJECTIVE The following protocol tests whether interdisciplinary home visits can 1) prevent decline in quality of life and 2) prevent worsening caregiver strain. Finally, the protocol explores whether program costs are offset by savings in healthcare use and institutionalization when compared with usual care. METHODS In this single-center, controlled trial, 65 patient-caregiver dyads affected by advanced PD (Hoehn & Yahr stages 3-5 and homebound) are recruited to receive quarterly interdisciplinary home visits over one year. The one-year intervention is delivered by a nurse and research coordinator who travel to the home supported by a movement disorders specialist and social worker (both present by video). Each dyad is compared with age-, sex-, and Hoehn and Yahr stage-matched control dyads drawn from US participants in the longitudinal Parkinson’s Outcome Project registry. The primary outcome measure is change in patient quality of life between baseline and one year. Secondary outcome measures include change in Hoehn & Yahr stage, caregiver strain, self-reported fall frequency, emergency room visits, hospital admissions, and time-to-institutionalization and/or death. Intervention costs and changes in healthcare utilization will be analyzed in a budget impact analysis exploring the potential for model adaptation and dissemination. RESULTS The protocol was funded in September 2017 and approved by the Rush Institutional Review Board in October 2017. Recruitment began in May 2018 and closed in November 2019 with 65 patient-caregiver dyads enrolled. All study visits have been completed and analysis is underway. CONCLUSIONS To our knowledge, this is the first controlled trial to investigate the effects of interdisciplinary home visits among homebound individuals with advanced Parkinson’s disease and their caregivers. This study also establishes a unique cohort of patients from whom we can study the natural course of advanced PD, its treatments, and unmet needs. CLINICALTRIAL Clinicaltrials.gov, NCT03189459.


2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.


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.


Sign in / Sign up

Export Citation Format

Share Document