scholarly journals Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Elisa Pelosin ◽  
Roberta Barella ◽  
Cristina Bet ◽  
Elisabetta Magioncalda ◽  
Martina Putzolu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measures ◽  
Physical Training ◽  
Action Observation ◽  
Freezing Of Gait ◽  
Berg Balance Scale ◽  
Control Group ◽  
Timed Up And Go ◽  
Balance Scale

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson’s disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

scholarly journals Long-Term Multimodal Exercise Program Enhances Mobility of Patients with Parkinson’s Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Marcelo Pinto Pereira ◽  
Maria Dilailça Trigueiro de Oliveira Ferreira ◽  
Maria Joana Duarte Caetano ◽  
Rodrigo Vitório ◽  
Ellen Lirani-Silva ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Status ◽  
Exercise Program ◽  
Training Group ◽  
Berg Balance Scale ◽  
Disease Stage ◽  
Control Group ◽  
Timed Up And Go

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n=22; aged 67.23±8.39 years) and a control group (CG—n=9; aged 71.56±8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P=0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.

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 Validity of the Brazilian version of the freezing of gait questionnaire

2012 ◽  
Vol 70 (8) ◽  
pp. 599-603 ◽  
Author(s):  
Jussara A. Oliveira Baggio ◽  
Mônica B. Curtarelli ◽  
Guilherme R. Rodrigues ◽  
Vitor Tumas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Roc Curve ◽  
Freezing Of Gait ◽  
Berg Balance Scale ◽  
Brazilian Population ◽  
Balance Scale ◽  
Brazilian Version ◽  
Valid Instrument

OBJECTIVE: To validate the freezing of gait questionnaire (FOG-Q) for a Brazilian population of Parkinson's disease (PD) patients. METHODS: One hundred and seven patients with a diagnosis of PD were evaluated by shortened UPDRS motor scale (sUPDRm), Hoehn and Yahr (HY), Schwab and England scale (SE), Berg balance scale (BBS), falls efficacy scale international (FES-I), gait and balance scale (GABS), and the FOG-Q Brazilian version. RESULTS: 47.7% of PD patients had FOG episodes; this group had worse scores on sUPDRSm, FOGQ, FES-I, BBS, GABS and FOG item of UPDRS when compared to the PD group without FOG. The internal consistency was 0.86, intra-rater 0.82 and inter-rater 0.78. The FOG-Q Brazilian version was significantly correlated with items related to gait and balance. The ROC curve was 0.94, the sensitivity was 0.90and specificity was 0.92. CONCLUSION: Our study suggests that the FOG-Q Brazilian version is a reliable and valid instrument for assessing FOG in PD patients.

163 Thai Traditional Game-Based Exercise for Gait and Balance of People with Parkinson's Disease

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Surasa Khongprasert ◽  
Keerati Sooksai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Planning ◽  
Computer Game ◽  
Berg Balance Scale ◽  
Gait Velocity ◽  
Control Group ◽  
Timed Up And Go ◽  
Eyes Open ◽  
Traditional Game

Abstract Falls and recurrent falls are serious complications for people with PD. Poor standing balance, impaired ambulation, impaired lower-limb motor planning, postural instability and falling in previous year are associated with falling in PD. Exercise based computer game (Exergaming) have been used for motor rehabilitation to promote gait and balance and can encourage therapeutic activity. However, many commercially available games are not affordable for some people with Parkinson’s Disease. The aim of this study was to evaluate the effectiveness of Thai Traditional game (TTG) based exercise on gait and balance in people with Parkinson’s Disease. A total of 22 participants with PD (mild –moderate severity) were randomly assigned to either a TTG group or a control group. Participants in TTG completed 1 hour, 3 sessions a week for 10 weeks. The TTG comprises 10 games involved instruction in sit to standing, slow and fast walking speed, turning, weight shifting, reaching, obstacle stepping, cognition, clapping and singing. Gait and balance were assessed before and after the training sessions. Measures included the Berg Balance Scale (BBS), Balance platform, Timed Up and Go (TUG) and The GaitRite walkway. Participants in TTG groups showed significantly improved BBS, TUG, gait velocity and sagittal mean sway with eyes open (p <0.05). Thai Traditional Game based exercise incorporated therapeutic movement could lead improvement in gait and balance and participants seem to enjoy playing as an activity while maintaining their functionality. Future studies should incorporate larger groups and focus on long-term compliance and follow-up.

scholarly journals Action Observation Improves Freezing of Gait in Patients With Parkinson’s Disease

2010 ◽  
Vol 24 (8) ◽  
pp. 746-752 ◽  
Author(s):  
Elisa Pelosin ◽  
Laura Avanzino ◽  
Marco Bove ◽  
Paola Stramesi ◽  
Alice Nieuwboer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapy ◽  
Physical Training ◽  
Action Observation ◽  
Freezing Of Gait ◽  
Walking Ability ◽  
Video Clips ◽  
Action Group

Background. Freezing of gait (FOG) is a disabling impairment for people with Parkinson’s disease (PD) and may not respond to medications. The effectiveness of physical therapy for FOG is debatable. Action observation strategies to overcome FOG may enhance physical training. Objective. To assess whether action observation, combined with practicing the observed actions, may reduce FOG episodes. Methods. Twenty patients with PD entered a single-blind trial and were randomly assigned to the experimental (Action) or control (Landscape) groups. Those in the Action group watched video clips showing specific movements and strategies to circumvent FOG episodes, whereas those in the Landscape group watched video clips of static pictures showing different landscapes. All patients underwent identical physical therapy training, 3 sessions a week for 4 weeks. Results. The FOG Questionnaire score and the number of FOG episodes were significantly reduced in both groups after the training period. At follow-up examination (4 weeks after the end of the intervention), a significant reduction in the number of FOG episodes was observed only in the Action group. Motor performance (walking and balance) and quality-of-life assessments were significantly improved in both groups at the end of training and at follow-up. Conclusions. Our results suggest that action observation has a positive additional effect on recovery of walking ability in PD patients with FOG. Further studies on the combination of observation and imitation to supplement a physical training program may result in an innovative rehabilitative approach for FOG.

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 Temporal Characteristics of High-Frequency Lower-Limb Oscillation during Freezing of Gait in Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Don A. Yungher ◽  
Tiffany R. Morris ◽  
Valentina Dilda ◽  
James M. Shine ◽  
Sharon L. Naismith ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
High Frequency ◽  
Freezing Of Gait ◽  
Body Motion ◽  
High Frequency Oscillation ◽  
Frequency Oscillation ◽  
Timed Up And Go ◽  
Clinical Onset ◽  
Acceleration Data

A cardinal feature of freezing of gait (FOG) is high frequency (3–8 Hz) oscillation of the legs, and this study aimed to quantify the temporal pattern of lower-body motion prior to and during FOG. Acceleration data was obtained from sensors attached to the back, thighs, shanks, and feet in 14 Parkinson’s disease patients performing timed-up-and-go tasks, and clinical assessment of FOG was performed by two experienced raters from video. A total of 23 isolated FOG events, defined as occurring at least 5 s after gait initiation and with no preceding FOG, were identified from the clinical ratings. The corresponding accelerometer records were analyzed within a 4 s window centered at the clinical onset of freezing. FOG-related high-frequency oscillation (an increase in power in the 3–8 Hz band >3 SD from baseline) followed a distal to proximal onset pattern, appearing at the feet, shanks, thighs, and then back over a period of 250 ms. Peak power tended to decrease as the focus of oscillation moved from feet to back. There was a consistent delay (mean 872 ms) between the onset of high frequency oscillation at the feet and clinical onset of FOG. We infer that FOG is characterized by high frequency oscillation at the feet, which progresses proximally and is mechanically damped at the torso.

scholarly journals Group-based music intervention in Parkinson’s disease – findings from a mixed-methods study

2020 ◽  
Vol 34 (4) ◽  
pp. 533-544
Author(s):  
Petra Pohl ◽  
Ewa Wressle ◽  
Fredrik Lundin ◽  
Paul Enthoven ◽  
Nil Dizdar
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Intervention Group ◽  
Group Differences ◽  
Control Group ◽  
Music Intervention ◽  
Post Intervention

Objective: To evaluate a group-based music intervention in patients with Parkinson’s disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention group ( n = 26), which received training with the music-based intervention, and control group ( n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinson’s disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.

scholarly journals The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Agata Wróblewska ◽  
Agata Gajos ◽  
Urszula Smyczyńska ◽  
Andrzej Bogucki
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Research Question ◽  
Freezing Of Gait ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Nordic Walking ◽  
Provocative Test ◽  
Step Initiation

Introduction. The effectiveness of the currently utilized therapies for FoG is limited. Several studies demonstrated a beneficial impact of Nordic walking (NW) on several gait parameters in Parkinson’s disease, but only one paper reported reduction of freezing. Research Question. In the present study, the question is whether NW is an effective therapeutic intervention in FoG. Methods. Twenty PD subjects trained NW for 12 weeks, with a frequency of twice per week. Each session lasted about 60 minutes. Twenty patients in the control group did not use any form of physiotherapy (no-intervention group). Freezing of Gait Questionnaire (FOGQ), the Timed Up and Go (TUG) test, and the Provocative Test for Freezing and Motor Blocks (PTFMB) were performed at baseline, immediately after the end of NW program, and three months later. Results. The results of FOGQ, TUG, and total PTFMB revealed significant improvement after completing the exercise program, and this effect persisted at follow-up. The results of the PTFMB subtests showed a different effect of NW on particular subtypes of FoG. Start hesitation, sudden transient blocks that interrupt gait, and blocks on turning improved considerably, while motor blocks, when walking through narrow space and on reaching the target, did not respond to NW training. Significance. The results show, for the first time, that FoG during turning and step initiation, two most common forms of this gait disorder, has been significantly reduced by NW training. Different responses of particular subtypes of FoG to NW probably reflect their different pathophysiologies. Conclusions. The present study showed that NW training had a beneficial effect on FOG in PD and that the achieved improvement is long-lasting. Future research should clarify whether the observed improvement limited to FoG triggered by only some circumstances reflects different pathomechanisms of FoG subtypes.

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