Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson’s disease: a randomized controlled pilot study

2016 ◽  
Vol 31 (8) ◽  
pp. 1107-1115 ◽  
Author(s):  
Daniele Volpe ◽  
Maria Giulia Giantin ◽  
Pilleri Manuela ◽  
Consuelo Filippetto ◽  
Elisa Pelosin ◽  
...  

Objective: To compare the efficacy of two physiotherapy protocols (water-based vs. non-water-based) on postural deformities of patients with Parkinson’s disease. Design: A single blind, randomized controlled pilot study. Setting: Inpatient (Rehabilitative Department). Participants: A total of 30 patients with idiopathic Parkinson’s disease. Interventions: Participants were randomly assigned to one of two eight-week treatment groups: Water-based ( n = 15) or non-water-based physiotherapy exercises ( n = 15). Outcome measures: Changes in the degree of cervical and dorsal flexion and in the angle of lateral inclination of the trunk (evaluated by means of a posturographic system) were used as primary outcomes. Unified Parkinson Disease Rating Scale section III, Time Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence, Falls Efficacy Scale and the Parkinson’s disease quality of life questionnaire (39 items) were the secondary outcomes. All outcomes were assessed at baseline, at the end of training and eight weeks after treatment. Patients were always tested at the time of their optimal antiparkinsonian medication (‘on’ phase). Results: After the treatment, only Parkinson’s disease subjects randomized to water-based treatment showed a significant improvement of trunk posture with a significant reduction of cervical flexion (water-based group: −65.2°; non-water-based group: +1.7°) and dorsal flexion (water-based group: −22.5°; non-water-based group: −6.5°) and lateral inclination of the trunk (water-based group: −2.3°; non-water-based group: +0.3°). Both groups presented significant improvements in the secondary clinical outcomes without between-group differences. Conclusion: Our results show that water-based physiotherapy was effective for improving postural deformities in patients with Parkinson’s disease.

2012 ◽  
Vol 70 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Paula Luciana Scalzo ◽  
Carolina Reis Flores ◽  
Juliana Rúbia Marques ◽  
Simone Cristina de Oliveira Robini ◽  
Antônio Lúcio Teixeira

Parkinson's disease (PD) is characterized by motor symptoms that cause the decline of functional capacity and affect the quality of life (QoL). Objective: To evaluate the impact of changes in balance and walking capacity on the PD. Methods: The instruments used were: Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr Scale (HY), Schwab and England scale (SE), quality of life questionnaire (PDQ-39), Berg balance Scale (BBS) and six-minute walk test (6MWT). Results: Thirty-six patients with mean disease duration of 7.3 years were assessed. Lower scores on the BBS and shorter distances walked during the 6MWT correlated with a poorer perception of QoL. This correlation occurred at the expense of the mobility and daily living activities domains. Conclusion: Our results indicated that the impairment in balance while performing functional activities and the reduction in walking capacity are important factors that negatively affect the perception of QoL in PD patients.


2021 ◽  
pp. 154596832110231
Author(s):  
Kishoree Sangarapillai ◽  
Benjamin M. Norman ◽  
Quincy J. Almeida

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.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Oriol De Fabregues ◽  
Alex Ferré ◽  
Odile Romero ◽  
Manuel Quintana ◽  
José Álvarez-Sabin

Background. Sleep problems in patients with advanced Parkinson’s disease (PD) have a deleterious impact on quality of life. Objective. To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. Methods. Seven patients participated in a prospective pilot study. Before and after 6 months of LCIG infusion, an overnight polysomnography was performed and the Epworth Sleepiness Scale, fatigue scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Hamilton Anxiety Rating Scale were administered. Results. PSG showed low sleep efficiency. REM sleep without atony was found in 5 patients. After 6 months of LCIG infusion, the percentage of REM sleep decreased as well as the number of arousals especially due to reduction of spontaneous arousals and periodic leg movements during REM sleep, but differences were not statistically significant. Also, scores of all study questionnaires showed a tendency to improve. Conclusion. The results show a trend toward an improvement of sleep quality after 6 months of LCIG infusion, although differences as compared to pretreatment values were not statistically significant. The sleep architecture was not modified by LCIG. Further studies with larger study samples are needed to confirm these preliminary findings.


2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Nadeeka N. W. Dissanayaka ◽  
Farah Idu Jion ◽  
Nancy A. Pachana ◽  
John D. O’Sullivan ◽  
Rodney Marsh ◽  
...  

Background. Motor and nonmotor symptoms negatively influence Parkinson’s disease (PD) patients’ quality of life. Mindfulness interventions have been a recent focus in PD. The present study explores effectiveness of a manualized group mindfulness intervention tailored for PD in improving both motor and neuropsychiatric deficits in PD.Methods. Fourteen PD patients completed an 8-week mindfulness intervention that included 6 sessions. The Five Facet Mindfulness Questionnaire (FFMQ), Geriatric Anxiety Inventory, Hamilton Depression Rating Scale, PD Cognitive Rating Scale, Unified PD Rating Scale, PD Quality of Life Questionnaire, and Outcome Questionnaire (OQ-45) were administered before and after the intervention. Participants also completed the FFMQ-15 at each session. Gains at postassessment and at 6-month follow-up were compared to baseline using pairedt-tests and Wilcoxon nonparametric tests.Results. A significant increase in FFMQ-Observe subscale, a reduction in anxiety, depression, and OQ-45 symptom distress, an increase in PDCRS-Subcortical scores, and an improvement in postural instability, gait, and rigidity motor symptoms were observed at postassessment. Gains for the PDCRS were sustained at follow-up.Conclusion. The mindfulness intervention tailored for PD is associated with reduced anxiety and depression and improved cognitive and motor functioning. A randomised controlled trial using a large sample of PD patients is warranted.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Lorena R. S. Almeida ◽  
Guilherme T. Valença ◽  
Nádja N. Negreiros ◽  
Elen B. Pinto ◽  
Jamary Oliveira-Filho

Falls can be considered a disabling feature in Parkinson’s disease. We aimed to identify risk factors for falling, testing simultaneously the ability of disease-specific and balance-related measures. We evaluated 171 patients, collecting demographic and clinical data, including standardized assessments with the Unified Parkinson’s Disease Rating Scale (UPDRS), activities of daily living (ADL) and motor sections, modified Hoehn and Yahr Scale, Schwab and England, eight-item Parkinson’s Disease Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale-International (FES-I), Berg Balance Scale, Dynamic Gait Index, Functional Reach, and Timed Up and Go. ROC curves were constructed to determine the cutoff scores for all measures. Variables withP<0.1entered a logistic regression model. The prevalence of recurrent falls was 30% (95% CI 24%–38%). In multivariate analysis, independent risk factors for recurrent falls were (P<0.05) levodopa equivalent dose (OR = 1.283 per 100 mg increase; 95% CI = 1.092–1.507), UPDRS-ADL > 16 points (OR = 10.0; 95% CI = 3.6–28.3), FES-I > 30 points (OR = 6.0; 95% CI = 1.6–22.6), and Berg ≤ 48 points (OR = 3.9; 95% CI = 1.2–12.7).We encourage the utilization of these modifiable risk factors in the screening of fall risk.


2009 ◽  
Vol 67 (3b) ◽  
pp. 831-835 ◽  
Author(s):  
Paula L. Scalzo ◽  
Isabella C. Nova ◽  
Mônica R. Perracini ◽  
Daniel R.C. Sacramento ◽  
Francisco Cardoso ◽  
...  

Background: Changes in balance occur with the progression of Parkinson's disease (PD). OBJECTIVE: To validate the Brazilian version of the Berg Balance Scale (BBS) for PD patients, determining its reliability and internal consistency and correlating it with PD-specific instruments. METHOD: We evaluated 53 patients (M/F 37/16, mean age±SD, 62±7.9 years) with PD (mean±SD, 7.8±4.4 years). Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England Scale (S&E), Hoehn and Yahr Staging Scale (HY) and BBS were used to assess patients. Statistical analyses for inter-rater reliability, internal consistency and correlations among BBS, UPDRS, S&E and HY were performed. RESULTS: The mean scores±SD on UPDRS and BBS were, respectively, 41.6±17.8 and 47.2±8.2. The median on S&E and HY scales were 80% and 2.5, respectively. The BBS presented a high intra-class correlation coefficient (ICC=0.84) and internal consistency (Cronbrach's α=0.92). There was a statistically significant correlation between BBS and disease duration (r s= -0.520, p<0.001), UPDRS subscales II and III (r s= -0.467, p=0.011; r s= -0.374, p=0.046, respectively), stage of disease (HY; r s= -0.507, p<0.001) and the activities of daily living (S&E; r s=0.492, p<0.001). CONCLUSION: The BBS is a promising tool for the assessment of balance in PD, correlating with the stage of disease and the level of independence.


2021 ◽  
Vol 79 (8) ◽  
pp. 686-691
Author(s):  
Ingrid Estrada-Bellmann ◽  
Jesús Daniel Meléndez-Flores ◽  
Carlos Rodrigo Cámara-Lemarroy ◽  
Sergio Andrés Castillo-Torres

ABSTRACT Background: Self-efficacy is the individual’s assessment of his or hers ability to complete a specific task successfully and has been closely related to self-management and quality of life in several diseases. Objective: To investigate self-efficacy in a population of Parkinson’s disease (PD) patients in Mexico and study the factors that are associated with this measure. Methods: We carried out a cross-sectional observational study involving patients with PD in an outpatient neurology clinic in Mexico, using the following instruments: Spanish version of the Chronic Disease Self-Efficacy Scale (CDSES), Quality of Life Questionnaire PDQ-8, Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), and Non-Motor Symptom Scale (NMSS). Clinical and demographic variables were also recorded. Results: We included 73 patients with a mean age of 65 years and most patients were male. Patients with lower CDSES scores (<7.75) had worse scores in MDS-UPDRS, NMSS, and PDQ-8 scales. CDSES scores were significantly correlated with MDS-UPDRS Part I (r=-0.497, p=<0.001), Part II (r= -0.271, p=0.020), Part III (r=-0.304, p=<0.001), PDQ-8 (r=-0.472, p=<0.001), and NMSS (r=-0.504, p=<0.001). Furthermore, when assessing the simultaneous effect of covariates associated with CDSES score, only Mood/Apathy domain of NMSS was significant (beta= -0.446, t= -3.807, p= 0.012). Conclusions: PD patients with lower self-efficacy scores had worse motor and non-motor symptomatology and quality of life. Mood/Apathy disorders were negatively associated with self-efficacy and contributed significantly to this measure.


2005 ◽  
Vol 21 (4) ◽  
pp. 543-548 ◽  
Author(s):  
Tanya Schmitz-Hübsch ◽  
Derek Pyfer ◽  
Karin Kielwein ◽  
Rolf Fimmers ◽  
Thomas Klockgether ◽  
...  

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