scholarly journals Treadmill training and kinesiotherapy versus conventional physiotherapy in Parkinson’s disease: a pragmatic study

2019 ◽  
Vol 32 ◽  
Author(s):  
Thiago da Silva Rocha Paz ◽  
Fernando Guimarães ◽  
Vera Lúcia Santos de Britto ◽  
Clynton Lourenço Correa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Statistical Tests ◽  
Clinical Status ◽  
Functional Independence ◽  
Treadmill Training ◽  
Clinical Aspects ◽  
Group 12 ◽  
Conventional Physiotherapy

Abstract Introduction: Physiotherapy has been identified in the literature as an important treatment for individuals with Parkinson’s disease (PD) to improve functional capacity. Little is discussed about the physiotherapy practice environment for this population. Objective: To assess pragmatically the effects of two physiotherapy protocols: Conventional Physiotherapy (CP) and Treadmill Training and Kinesiotherapy (TTK) in PD patients. Method: Twenty-four PD patients classified from 1 to 3 on the Hoehn and Yahr scale were randomly distributed into two groups. In CP group (12 patients), exercises aimed to improve range of motion, bradykinesia, postural adjustments and gait. In TTK group (12 patients), exercises aimed to improve physical fitness, mobility and functional independence. The treatments were performed for 50 minutes, twice a week for 14 weeks. The following evaluations were performed before and after the interventions: Unified Parkinson’s Disease Rating Scale (UPDRS); gait speed (GS); up stairs (US) and down stairs (DS) tests; timed get-up-and-go test (TUG) and 6-Minute Walk Distance Test (6-MWDT). Sociodemographic and clinical data were presented as descriptive analysis. Variables with normal and non-normal distributions were analyzed by specific statistical tests. Results: Intragroup analysis showed significant results for the TTK group (TUG, US, DS, GS, UPDRS total and UPDRS II) and for the CP group only UPDRS total. Intergroup analysis was favorable for the TTK group (TUG, US, DS, 6-MWDT). Conclusion: CP group improved the patients’ general clinical status, while treadmill and kinesiotherapy improved the physical-functional and clinical aspects.

scholarly journals Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

2013 ◽  
Vol 71 (9A) ◽  
pp. 591-595 ◽  
Author(s):  
Raimundo Nonato Campos-Sousa ◽  
Elizabeth Maria Aparecida Barasnevicius Quagliato ◽  
Kelson James Almeida ◽  
Inacio Augusto Dias de Castro ◽  
Viriato Campelo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Performance ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Urinary Dysfunction ◽  
Clinical Aspects ◽  
Yahr Scale ◽  
Disease Rating ◽  
Detrusor Hyperactivity

Introduction Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time - groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.

Comprehensive analysis of resting tremor based on acceleration signals of patients with Parkinson’s disease

2021 ◽  
pp. 1-13
Author(s):  
Sen Liu ◽  
Han Yuan ◽  
Jiali Liu ◽  
Hai Lin ◽  
Cuiwei Yang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Statistical Tests ◽  
Real Life ◽  
Feature Analysis ◽  
Support Vector ◽  
Monitoring Methods ◽  
Resting Tremor ◽  
Acceleration Signals

BACKGROUND: Resting tremor is an essential characteristic in patients suffering from Parkinson’s disease (PD). OBJECTIVE: Quantification and monitoring of tremor severity is clinically important to help achieve medication or rehabilitation guidance in daily monitoring. METHODS: Wrist-worn tri-axial accelerometers were utilized to record the long-term acceleration signals of PD patients with different tremor severities rated by Unified Parkinson’s Disease Rating Scale (UPDRS). Based on the extracted features, three kinds of classifiers were used to identify different tremor severities. Statistical tests were further designed for the feature analysis. RESULTS: The support vector machine (SVM) achieved the best performance with an overall accuracy of 94.84%. Additional feature analysis indicated the validity of the proposed feature combination and revealed the importance of different features in differentiating tremor severities. CONCLUSION: The present work obtains a high-accuracy classification in tremor severity, which is expected to play a crucial role in PD treatment and symptom monitoring in real life.

scholarly journals Motoric impairment versus iron deposition gradient in the subthalamic nucleus in Parkinson’s disease

2020 ◽  
pp. 1-7
Author(s):  
Weiyuan Huang ◽  
Richard Ogbuji ◽  
Liangdong Zhou ◽  
Lingfei Guo ◽  
Yi Wang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Subthalamic Nucleus ◽  
Rating Scale ◽  
Statistical Tests ◽  
Motor Impairment ◽  
Iron Deposition ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
The Right

OBJECTIVEThe objective of this study was to investigate the correlation between the quantitative susceptibility mapping (QSM) signal gradient of the subthalamic nucleus (STN) and motor impairment in patients with Parkinson’s disease (PD).METHODSAll PD patients who had undergone QSM MRI for presurgical deep brain stimulation (DBS) planning were eligible for inclusion in this study. The entire STN and its three functional subdivisions, as well as the adjacent white matter (WM), were segmented and measured. The QSM value difference between the entire STN and adjacent WM (STN-WM), between the limbic and associative regions of the STN (L-A), and between the associative and motor regions of the STN (A-M) were obtained as measures of gradient and were input into an unsupervised k-means clustering algorithm to automatically categorize the overall boundary distinctness between the STN and adjacent WM and between STN subdivisions (gradient blur [GB] and gradient sharp [GS] groups). Statistical tests were performed to compare clinical and image measurements for discrimination between GB and GS groups.RESULTSOf the 39 study patients, 19 were categorized into the GB group and 20 into the GS group, based on quantitative cluster analysis. The GB group had a significantly higher presurgical off-medication Unified Parkinson’s Disease Rating Scale Part III score (51.289 ± 20.741) than the GS group (38.5 ± 16.028; p = 0.037). The GB group had significantly higher QSM values for the STN and its three subdivisions and adjacent WM than those for the GS group (p < 0.01). The GB group also demonstrated a significantly higher STN-WM gradient in the right STN (p = 0.01). The GB group demonstrated a significantly lower L-A gradient in both the left and the right STN (p < 0.02).CONCLUSIONSAdvancing PD with more severe motor impairment leads to more iron deposition in the STN and adjacent WM, as shown in the QSM signal. Loss of the STN inner QSM signal gradient should be considered as an image marker for more severe motor impairment in PD patients.

scholarly journals Effects of using the Nintendo Wii Fit Plus Platform in the sensorimotor training of gait disorders in Parkinson’s disease

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Giovanna Barros Gonçalves ◽  
Marco Antônio A. Leite ◽  
Marco Orsini ◽  
João Santos Pereira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Gait Disorders ◽  
Lower Limbs ◽  
Stair Climbing ◽  
Sensorimotor Training ◽  
Nintendo Wii

The use of the Nintendo Wii has been considered a good alternative in the motor rehabilitation of individuals with Parkinson’s disease (PD), requiring simultaneous interaction to develop strategies for physical, visual, auditory, cognitive, psychological and social activities in the performing of virtual activities, resulting in improvement in functional performance and gait. The aim of this study was to analyze the effect of virtual sensorimotor activity on gait disorders in people with PD. Fifteen subjects with a clinical diagnosis of PD were submitted to the Unified Parkinson’s Disease Rating Scale (UPDRS III), Schwab and England Activities of Daily Living Scale (SE), Functional Independence Measure (FIM), and biomechanical gait analysis using digital images taken with a video camera before and after the treatment program. The activities with the Nintendo Wii virtual platform were standardized into three categories: aerobics, balance and Wii plus exercises. Participants carried out separate virtual exercises for 40 min, twice a week, for a total of 14 sessions. The program improved sensorimotor performance in PD gait, with an increase in stride length and gait speed, in addition to a reduction in motor impairment, especially in items of rigidity and flexibility of the lower limbs evaluated by UPDRS III, and greater functional independence, as evidenced in the SE and FIM scales. Improvements in items related to locomotion and stair climbing were also observed. The training was effective in motor recovery in chronic neurodegenerative diseases, showing improvement in motor performance and functional independence in individuals with PD.

Extradural Motor Cortex Stimulation in Advanced Parkinson's Disease: The Turin Experience: Technical Case Report

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-E402-ONS-E402 ◽  
Author(s):  
Carlo Alberto Pagni ◽  
Sergio Zeme ◽  
Francesco Zenga ◽  
Raffaella Maina
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Cortex ◽  
Rating Scale ◽  
Clinical Status ◽  
Motor Cortex Stimulation ◽  
Advanced Parkinson’S Disease ◽  
Neurophysiological Mechanisms ◽  
Updrs Score ◽  
Negative Side Effects

Abstract OBJECTIVE AND IMPORTANCE: At our institution, extradural motor cortex stimulation (EMCS) has recently been applied for treating Parkinson's disease symptoms. We report our results and review the literature supporting this application of EMCS. CLINICAL PRESENTATION: Since 1998, six patients affected by advanced Parkinson's disease and not fulfilling inclusion criteria for deep brain stimulation underwent EMCS. INTERVENTION: A quadripolar electrode was introduced in the extradural space over the motor cortex, opposite to the side on which parkinsonian symptoms had begun. Bipolar chronic electrostimulation was delivered at 2.5 to 6 V, 150 to 180 microseconds, and 25 to 40 Hz. Preoperative and postoperative clinical status was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) and recorded on videotapes. The follow-up of this series varied from 4 months to 2.5 years. After EMCS, the overall UPDRS score decreased by 42 to 62%; Section III UPDRS score (motility evaluation) by 32 to 83%; and Section IV UPDRS score (therapy complications) by 100% in two patients, by 50 to 67% in four patients, and by 33% in one patient. l-Dopa therapy was reduced by 11 to 33% in three patients and by 70 to 73% in the other two patients. No postoperative complications or negative side effects of electrostimulation were recorded, except for a misplacement of the electrodes in one patient. CONCLUSION: Unilateral EMCS relieves, at least partially, but sometimes dramatically, the whole spectrum of symptoms in advanced Parkinson's disease. l-Dopa may be reduced up to 70%. The symptoms of long-term l-dopa syndrome are usually markedly improved. The neurophysiological mechanisms involved are still under debate. Our clinical experience adds favorable data to enlarge the series of parkinsonian patients treated by EMCS.

020 Postural sway as a measure of disease severity in parkinson’s disease

2018 ◽  
Vol 89 (6) ◽  
pp. A9.2-A9
Author(s):  
Christian J Lueck ◽  
Susanne Ilschner ◽  
Alex Smith ◽  
Robin Vlieger ◽  
Chandi P Das ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Severity ◽  
Cognitive Assessment ◽  
Verbal Fluency ◽  
Rating Scale ◽  
Postural Sway ◽  
Clinical Status ◽  
Parkinson’S Diseases ◽  
Motor Component

IntroductionThe severity of Parkinson’s disease (PD) is difficult to assess accurately owing to the lack of a robust biological marker of disease progression, with consequent implications for prognosis and treatment. The current standard measure is the Unified Parkinson’s Disease Rating Scale (UPDRS) but this is hampered by considerable variability between observers and within subjects. Postural sway correlates well with complex brain functioning in other conditions. This study aimed to investigate the correlation of postural sway with the UPDRS and other non-motor measures of disease severity in patients with PD.Methods28 patients with PD (mean age 68 years, range 54–91; 18 male) underwent tests of cognition and quality of life [Montreal Cognitive Assessment (MoCA), Neuropsychiatry Unit Cognitive Assessment (NUCOG) and Parkinson’s Diseases Questionnaire (PDQ-39–1)], assessment of postural sway using a force plate, and assessment of clinical status using the motor component of the UPDRS.ResultsSway path length showed strong correlations with PDQ-39–1, MoCA and the verbal fluency component of the NUCOG (r=0.63,–0.75 and −0.57, respectively; p=0.002,<0.001 and 0.002, respectively) and, to a lesser degree, with the UPDRS III (r=0.45, p=0.018).ConclusionPostural sway shows potential as a sensitive measure of disease severity and brain function in PD, either alone or in combination with other measures. It appears to correlate better with measures of cognition, both general and executive (verbal fluency), and the PDQ measure of disease severity than with the motor component of the UPDRS.

scholarly journals EFFECTS OF VIRTUAL REALITY ON PARKINSONIAN GAIT: BLIND CONTROLLED RANDOMIZED CLINICAL TRIAL PROTOCOL

2020 ◽  
pp. 1-7
Author(s):  
Gileno Edu Lameira de Melo ◽  
Renata Calhes Franco de Moura ◽  
Jamile Benite Palma Lopes ◽  
Paulo Roberto Fonseca Junior ◽  
Roberta Delasta Lazzari ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Clinical Trial ◽  
Parkinson's Disease ◽  
Virtual Reality ◽  
Rating Scale ◽  
Inertial Sensor ◽  
Gait Training ◽  
Treadmill Training ◽  
Timed Up And Go ◽  
Parametric Data

Background: Parkinson’s disease (PD) is a neurodegenerative condition that exerts a negative influence on postural control and mobility, predominantly among older adults, affecting mobility and increasing the risk of slipping, tripping and falls. Objectives: Determine the effectiveness of gait training with the aid of virtual reality on balance and gait in comparison to treadmill training and conventional gait training for subjects with PD. Methods/design: A prospective, randomized, controlled blind, clinical trial is proposed. The sample will comprise 45 individuals with Parkinson’s disease randomly allocated to three groups (Control: conventional gait training; Experimental I: treadmill training; and Experimental II: gait training involving virtual reality). Evaluations will be conducted on four occasions: 1) pre-intervention; 2) immediately after one session; 3) post-intervention; and 4) one month after last session. The evaluations will involve the Berg Balance Scale, Tinetti Test, Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr Scale. The G-WALK (BTS) inertial sensor will be used for the evaluation of spatiotemporal gait variables, the Timed Up and Go test and the Six-Minute Walk Test. Training will involve 20-minute sessions held three times per week for four consecutive weeks. The results will be analyzed statistically by two-way ANOVA for the data with parametric distribution or Friedman’s two-way ANOVA for non-parametric data (α<0.05). Conclusion: The proposed study will compare gait conventional training, treadmill training and training with virtual reality with regard to improvements in gait and balance in patients with PD. The results will be published and will contribute evidence on the use of these interventions for individuals with PD.

scholarly journals Differences Between Exergaming Rehabilitation and Conventional Physiotherapy on Quality of Life in Parkinson's Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Papamichael Elena ◽  
Solou Demetris ◽  
Michailidou Christina ◽  
Papamichail Marios
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Meta Analysis ◽  
Population Group ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Conventional Physiotherapy

Parkinson's disease (PD) is a neurodegenerative condition with both motor and non-motor symptoms affecting the quality of life (QoL) of older adults. Exergaming rehabilitation allows the interaction of the subject with digital games through the implementation of repetitive functional activities. Conventional physiotherapy uses patient-centered programs that include a variety of active exercises. The aim of this review was to look into the effectiveness of exergaming rehabilitation on the QoL of people with PD and compare it with conventional physiotherapy. Five electronic databases were searched for eligible studies until February 2021. For the statistical analysis, the mean, standard deviation, and 95% confidence interval were used to calculate effect sizes between groups. To determine heterogeneity, statistical index I2 was used. A total of 548 participants were included in 14 studies. Exergaming rehabilitation related with improved QoL (p = 0.687, 95% CI: −1.682 to −0.734), balance (p = 0.039, 95% CI: 0.364–13.689), (p = 0.018, 95% CI: 0.446–4.830), and gait (p = 0.005, 95% CI: 0.351–1.924). No significant difference was found between groups regarding the Unified Parkinson's Disease Rating Scale (p = 0.196, 95% CI: −5.970 to 1.225) and for the Timed Up and Go Test (p = 0.12, 95% CI: 0.446–4.830). Exergames as a rehabilitation method can be used to provide alternative interactive intervention with positive results for QoL in people with PD. Further investigation is needed to assess the effect on mental health in this population group.

Parkinson's Disease Cognitive Functional Rating Scale

2012 ◽  
Author(s):  
Jaime Kulisevsky ◽  
Ramón Fernández de Bobadilla ◽  
Javier Pagonabarraga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale

scholarly journals Azathioprine immunosuppression and disease modification in Parkinson’s disease (AZA-PD): a randomised double-blind placebo-controlled phase II trial protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040527
Author(s):  
Julia C Greenland ◽  
Emma Cutting ◽  
Sonakshi Kadyan ◽  
Simon Bond ◽  
Anita Chhabra ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Immune System ◽  
Phase Ii ◽  
Rating Scale ◽  
Positron Emission Tomography Imaging ◽  
Clinical Markers ◽  
Double Blind ◽  
Positron Emission ◽  
Immunosuppressant Medication

IntroductionThe immune system is implicated in the aetiology and progression of Parkinson’s disease (PD). Inflammation and immune activation occur both in the brain and in the periphery, and a proinflammatory cytokine profile is associated with more rapid clinical progression. Furthermore, the risk of developing PD is related to genetic variation in immune-related genes and reduced by the use of immunosuppressant medication. We are therefore conducting a ‘proof of concept’ trial of azathioprine, an immunosuppressant medication, to investigate whether suppressing the peripheral immune system has a disease-modifying effect in PD.Methods and analysisAZA-PD is a phase II randomised placebo-controlled double-blind trial in early PD. Sixty participants, with clinical markers indicating an elevated risk of disease progression and no inflammatory or immune comorbidity, will be treated (azathioprine:placebo, 1:1) for 12 months, with a further 6-month follow-up. The primary outcome is the change in the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale gait/axial score in the OFF state over the 12-month treatment period. Exploratory outcomes include additional measures of motor and cognitive function, non-motor symptoms and quality of life. In addition, peripheral and central immune markers will be investigated through analysis of blood, cerebrospinal fluid and PK-11195 positron emission tomography imaging.Ethics and disseminationThe study was approved by the London-Westminster research ethics committee (reference 19/LO/1705) and has been accepted by the Medicines and Healthcare products Regulatory Agency (MHRA) for a clinical trials authorisation (reference CTA 12854/0248/001–0001). In addition, approval has been granted from the Administration of Radioactive Substances Advisory Committee. The results of this trial will be disseminated through publication in scientific journals and presentation at national and international conferences, and a lay summary will be available on our website.Trial registration numbersISRCTN14616801 and EudraCT- 2018-003089-14.

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