Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

The purpose of this study was to investigate the effects of a multimodal exercise program (MEP) on the functional capacity of patients with Parkinson's disease (PD) according to disease severity and gender. Fourteen patients with PD participated in the study and were distributed into groups according to 1) stage of disease and 2) gender. Functional capacity was evaluated before and after 6 months of intervention. The overall PD patient group improved their coordination and strength. Men and women improved in strength performance after exercise. Men also improved on coordination. For severity of disease, the unilateral group improved in strength, while the bilateral group improved in strength, balance, coordination and the UPDRS-functional score. In conclusion, a MEP is efficient in improving components of functional capacity in patients with PD, especially in strength. Gender may be considered in the exercise program. Individuals in the bilateral disease group appeared to benefit more from exercise.

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Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

Motriz Revista de Educação Física ◽

10.1590/s1980-65742014000400014 ◽

2014 ◽

Vol 20 (4) ◽

pp. 461-469 ◽

Cited By ~ 2

Author(s):

Claudia Teixeira-Arroyo ◽

Natália Madalena Rinaldi ◽

Rosangela Alice Batistela ◽

Fabio Augusto Barbieri ◽

Rodrigo Vitório ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Episodic Memory ◽

Executive Functions ◽

Disease Severity ◽

Cognitive Functions ◽

Exercise Program ◽

Preventive Strategy ◽

Immediate Memory ◽

Before And After

This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson's disease, taking into account disease severity and gender. Twenty-three patients with Parkinson's disease (PD) were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observed the effects of the intervention on executive functions (ability to abstract: p = .01), immediate memory (p= .04) and declarative episodic memory (p < .001). Women showed higher scores on declarative episodic memory (p = .03) than men, however there was no interaction between gender and the intervention. Regardless of sex and disease severity, these preliminary results indicate that the multimodal exercise seems to be effective in improving cognitive functions in patients with PD, suggesting that this program can be indicated as a preventive strategy to mitigate progressive cognitive deficits in the later stages of the disease.

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Functional capacity of Brazilian patients with Parkinson's disease (PD): Relationship between clinical characteristics and disease severity

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2011.07.008 ◽

2012 ◽

Vol 54 (2) ◽

pp. e83-e88 ◽

Cited By ~ 13

Author(s):

Fabio A. Barbieri ◽

Natalia M. Rinaldi ◽

Paulo Cezar R. Santos ◽

Ellen Lirani-Silva ◽

Rodrigo Vitório ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Functional Capacity ◽

Clinical Characteristics

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Dynamic Neuro-Cognitive Imagery Improves Mental Imagery Ability, Disease Severity, and Motor and Cognitive Functions in People with Parkinson’s Disease

Neural Plasticity ◽

10.1155/2018/6168507 ◽

2018 ◽

Vol 2018 ◽

pp. 1-15 ◽

Cited By ~ 8

Author(s):

Amit Abraham ◽

Ariel Hart ◽

Isaac Andrade ◽

Madeleine E. Hackney

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Mental Imagery ◽

Cognitive Functions ◽

Control Strategies ◽

Exercise Program ◽

Imagery Ability ◽

Physically Active ◽

Imagery Training

People with Parkinson’s disease (PD) experience kinesthetic deficits, which affect motor and nonmotor functions, including mental imagery. Imagery training is a recommended, yet underresearched, approach in PD rehabilitation. Dynamic Neuro-Cognitive Imagery (DNI™) is a codified method for imagery training. Twenty subjects with idiopathic PD (Hoehn and Yahr stages I–III) were randomly allocated into DNI training (experimental;n=10) or in-home learning and exercise program (control;n=10). Both groups completed at least 16 hours of training within two weeks. DNI training focused on anatomical embodiment and kinesthetic awareness. Imagery abilities, disease severity, and motor and nonmotor functions were assessed pre- and postintervention. The DNI participants improved (p<.05) in mental imagery abilities, disease severity, and motor and spatial cognitive functions. Participants also reported improvements in balance, walking, mood, and coordination, and they were more physically active. Both groups strongly agreed they enjoyed their program and were more mentally active. DNI training is a promising rehabilitation method for improving imagery ability, disease severity, and motor and nonmotor functions in people with PD. This training might serve as a complementary PD therapeutic approach. Future studies should explore the effect of DNI on motor learning and control strategies.

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Visual Attention Cut Points for Driver Fitness in Parkinson’s Disease

OTJR Occupation Participation and Health ◽

10.1177/1539449219836689 ◽

2019 ◽

Vol 39 (4) ◽

pp. 257-265

Author(s):

Sherrilene Classen ◽

Babette Brumback ◽

Karla Crawford ◽

Sara Jenniex

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Visual Attention ◽

Disease Severity ◽

Characteristic Curve ◽

Risk Index ◽

Community Dwelling ◽

Cut Points ◽

Moderate Sensitivity ◽

And Gender

This study determined whether the Useful Field of View™ Risk Index (UFOV RI) adds value as a predictor of on-road outcomes in drivers with Parkinson’s disease (PD) when considered with age, gender, and disease severity and compared with community-dwelling older drivers (Controls). A total of 101 PD drivers and 138 Controls underwent a comprehensive driving evaluation, including an on-road assessment. Logistic regression analyses determined the associations of age, gender, visual attention, and disease severity to on-road outcomes. Receiver operating characteristic curve analyses determined the optimal UFOV RI cut points to predict on-road outcomes. Above adding age and gender, the UFOV RI alone predicted on-road outcomes in PD, while the UFOV RI and age predicted on-road outcomes in Controls. Regardless of disease severity, visual attention was more impaired in PD than in Controls. The UFOV RI cut point of 3 provided the fewest misclassifications ( n = 25) in PD. The UFOV RI is a valid screening predictor of on-road outcomes across PD drivers of different disease severity, but has moderate sensitivity and specificity.

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Effects of four months of periodized aquatic exercise program on functional autonomy in post-menopausal women with parkinson's disease (Efecto de cuatro meses de entrenamiento de ejercicio acuático periodizado sobre la autonomía funcional en mujeres posm

Retos ◽

10.47197/retos.v0i33.53000 ◽

2017 ◽

pp. 217-220

Author(s):

Javier Arturo Hall López ◽

Paulina Yesica Ochoa Martínez ◽

Cristhian Obed Lara Monzon ◽

Rodrigo Gomes de Souza Vale

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Latin American ◽

Exercise Program ◽

Aquatic Exercise ◽

Paired Samples ◽

Menopausal Women ◽

Before And After ◽

Functional Autonomy ◽

Post Menopausal

Objective: To determine the effect of a periodized aquatic exercise program on functional autonomy in post-menopausal women with Parkinson's disease. Methods: Nine post-menopausal women diagnosed with idiopathic Parkinson's disease, with stage I-III according to Hoehn and Yahr scale, (age 60.4 ± 3.87 years) participated in the 16-week of periodized aquatic exercise program five times a week, 30 minutes of aquatic exercise with work heart rate reserve of 40-50% (1-8th week) increasing the load to 50-60% (9-16th week. The protocol of the Group of Latin-American Development for Maturity (GDLAM) was used to evaluate functional autonomy; As statistical analyses student T test for paired samples was used, also percent changes (Δ %) were calculated, the results showed significant improvement (p<0.05) comparing before and after the aquatic exercise program in 10 meters walk test (C 10m) (p=0.001) and general GDLAM index (IAF) (p=0.003), percent changes (Δ %) showed positive improvements in the five components of GDLAM. Conclusion: Periodized aquatic exercise program was able to enhance (C 10m) and (IAF) however, will be appropriated in the future more studies to better clarify the possibilities of improvements between aquatic exercise program and functional autonomy in post-menopausal women with Parkinson's disease. Resumen. Objetivo: Evaluar el efecto de un programa de entrenamiento periodizado de hydrogimnasia sobre la autonomía funcional en adultos mayores con enfermedad de Parkinson. Método: once adultos mayores diagnosticados con enfermedad de Parkinson idiopática, con estadios I-III según la escala de Hoehn y Yahr, (5) masculinos y (6) femeninos (edad 66.8± 4.81 años), participaron en un programa de entrenamiento de hydrogimnasia 5 veces por semana en un periodo de 16 semanas, compuesto por ejercicios aerobios de hydrogimnasia con intensidad de 40% a 50% de su frecuencia cardíaca de reserva de la semana 1 a la 8 y una periodización con aumento de carga de 50% a 60% de su frecuencia cardíaca de reserva de la semana 9 a la 16, monitoreado por pulsómetro polar FT1. La autonomía funcional se evaluó mediante el protocolo del Grupo de Desarrollo Latino Americano para la Madurez (GDLAM) antes y después del programa. Resultados: Se mostraron mejoras significativas (p<0,05) al comparar la igualdad de la varianza mediante la prueba t Student para muestras relacionadas en el test de caminar 10 metros (C 10m) (p=0,002) y el índice de autonomía funcional (IAF) (p=0,002), los cambios porcentuales (Δ%) mostraron mejoras en los componentes del protocolo GDLAM. Conclusión: El entrenamiento periodizado de hydrogimnasia fue capaz de mejorar (C 10m) e (IAF) en adultos mayores con enfermedad de Parkinson, aun sin embargo, se requieren futuros estudios para aclarar las posibilidades de mejora en el ejercicio de hydrogimnasia y autonomía funcional.

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Visual Effects of Deep Brain Stimulation in a Patient with Parkinson’s Disease

Vision Development & Rehabilitation ◽

10.31707/vdr2019.5.3.p158 ◽

2019 ◽

pp. 158-173

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Visual System ◽

Brain Stimulation ◽

Neurodegenerative Disorder ◽

Initial Examination ◽

Before And After ◽

Deep Brain ◽

Cover Test

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system. Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance alternating cover test showed exophoria with a right hyperphoria. Near alternating cover test revealed a significantly larger exophoria accompanied by a reduced near point of convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence tomography (OCT) of the nerve and macula were unremarkable. The patient underwent DBS implantation five weeks after initial examination, and the device was activated four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged. Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.

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Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) in Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212688 ◽

2021 ◽

pp. 1-9

Author(s):

Travis H. Turner ◽

Alexandra Atkins ◽

Richard S.E. Keefe

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Virtual Reality ◽

Cognitive Impairment ◽

Functional Capacity ◽

Visual Memory ◽

Assessment Tool ◽

Task Force ◽

Self Report ◽

Capacity Assessment

Background: Cognitive impairment is common in Parkinson’s disease (PD) and highly associated with loss of independence, caregiver burden, and assisted living placement. The need for cognitive functional capacity tools validated for use in PD clinical and research applications has thus been emphasized in the literature. The Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) is a tablet-based instrument that assesses proficiency for performing real world tasks in a highly realistic environment. Objective: The present study explored application of the VRFCAT-SL in clinical assessments of patients with PD. Specifically, we examined associations between VRFCAT-SL performance and measures of cognition, motor severity, and self-reported cognitive functioning. Methods: The VRFCAT-SL was completed by a sample of 29 PD patients seen in clinic for a comprehensive neuropsychological evaluation. Fifteen patients met Movement Disorders Society Task Force criteria for mild cognitive impairment (PD-MCI); no patients were diagnosed with dementia. Non-parametric correlations between VRFCAT-SL performance and standardized neuropsychological tests and clinical measures were examined. Results: VRFCAT-SL performance was moderately associated with global rank on neuropsychological testing and discriminated PD-MCI. Follow-up analyses found completion time was associated with visual memory, sustained attention, and set-switching, while errors were associated with psychomotor inhibition. No clinical or motor measures were associated with VRFCAT-SL performance. Self-report was not associated with VRFCAT-SL or neuropsychological test performance. Conclusion: The VRFCAT-SL appears to provide a useful measure of cognitive functional capacity that is not confounded by PD motor symptoms. Future studies will examine utility in PD dementia.

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Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation

Microbial Cell Factories ◽

10.1186/s12934-021-01589-0 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Xiao-yi Kuai ◽

Xiao-han Yao ◽

Li-juan Xu ◽

Yu-qing Zhou ◽

Li-ping Zhang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Neurodegenerative Disorder ◽

Fecal Microbiota Transplantation ◽

Fecal Microbiota ◽

Motor Symptoms ◽

Gastrointestinal Dysfunction ◽

Before And After ◽

Non Motor Symptoms

AbstractParkinson’s disease (PD) is a neurodegenerative disorder and 70–80% of PD patients suffer from gastrointestinal dysfunction such as constipation. We aimed to assess the efficacy and safety of fecal microbiota transplantation (FMT) for treating PD related to gastrointestinal dysfunction. We conducted a prospective, single- study. Eleven patients with PD received FMT. Fecal samples were collected before and after FMT and subjected to 16S ribosomal DNA (rDNA) gene sequencing. Hoehn-Yahr (H-Y) grade, Unified Parkinson's Disease Rating Scale (UPDRS) score, and the Non-Motion Symptom Questionnaire (NMSS) were used to assess improvements in motor and non-motor symptoms. PAC-QOL score and Wexner constipation score were used to assess the patient's constipation symptoms. All patients were tested by the small intestine breath hydrogen test, performed before and after FMT. Community richness (chao) and microbial structure in before-FMT PD patients were significantly different from the after-FMT. We observed an increased abundance of Blautia and Prevotella in PD patients after FMT, while the abundance of Bacteroidetes decreased dramatically. After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.

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