Versatile guideline-based physiotherapy intervention in groups to improve gait speed in Parkinson’s disease patients

Abstract Few exercise interventions practice both gait and balance tasks with cognitive tasks to improve functional mobility in people with PD. We aimed to investigate whether the Agility Boot Camp with Cognitive Challenge (ABC-C), that simultaneously targets both mobility and cognitive function, improves dynamic balance and dual-task gait in individuals with Parkinson’s disease (PD). We used a cross-over, single-blind, randomized controlled trial to determine efficacy of the exercise intervention. Eighty-six people with idiopathic PD were randomized into either an exercise (ABC-C)-first or an active, placebo, education-first intervention and then crossed over to the other intervention. Both interventions were carried out in small groups led by a certified exercise trainer (90-min sessions, 3 times a week, for 6 weeks). Outcome measures were assessed Off levodopa at baseline and after the first and second interventions. A linear mixed-effects model tested the treatment effects on the Mini-BESTest for balance, dual-task cost on gait speed, SCOPA-COG, the UPDRS Parts II and III and the PDQ-39. Although no significant treatment effects were observed for the Mini-BESTest, SCOPA-COG or MDS-UPDRS Part III, the ABC-C intervention significantly improved the following outcomes: anticipatory postural adjustment sub-score of the Mini-BESTest (p = 0.004), dual-task cost on gait speed (p = 0.001), MDS-UPDRS Part II score (p = 0.01), PIGD sub-score of MDS-UPDRS Part III (p = 0.02), and the activities of daily living domain of the PDQ-39 (p = 0.003). Participants with more severe motor impairment or more severe cognitive dysfunction improved their total Mini-BESTest scores after exercise. The ABC-C exercise intervention can improve specific balance deficits, cognitive-gait interference, and perceived functional independence and quality of life, especially in participants with more severe PD, but a longer period of intervention may be required to improve global cognitive and motor function.

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Gait characteristics in individuals with Parkinson’s disease during 1-minute treadmill walking

PeerJ ◽

10.7717/peerj.9463 ◽

2020 ◽

Vol 8 ◽

pp. e9463

Author(s):

Byungjoo Noh ◽

Changhong Youm ◽

Myeounggon Lee ◽

Sang-Myung Cheon

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Step Length ◽

Treadmill Walking ◽

Measurement Unit ◽

Gait Characteristics ◽

Age Related ◽

Axial Acceleration ◽

Spatiotemporal Parameters

Background No previous study has examined the age-dependent characteristics of gait in individuals between 50 and 79 years simultaneously in healthy individuals and individuals with Parkinson’s disease (PD) over continuous gait cycles. This study aimed to investigate age-related differences in gait characteristics on individuals age ranged 50–79 years, including individuals with PD, during a 1-minute treadmill walking session. Additionally, we aimed to investigate the differences associated with spatiotemporal gait parameters and PD compared in age-matched individuals. Methods This study included 26 individuals with PD and 90 participants age ranged 50–79 years. The treadmill walking test at a self-preferred speed was performed for 1 min. The embedded inertial measurement unit sensor in the left and right outsoles-based system was used to collect gait characteristics based on tri-axial acceleration and tri-axial angular velocities. Results Participants aged >60 years had a decreased gait speed and shortened stride and step, which may demonstrate a distinct shift in aging (all p < 0.005). Individuals with PD showed more of a decrease in variables with a loss of consistency, including gait asymmetry (GA), phase coordination index (PCI) and coefficient of variation (CV) of all variables, than age-matched individuals (all p < 0.001). Gait speed, stride and step length, stance phase, variability, GA and PCI were the variables that highly depended on age and PD. Discussion Older adults could be considered those older than 60 years of age when gait alterations begin, such as a decreased gait speed as well as shortened stride and step length. On the other hand, a loss of consistency in spatiotemporal parameters and a higher GA and PCI could be used to identify individuals with PD. Thus, the CV of all spatiotemporal parameters, GA and PCI during walking could play an important role and be useful in identifying individuals with PD. Conclusion This study provided the notable aging pattern characteristics of gait in individuals >50 years, including individuals with PD. Increasing age after 60 years is associated with deterioration in spatiotemporal parameters of gait during continuous 1-minute treadmill walking. Additionally, GA, PCI and the CV of all variables could be used to identify PD which would be placed after 70 years of age. It may be useful to determine the decline of gait performance in general and among individuals with PD.

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Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis

BMJ ◽

10.1136/sbmj.e6256 ◽

2012 ◽

pp. e6256

Author(s):

Wim Weber

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Physiotherapy Intervention

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Plantarflexor strength, gait speed, and step length change in individuals with Parkinson’s disease

International Journal of Rehabilitation Research ◽

10.1097/mrr.0000000000000439 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Staci M. Shearin ◽

Ann Medley ◽

Elaine Trudelle-Jackson ◽

Chad Swank ◽

Ross Querry

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Speed ◽

Length Change ◽

Step Length

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Correlation between disease severity and gait speed in elderly with Parkinson's disease submitted to virtual reality exposure therapy

2015 International Conference on Virtual Rehabilitation (ICVR) ◽

10.1109/icvr.2015.7358606 ◽

2015 ◽

Cited By ~ 1

Author(s):

Matheus Silva d'Alencar ◽

Katia Nunes Sa ◽

Elen Beatriz Carneiro Pinto ◽

Abrahao Fontes Baptista ◽

Inara da Silva Pereira ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Virtual Reality ◽

Disease Severity ◽

Gait Speed ◽

Exposure Therapy ◽

Virtual Reality Exposure Therapy ◽

Virtual Reality Exposure

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Effects of mental practice strategies associated to physiotherapy on gait and risk of falls in Parkinson’s disease: a pilot study of a randomized clinical trial

European Journal of Public Health ◽

10.1093/eurpub/ckaa040.037 ◽

2020 ◽

Vol 30 (Supplement_2) ◽

Author(s):

T Silva ◽

L Silva ◽

K Silva ◽

S Silva ◽

D Silva ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pilot Study ◽

Gait Speed ◽

Mental Practice ◽

Control Group ◽

Timed Up And Go ◽

Increased Risk ◽

Risk Of Falls ◽

Degenerative Disorder

Abstract Introduction Parkinson’s Disease (PD) is a degenerative disorder that interferes with the voluntary movements due to dysfunction of the basal ganglia and presenting with motor signals, such as the reduction of gait speed. This contributes to an increased risk of falls. In rehabilitation, mental practice (MP) has been shown to promote plastic modulation of neural circuits and improve motor learning, but the results of research with MP in PD are still ambiguous due to the diversity of intervention strategies. Objectives To compare the effects of MP strategies associated to physiotherapy in gait and risk of falls in PD patients. Methodology We performed a pilot study of a clinical randomized, single blind, trial, conducted in accordance with the consort checklist. Patients with idiopathic PD were included and allocated to four groups: Control group (CG); Group with mental practice guided by images (MPI); Group with mental practice guided by audio (MPA); group with mental practice without a guide (MPWG). The subjects of the experimental groups were submitted to 15 sessions of physiotherapy and mental practice, while the CG received only physiotherapy. The sessions were held 2 times per week, 40 minutes for physiotherapy and approximately 5-10 minutes for the corresponding mental practice protocol. Spatial-temporal parameters of gait were assessed with the 10 meters Walking Test (TC10m), and the risk of falls was evaluated with the Timed Up and Go (TUG) test. Results The MPI group showed significant results for the parameters time (p = 0.027) and speed (p = 0.025) when compared with the results of the CG. No main effects for the group were observed concerning cadence and risk of falls had. Groups MPWG and MPA showed no significant results for the TC10m and TUG when compared with the CG. Conclusion The results of this pilot study suggest that MP guided by images associated to physical therapy was more effective to increase the gait speed than the alternative strategies.

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