Short-term effects of vibration therapy on motor impairments in Parkinson's disease

Background. Turning has been associated with instability, falls, and freezing in people with Parkinson’s disease (PD). Objective. To investigate the effect of different modalities of rhythmic cueing on the duration of a functional turn in freezers and nonfreezers. Methods. A total of 133 patients with idiopathic PD while in the on phase of the medication cycle participated in this study as part of a subanalysis from the RESCUE trial. The effect of 3 different cue modalities on functional turning performance was investigated, involving a 180° turn while picking up a tray. Time to perform this task was measured using an activity monitor. Tests were performed without cues and with auditory, visual, and somatosensory cues delivered in a randomized order at preferred straight-line stepping frequency. Results. Cueing (all types) increased the speed of the turn in all subjects. There was no difference between turn performance of freezers and nonfreezers in cued and noncued conditions. Auditory cues made turning significantly faster than visual cues ( P < .01) but not compared with somatosensory cues, except in nonfreezers. There was a short-term carryover in the final noncued trial. Conclusions. Rhythmical cueing yielded faster performance of a functional turn in both freezers and nonfreezers. This may be explained by enhancing attentional mechanisms during turning. Although no harmful effects were recorded, the safety of cueing for turning as a therapeutic strategy needs further study.

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Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis

Brain Sciences ◽

10.3390/brainsci11080959 ◽

2021 ◽

Vol 11 (8) ◽

pp. 959

Author(s):

Konstantin G. Heimrich ◽

Thomas Lehmann ◽

Peter Schlattmann ◽

Tino Prell

Keyword(s):

Parkinson’S Disease ◽

Heart Rate ◽

Parkinson's Disease ◽

Heart Rate Variability ◽

Meta Analysis ◽

Cardiac Activity ◽

Heart Rate Variability Analysis ◽

Short Term ◽

Variability Analysis ◽

Parasympathetic Regulation

Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson’s disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson’s disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate.

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