scholarly journals The Effects of a 10-Week Home-Based Exercise Programme in Individuals with Parkinson’s Disease during the COVID-19 Pandemic: A Pilot Study

2021 ◽  
Vol 11 (10) ◽  
pp. 4518
Author(s):  
Fuengfa Khobkhun ◽  
Jinjuta Suwannarat ◽  
Anuchai Pheungphrarattanatrai ◽  
Kanjana Niemrungruang ◽  
Sakaowrat Techataweesub ◽  
...  

Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD). This study aimed to evaluate the effectiveness of a 10-week home-based exercise program designed to target improvements in axial rigidity and gait. The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), motor scale and rigidity items, Functional axial rotation–physical (FAR-p), functional reach test (FRT), and time up and go (TUG) test were recorded. In addition, the 10-metre walk test, the fall efficacy scale international (FES-I) and the global rating of change score (GROC) were also recorded. Eighteen individuals were divided randomly into two groups: a home-based exercise group (n = 10) and a traditional physiotherapy control group (n = 8). Participants in the 10-week home-based exercise group showed significant improvements (p < 0.05) in the MDS-UPDRS rigidity item, FAR-p, step length, gait velocity, FRT and FES-I when compared with the control group. This study supports the use of home-based exercises in individuals with PD. These preliminary results also support the hypothesis that targeting axial deficits may be an effective approach for improving gait and reducing falls.

Sensors ◽  
2020 ◽  
Vol 20 (15) ◽  
pp. 4106
Author(s):  
Changhong Youm ◽  
Youkyung Kim ◽  
Byungjoo Noh ◽  
Myeounggon Lee ◽  
Jinhee Kim ◽  
...  

Background: This study aimed to examine the effect of a 12-week progressive trunk resistance and stretching exercise program on fall-related factors in patients with Parkinson’s disease (PD). Methods: A randomized study assessed a progressive trunk resistance and stretching exercise program over a 12-week period. A total of 17 patients with PD participated and wererandomly allocated into an exercise group (n = 10) or a control group (n = 7). Participants in the exercise group completed the exercise program in 60- to 90-min sessions for three days per week. Primary and secondary outcome measures included the trunk mobility scale, functional fitness test, standing balance, and sit-to-walk test. Results: The exercise group showed improvements in functional fitness, trunk mobility, standing balance, and dynamic stability compared with the control group (all p < 0.05). The 2.44 m timed up and go test (odds ratio (OR): 0.125) and the 2 min step test (OR: 10.584) of the functional fitness test, and the first-step length (OR: 3.558) and first-toe clearance height (OR: 4.777) of the sit-to-walk test, were different between the groups following the exercise program. Conclusion: This 12-week exercise program improved fall-related factors in patients with PD and may lead to prevention of fall-related injuries.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anson B. Rosenfeldt ◽  
Tanujit Dey ◽  
Jay L. Alberts

Introduction. Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson’s disease (PD).Methods. Thirty-eight participants with idiopathic PD were randomized to either an aerobic exercise group (n=23) or a nonexercise control group (n=15). The aerobic exercise group completed a 60-minute cycling session three times per week for eight weeks while the nonexercise control group received no intervention. All participants completed the University of Pennsylvania Smell Identification Test (UPSIT) at baseline, end of treatment, and a four-week follow up.Results. Change in UPSIT scores between the exercise and nonexercise groups from baseline to EOT (p=0.01) and from baseline to EOT+4 (p=0.02) favored the aerobic exercise group. Individuals in the nonexercise group had worsening olfaction function over time, while the exercise group was spared from decline.Discussion. The difference in UPSIT scores suggested that aerobic exercise may be altering central nervous system pathways that regulate the physiologic or cognitive processes controlling olfaction in individuals with PD. While these results provide promising preliminary evidence that exercise may modify the disease process, further systematic evaluation is necessary.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.


2015 ◽  
Vol 30 (5) ◽  
pp. 411-418 ◽  
Author(s):  
Cecilia Fontanesi ◽  
Svetlana Kvint ◽  
Giuseppe Frazzitta ◽  
Rossana Bera ◽  
Davide Ferrazzoli ◽  
...  

Background. In a combined animal and human study, we have previously found that a 5-day treatment that enhances cortical plasticity also facilitates brain-derived neurotrophic factor (BDNF)-tyrosine receptor kinase B (TrkB) signaling and increases activated TrkB and N-methyl-d-aspartate receptor (NMDAR) association in both the cortex and the peripheral lymphocytes. Patients with Parkinson’s disease (PD), in general, show decreased cortical plasticity, as demonstrated by electrophysiological and behavioral studies. Here, we test the hypothesis that an exercise program that improves motor function and seems to slow down symptom progression can enhance BDNF-TrkB signaling in lymphocytes. Methods. A total of 16 patients with PD underwent a 4-week multidisciplinary intensive rehabilitation treatment (MIRT), which included aerobic training and physical and occupational therapy. Blood was collected before and after 2 and 4 weeks of MIRT. Lymphocytes were isolated to examine BDNF-TrkB signaling induced by incubation with recombinant human BDNF. TrkB signaling complexes, extracellular-signal-regulated kinase-2 and protein-kinase-B were immunoprecipitated; the content of immunocomplexes was determined by Western blotting. Results. After MIRT, all patients showed improvement in motor function. TrkB interaction with NMDAR and BDNF-TrkB signaling increased in peripheral lymphocytes at receptor, intracellular mediator, and downstream levels. The decrements in Unified Parkinson’s Disease Rating Scale II (UPDRSII) and total scores were significantly correlated with the increases in TrkB signaling at receptor, intracellular mediator, and NMDAR interaction levels. Conclusions. The significant correlation between reduced UPDRS scores and the changes in lymphocyte activity suggest that enhanced BDNF-TrkB signaling in lymphocyte and reduced severity of PD symptoms may be related.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Emma Stack ◽  
Helen Roberts ◽  
Ann Ashburn

Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding.Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balancein situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case.Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention.


2020 ◽  
Author(s):  
Fang Ba ◽  
Tina T. Sang ◽  
Jaleh Fatehi ◽  
Wenjing He ◽  
Emanuel Mostofi ◽  
...  

Abstract Background: Parkinson's disease (PD) is not exclusively a motor disorder. Among non-motor features, PD patients possess sensory visual dysfunctions. Stereopsis deficit can significantly impact patients' motor performance. However, it is not routinely tested, and its significance is under-investigated. Studying stereopsis using reliable 3D stimuli may help determine its implications in disease status in PD.The objective of the study is to investigate stereopsis abnormalities in PD with reliable and more physiological tools, and their correlation with indicators of PD severity. Methods: Twenty-four healthy control and 20 PD participants were first evaluated for visual acuity, visual field, contrast acuity, and stereoperception with 2D and Titmus stereotests, followed by the assessment with the 3D active shutter system. The correlation between stereopsis and disease severity, Unified Parkinson’s disease rating scale motor scores (UPDRS-III), levodopa equivalent daily dose (LEDD), course of disease and cognitive status were evaluated using univariate regression models. Results: Screening visual tests did not reveal any differences between PD and control group. With the 3D active shutter system, PD patients demonstrated significantly worse stereopsis (i.e p=0.002, 26 seconds of arc). There was a trend that UPDRS-III and LEDD negatively correlate with the stereo acuity, suggesting poorer stereoperception is related to disease severity. Preserved cognitive function correlated with more intact stereo acuity. Conclusion: With more reliable and physiological tools, PD patients exhibit poorer stereopsis. These deficits reflected PD motor and cognitive status. How stereopsis relates to gait, fall risks and navigation warrants more investigations in the future.


2008 ◽  
Vol 2 (3) ◽  
pp. 201-205 ◽  
Author(s):  
Marina Ceres Silva Pena ◽  
Emmanuelle Silva Tavares Sobreira ◽  
Carolina Pinto Souza ◽  
Guiomar Nascimento Oliveira ◽  
Vitor Tumas ◽  
...  

Abstract Parkinson's disease (PD) is a neurological disorder characterized by motor disturbances, neuropsychological symptoms and cognitive changes, including cases of dementia. The most frequently described cognitive changes in these patients involve executive and visuospatial functions, which are very important for the execution of daily life activities. Objective: To compare different tests used to examine visuospatial functions in patients with PD. Methods: Thirty-five patients (21 women) with PD symptoms (medicated and "on") and mean schooling of 5.5±4.2 years were examined using the following tests: Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), Scales of Outcomes of Parkinson's Disease (SCOPA-COG), Hooper Visual Organization Test (HVOT), Judgment of Line Orientation, Form V (JLO), and Clock drawing task - CLOX (1 and 2). Results: The mean MMSE score was 24.8±3.03 and 54.8% of the patients performed correctly in the copy of a pentagon drawing, with a medium-level performance in most tests. Good correlations were detected between JLO versus SCOPA Assembling patterns (0.67), JLO versus HVOT (0.56), JLO versus CLOX2 (0.64), SCOPA Figure Composition versus HVOT (0.54), CLOX1 versus CLOX2 (0.43), and DRS Construction versus CLOX2 (0.42). Discussion: Although correlations were detected, not all were strong, probably because the tests employed do not measure solely visuospatial functions, but also other skills such as attention, motor ability and executive functions. A limitation of the present study was the lack of a control group for the establishment of adequate standards for this population.


CNS Spectrums ◽  
2016 ◽  
Vol 21 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Isabel Hindle Fisher ◽  
Hardev S. Pall ◽  
Rosalind D. Mitchell ◽  
Jamilla Kausar ◽  
Andrea E. Cavanna

ObjectiveApathy has been reported as a possible adverse effect of deep brain stimulation of the subthalamic nucleus (STN-DBS). We investigated the prevalence and severity of apathy in 22 patients with Parkinson’s disease (PD) who underwent STN-DBS, as well as the effects of apathy on quality of life (QOL).MethodsAll patients were assessed with the Lille Apathy Rating Scale (LARS), the Apathy Scale (AS), and the Parkinson’s Disease Questionnaire and were compared to a control group of 38 patients on pharmacotherapy alone.ResultsThere were no significant differences in the prevalence or severity of apathy between patients who had undergone STN-DBS and those on pharmacotherapy alone. Significant correlations were observed between poorer QOL and degree of apathy, as measured by the LARS (p<0.001) and the AS (p=0.021). PD-related disability also correlated with both apathy ratings (p<0.001 and p=0.017, respectively).ConclusionOur findings suggest that STN-DBS is not necessarily associated with apathy in the PD population; however, more severe apathy appears to be associated with a higher level of disability due to PD and worse QOL, but no other clinico-demographic characteristics.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Marcelo Pinto Pereira ◽  
Maria Dilailça Trigueiro de Oliveira Ferreira ◽  
Maria Joana Duarte Caetano ◽  
Rodrigo Vitório ◽  
Ellen Lirani-Silva ◽  
...  

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n=22; aged 67.23±8.39 years) and a control group (CG—n=9; aged 71.56±8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P=0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.


Author(s):  
Eman M. Khedr ◽  
Anwar M. Ali ◽  
Enas Deaf ◽  
Hebatallah M. Hassan ◽  
Ahmed Alaa ◽  
...  

Abstract Background Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. There is accumulating evidence that link gut microbiota to symptomatology and pathophysiology of PD. The aim of this study was to describe the pattern of gut microbiota and its association with PD and identify the effect of environmental factors on gut microbiota. This case–control study included 46 patients diagnosed as Parkinson’s disease (PD) and 31 healthy volunteers age and sex matched. Detailed history including age of onset, duration of disease, environmental risk factors, diet data, treatment, Unified Parkinson’s Disease Rating Scale (UPDRS), and gastrointestinal tract (GIT) domain of Non‐Motor Symptoms Scale (NMSS) were assessed. After extraction of bacterial DNA from the fecal samples, bacterial abundance was quantified by qPCR using 16S rRNA group-specific primers. Results Significant high abundance of Clostridium cluster IV, Akkermansia, Bifidobacterium, and lactic acid bacteria were found in the PD group compared with the control group (P < 0.001, 0.04, 0.02 and < 0.001, respectively), while Firmicutes were significantly less abundant in the PD group (P < 0.001) compared with the control group. The naive PD patients had significant abundance of Bifidobacterium, and lactic acid compared with control group. Interestingly, Akkermansia was more abundant in treated than untreated patients. There were significant associations between pesticide exposure and Bifidobacterium (P = 0.002), while no significant correlations between different gut microbiota and demographic, environment data, different rating scores or dominant type of PD. There was a significant negative correlation between the Bifidobacterium with the duration of illness (P = 0.012). Conclusion The present study highlighted a significant connection between PD and levels of certain types of gut microbiota, in support of a possible link between gut microbiota and a neurodegenerative cascade of PD.


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