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.

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 Evaluation of Knee Proprioception and Factors Related to Parkinson’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Nathalie Ribeiro Artigas ◽  
Giovana Duarte Eltz ◽  
Alexandre Severo do Pinho ◽  
Vanessa Bielefeldt Leotti Torman ◽  
Arlete Hilbig ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Ability ◽  
Rating Scale ◽  
Center Of Pressure ◽  
Postural Instability ◽  
Lower Limbs ◽  
Controlled Study ◽  
Motor Symptoms ◽  
Cross Sectional

Background. Changes in proprioception may contribute to postural instability in individuals with neurological disorders. Objectives. Evaluate proprioception in the lower limbs of patients with Parkinson’s disease (PD) and the association between proprioception and cognitive ability, motor symptoms, postural instability, and disease severity. Methods. This is a cross-sectional, controlled study that evaluated proprioception in PD patients and healthy age- and sex-matched individuals. Kinetic postural proprioception of the knee was evaluated using an isokinetic dynamometer (Biodex® Multi-Joint System 4 Pro). Participants were evaluated using the Montreal Cognitive Assessment (MoCA), the Hoehn and Yahr rating scale and postural instability (pull test and stabilometric analysis), and motor function (UPDRS-III) tests. Results. A total of 40 individuals were enrolled in the study: 20 PD patients and 20 healthy controls (CG). The PD patients had higher angular errors on the proprioceptive ratings than the CG participants (p=0.002). Oscillations of the center of pressure (p=0.002) were higher in individuals with PD than in the controls. Proprioceptive errors in the PD patients were associated with the presence of tremors as the dominant symptom and more impaired motor performance. Conclusion. These findings show that individuals with PD have proprioceptive deficits, which are related to decreased cognitive ability and impaired motor symptoms.

The Relationships Between the Unified Parkinson’s Disease Rating Scale and Lower Extremity Functional Performance in Persons With Early-Stage Parkinson’s Disease

2009 ◽  
Vol 23 (7) ◽  
pp. 657-661 ◽  
Author(s):  
Jooeun Song ◽  
Beth E. Fisher ◽  
Giselle Petzinger ◽  
Allan Wu ◽  
James Gordon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Extremity ◽  
Rating Scale ◽  
Functional Performance ◽  
Early Stage ◽  
Motor Fluctuation ◽  
Stair Climbing ◽  
Functional Capabilities ◽  
Disease Rating

Background. The Unified Parkinson’s Disease Rating Scale (UPDRS) is the “gold standard” assessment tool for characterizing impairments in persons with Parkinson’s disease (PD); however, this scale’s ability to predict functional capabilities across different functional tasks has not been adequately assessed in persons with early-stage PD. Methods. Thirty persons with PD within 3 years of diagnosis and without motor fluctuation performed self-selected walking, fast walking, and sit-to-stand and stair-climbing tasks. Pearson’s correlation coefficients were used to calculate correlations with a standard UPDRS examination ( P < .05). Simple linear regression models were used to fit each functional performance outcome measure with the UPDRS total predictor scores. Results. The correlations between the UPDRS motor (section III), UPDRS total scores, and all timed functional performance measures were fair to good (range, 0.45-0.57). Conversely, only greater self-selected time to walk 50 ft correlated with a higher UPDRS activities of daily living (II) score ( r = .386; P < .05). Conclusions. The UPDRS motor (III) and total scores may be good predictors of overall lower extremity function in persons with early-stage PD. Understanding the relationships between UPDRS scores and functional capabilities may allow clinicians to better quantify early physical functioning, longitudinally assess disease progression, and assess the efficacy of interventions.

scholarly journals Application of nonlinear analysis for the assessment of gait in patients with Parkinson’s disease

2021 ◽  
pp. 1-8
Author(s):  
Donatas Lukšys ◽  
Julius Griškevičius
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Lower Limbs ◽  
Nonlinear Method ◽  
Nonlinear Parameters ◽  
Kinematic Data ◽  
Disease Rating ◽  
Measurement Units ◽  
Updrs Score

BACKGROUND: Gait can be affected by diseases such as Parkinson’s disease (PD), which lead to alterations like shuffle gait or loss of balance. PD diagnosis is based on subjective measures to generate a score using the Unified Parkinson’s Disease Rating Scale (UPDRS). To improve clinical assessment accuracy, gait analysis can utilise linear and nonlinear methods. A nonlinear method called the Lyapunov exponent (LE) is being used to identify chaos in dynamic systems. This article presents an application of LE for diagnosing PD. OBJECTIVE: The objectives were to use the largest Lyapunov exponents (LaLyEx), sample entropy (SampEn) and root mean square (RMS) to assess the gait of subjects diagnosed with PD; to verify the applicability of these parameters to distinguish between people with PD and healthy controls (CO); and to differentiate subjects within the PD group according to the UPDRS assessment. METHODS: The subjects were divided into the CO group (n= 12) and the PD group (n= 14). The PD group was also divided according to the UPDRS score: UPDRS 0 (n= 7) and UPDRS 1 (n= 7). Kinematic data of lower limbs were measured using inertial measurement units (IMU) and nonlinear parameters (LaLyEx, SampEn and RMS) were calculated. RESULTS: There were significant differences between the CO and PD groups for RMS, SampEn and the LaLyEx. After dividing the PD group according to the UPDRS score, there were significant differences in LaLyEx and RMS. CONCLUSIONS: The selected parameters can be used to distinguish people with PD from CO subjects, and separate people with PD according to the UPDRS score.

scholarly journals Nutritional status and activities of daily living in patients with Parkinson’s disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246329
Author(s):  
Tomohiko Nagano ◽  
Tatsuyuki Kakuma ◽  
Yuichi Umezu ◽  
Takashi Yanagawa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nutritional Status ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Piecewise Linear ◽  
Functional Independence Measure ◽  
Nutritional Intervention ◽  
Functional Independence ◽  
Status Score

Patients with Parkinson’s disease are often frail and likely to be malnourished. Several studies have reported the adverse effects of malnutrition on functional outcomes; however, the association between nutritional status and activities of daily living is unclear among patients with Parkinson’s disease. This study aimed to investigate the relationship between nutritional status and activities of daily living in patients with Parkinson’s disease. We conducted a retrospective cohort study with the data of 124 patients who were consecutively admitted to a rehabilitation hospital in Japan, among whom the data of 61 patients were included in the analyses. The Controlling Nutritional Status score was used to measure the nutritional status of the participants, and the motor subdomain of the Functional Independence Measure was used to assess the activities of daily living. Piecewise linear mixed-effects models were fitted to the data after adjusting for confounding factors. A poor nutritional status (i.e., Controlling Nutritional Status score >3) was significantly associated with a poor Functional Independence Measure gain, which was defined as difference in the score values of the Functional Independence Measures between discharge and admission. Our findings could aid in developing nutritional intervention programs for patients with Parkinson’s disease by employing the Controlling Nutritional Status score to improve their activities of daily living.

scholarly journals Effects of proprioceptive neuromuscular facilitation on the functional independence measure in patients with Parkinson’s disease.

2015 ◽  
Vol 13 ◽  
pp. 299 ◽  
Author(s):  
Emilton Lima De Carvalho ◽  
Ilkiane Pinheiro Queiroz ◽  
Ilkilene Pinheiro Queiroz ◽  
Ingred Merllin de Souza Batista ◽  
Thiago Dos Santos Maciel ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopaminergic Neurons ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Muscle Rigidity ◽  
Significant Difference ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Before And After ◽  
Positive Results

Background: Parkinson’s disease is classified as a chronic, degenerative disease and is characterized by a regression in the number of dopaminergic neurons in the substantia nigra region, the main clinical features of PD are: muscle rigidity and tremor at rest six cycles per second. Objective: To evaluate the effects of pop on the Functional Independence Measure (FIM) in patient carriers of Parkinson disease. Method: The above study five elderly patients with Parkinson’s disease with a mean age of 82,5±10,33 years. The study was carried out applying the FIM questionnaire before and after treatment with PNF to assess cognitive and motor control levels. The patients were submitted to 10 sessions estimated time between 40 and 50 minutes. Results: The analysis of the functional independence of patients, although the results have been optimistic, improving patient’s functional pattern not observed statistically significant difference (p >0,05). Conclusion: It did not get positive results when assessing the level of motor and cognitive functional independence. Although there have been reports of improvement in locomotion and sphincter control by the patients themselves.

scholarly journals Quantifying Viscous Damping and Stiffness in Parkinsonism Using Data-Driven Model Estimation

2021 ◽  
Author(s):  
Alec Werning ◽  
Daniel Umbarila ◽  
Maxwell Fite ◽  
Sinta Fergus ◽  
Jianyu Zhang ◽  
...  
Keyword(s):  
Experimental Data ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Computer Simulations ◽  
Rating Scale ◽  
Angular Position ◽  
Estimation Method ◽  
Human Perception ◽  
Lower Limbs ◽  
Viscous Damping

AbstractRigidity of upper and lower limbs in Parkinson’s disease (PD) is typically assessed via a clinical rating scale that is subject to biases inherent to human perception. Methodologies and systems to systematically quantify changes in rigidity associated with angular position (stiffness) or velocity (viscous damping) are needed to enhance our understanding of PD pathophysiology and objectively assess therapies. We developed a robotic system and a model-based approach to estimate viscous damping and stiffness of the elbow. Our methodology enables the subject to freely rotate the elbow, while torque perturbations tailored to identify the arm dynamics are delivered. The viscosity and stiffness are calculated based on the experimental data using least-squares optimization. We validated our technique using computer simulations of the arm dynamics and experiments with a nonhuman animal model of PD in the presence and absence of deep brain stimulation (DBS) therapy. Computer simulations of the arm demonstrate that the proposed approach can accurately estimate viscous damping and stiffness. The experimental data show that both viscosity and stiffness significantly decreased when DBS was delivered. Computer simulations and experiments showed that stiffness and viscosity measurements obtained with the proposed methodology could better differentiate changes in rigidity than scores previously used for research, including the work score, impulse score, and modified Unified Parkinson’s Disease Rating Scale (mUPDRS). The proposed estimation method is suitable to quantify the effect of therapies on viscous damping and stiffness and study the pathophysiological mechanisms underlying rigidity in PD.

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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