scholarly journals The Relationship between Periodontal Disease and Motor Impairment in the Course of Parkinson’s Disease

2020 ◽  
Vol 74 ◽  
pp. 340-347
Author(s):  
Beata Ledwon ◽  
Andrzej Miskiewicz ◽  
Ewa Grabowska ◽  
Jan Kowalski ◽  
Renata Górska

Introduction: The incidence of Parkinson’s disease and the severity of accompanying motor impairment increase significantly with age. The etiopathogenesis and progression of Parkinson’s disease at the molecular level is associated with the production of cytokines and acute phase proteins, which are also typical for inflammatory diseases, such as periodontitis and gingivitis. Objectives: The aim of the study was to assess the correlation between neurological parameters, the indices of periodontal status and systemic parameters of inflammation, as well as their change after treatment. Patients/Methods: The presented study is a retrospective analysis of data obtained from medical histories and patient charts. Charts of 93 patients diagnosed with Parkinson’s disease and periodontal diseases over the period 2015–2017 were selected. Sixty-one of these patients received periodontal treatment: professional scaling, root planning – SRP and periodontal pockets rinsing with 3% H2O2 and constituted a study group. Additionally, the patients were instructed to use a 0.2% chlorhexidine mouthwash. The other 32 patients, who were not periodontally treated, formed a control group. Both groups continued their anti-parkinsonian treatment. Results: The mean pocket depth at the baseline was 4.0 mm (SD 0.9 mm), mean bleeding index was 56.2%, and 63.9% of patients presented tooth mobility grade II or III. A significant correlation between periodontal and neurological parameters was observed at the baseline. After periodontal treatment, an improvement of both periodontal parameters and those related to the Parkinson’s disease was observed in the study group. Those periodontally treated exhibited lower number of anti-parkinsonian medicines, lower number of falls, as well as better results in10-m walk test and timed-up-and-go test, as compared to the control group. The improvement was observed both 3 and 9 months after the end of treatment.

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Marco Cicciù ◽  
Giacomo Risitano ◽  
Giuseppe Lo Giudice ◽  
Ennio Bramanti

Parkinson's disease (PD) is a progressive neurodegenerative disorder related to the loss or absence of dopaminergic neurons in the brain. These deficits result in slowness of movement, tremor, rigidity, and dysfunction of behaviour. These symptoms negatively influence the patient’s capability to carry out the daily oral hygiene manoeuvres. The aim of this work is to record the oral health condition of PD patients evaluated at the IRCSS Bonino-Puleio in Messina. The oral health of 45 consecutive PD patients (study group) with neurologic diagnosis based on United Kingdom Brain Bank Criteria has been compared with that of another 45 no PD patients of the same age (control group). The evaluation of the general oral condition was recorded underlining tooth loss, active periodontal disease, and presence of untreated caries. The frequency of untreated caries, periodontal diseases, and missing teeth of the study group was significantly higher than in control group. Based on the data results, clinicians should direct high attention to the oral hygiene of patients with PD, above all at the early stages of the caries or periodontal disease, in order to prevent serious evolution of those pathologic dental conditions that may finally result in the tooth extraction event.


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.


2020 ◽  
Vol 14 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Corsalini Massimo ◽  
Rapone Biagio ◽  
Cagnetta Giovanni ◽  
Carossa Massimo ◽  
Sportelli Pasquale ◽  
...  

Background: Parkinson’s Disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. It is one of the movement disorders that can affect oro-facial conditions. It is more common in the elderly, having an average age of onset of around 60 years. Objective: The aim was to study orofacial functions in patients suffering from PD with partial or total edentulism, wearing removable prostheses. Methods: Forty-eight (48) elders, rehabilitated with removable dentures, were included: 24 patients suffering from Parkinson's disease constitute the Study Group (SG), and 24 subjects not suffering from Parkinson's disease or neurological degenerative diseases represent the Control Group (CG). In SG, the severity of Parkinson's disease was assessed according to the Unified Parkinson's Disease Rating objective motor scale III, and oro-facial dysfunctions were evaluated using Nordic Orofacial Test-Screening (NOT-S). The duration of the use of dental prostheses expressed in years has been reported. In both the groups, the subjective chewing index for the analysis of masticatory ability and the two-color chewing gum test for the analysis of masticatory efficiency were conducted . Results: There was a statistically significant difference between the SG and CG compared to the NOT-S (P = 0.001). Analyzing the study group, a statistically significant correlation was found between the masticatory efficiency and prosthetic years of use (rs = 0.436; P <0.05); instead, no statistically significant correlation was found between the masticatory efficiency and the severity of Parkinson's disease. Conclusion: In our study, we did not find differences between SG and CG in terms of the degree of masticatory efficiency; therefore, only a correlation between the duration of use of dental prostheses and the degree of masticatory efficiency was found.


2020 ◽  
Vol 47 (4) ◽  
pp. 405-414
Author(s):  
Beverley Chow ◽  
Florin Feloiu ◽  
Assunta Berardocco ◽  
David Ceglie ◽  
Shanker Nesathurai

BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder with manifestations such as tremors, rigidity and bradykinesia. OBJECTIVE: The objective of this study was to evaluate the efficacy of outpatient multidisciplinary rehabilitation. METHODS: 179 patients participated in the six-week program. The following outcomes were measured: Timed Up and Go (TUG), sit to stand five times (STSx5) and in 30 seconds (STS30), six minute walk distance (6MWD) and gait velocity (6MWV), MOCA, bilateral grip strength, 360-degree turn (360 R, 360 L) and bilateral nine hole peg test. Pre- and post- data was analyzed via paired t-tests. Multiple regression was used to determine age- or gender-affected outcomes. RESULTS: Patients showed a statistically significant improvement (p < 0.05) in all outcomes. Mean TUG improved by 1.63 seconds (s), STSx5 by 4.19s, STS30 by 2.37 repetitions, 6MWD by 66.8 metres, 6MWV by 0.15 m/s, MOCA by 1.50 points, 360 R by 1.17s, 360 L by 1.60s, Grip R by 0.78 kg, Grip L by 0.95 kg, 9HP R by 1.71s and 9HP L by 1.58s. Gender had no influence. Age was a statistically significant predictor in STSx5 and 6MW. CONCLUSIONS: An outpatient multidisciplinary program successfully decreased motor impairment and increased overall functional independence in PD.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Santos García D. ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores ◽  
Guillermo Muñoz ◽  
Jose M. Paz González ◽  
...  

AbstractQuality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.


2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
T Silva ◽  
L Silva ◽  
K Silva ◽  
S Silva ◽  
D Silva ◽  
...  

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.


2020 ◽  
Vol 48 (7) ◽  
pp. 030006052092244
Author(s):  
Jinzhong Huang ◽  
Wei Hong ◽  
Zhilong Yang ◽  
Jian Ding ◽  
Yi Ren

Purpose To investigate the efficacy of combining the dopamine receptor agonist pramipexole with levodopa for Parkinson’s disease (PD) treatment and to measure their effects on quality of life and tumor necrosis factor (TNF)-α levels in PD patients. Basic Procedure In total, 160 PD patients who were admitted to our hospital were equally randomized into a control treatment group (levodopa alone) and the study group (pramipexole combined with levodopa). Both groups were treated for 12 weeks. Findings After treatment, scores from the Unified Parkinson’s Disease Rating Scales (1–3), the Hamilton Depression Scale, and the Parkinson’s Disease Questionnaire (PDQ-39) were significantly decreased in both groups, whereas Mini-Mental State Examination scores were significantly increased. After treatment, the study group had significantly lower scores for all scales except the Mini-Mental State Examination, for which those who received combined treatment had significantly higher scores than the control group. The incidence of adverse reactions was significantly lower in the study group than in the control group. Furthermore, after treatment, serum TNF-α levels were significantly decreased in both groups compared with pre-treatment levels. Conclusion Pramipexole combined with levodopa relieved PD symptoms and improved the quality of life of PD patients, potentially by suppressing serum TNF-α levels.


2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Xiao Lei Liu ◽  
Shihui Chen ◽  
Yongtai Wang

The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson’s disease (PD). Fifty-four moderate PD patients (N=54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P<0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson’s disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD.


Author(s):  
Luca Palmerini ◽  
Sabato Mellone ◽  
Guido Avanzolini ◽  
Franco Valzania ◽  
Lorenzo Chiari

2018 ◽  
Vol 2 (2) ◽  

It is hypothesised that Parkinson’s disease and chronic strokes may interfere with patient’s ability to multitask. The aim of the study is to explore the impact of chronic stroke or Parkinson’s on simple multitasking abilities. Both diseases cause the inability to perform simple activities such as walking and mental mathematics simultaneously. In a controlled sample of 15 patients of Indian origin with either chronic stroke or Parkinson’s disease it was observed that there was a significant deterioration in the ability to multitask (increase in time taken to multitask between Timed up and Go (TUG) and Dual Timed up and Go (Dual TUG) versus a normal control group). The study found that the average increase in time required to complete the tests was 49% (for chronic stroke patients) and 36 % (for patients with Parkinson’s disease) as compared to a normal baseline of less than 10%. In patients with chronic stroke or Parkinson’s disease, special attention must be paid to these impairments as they significantly affect independent living.


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