Parkinson's disease (PD) is a degenerative neurological disease presenting with motor and non-motor signs and symptoms. Approximately 30-50% of the patients experience pain. There is no consensus regarding the mechanisms and classification of pain in PD. This paper reviews current data on the possible mechanisms, classifications, evaluation and potential risk factors for pain in PD. Literature searches were performed to identify clinical trials and reviews covering patho-physiology, classification, type, evaluation and risk factors associated with pain in PD. Pain in PD could be related to pathologic changes in the anatomic structures involved in nociceptive mechanisms. Studies on pain mechanisms have been mostly conducted in animals. The mechanism of pain is complicated and influenced by different factors. There are several methodological differences between the studies trying to classify pain and to characterize its subtypes. Potential risk factors for pain in PD include: age, gender, and duration of the disease. Although pain is one of the non-motor symptoms most frequency experienced by patients, it is often under recognized and inadequately treated in contrast to motor symptoms Multicenter studies are needed that include a large cohort of subjects evaluated in multiple dimensions including pain in order to obtain more data and to allow improved management of pain in patients with PD.
Application of electrical stimulation combined with the Bobath approach proved to be efficient in preventing inferior and anterior shoulder subluxation in the acute stages of stroke.
Balance training alone is not sufficient for rehabilitation of ataxic MS patients. A combination of lumbar stabilization exercises or task-oriented training increases the success of balance rehabilitation. Implications for rehabilitation Multiple sclerosis is a chronic inflammatory and autoimmune disease of central nervous system and ataxia is one of the most challenging symptoms of this disease. Different exercise modalities are commonly employed to control ataxic symptoms in MS patients. Lumbar stabilization exercises or task-oriented training should be considered as complementary approach to improve balance and coordination in ataxic multiple sclerosis patients.
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