BACKGROUND: Decreased mobility and walking capacity occur frequently in Parkinson's disease (PD). Robotic treadmill training is a novel method to improve the walking capacity in rehabilitation.
OBJECTIVES:The primary aim of this study was to investigate the effects of robotic treadmill training on functional mobility and walking capacity in PD. Secondly, we aimed to assess the effects of the robotic treadmill training the motor symptoms and quality of life in patients with PD. METHODS: Seventy patients with idiopathic Parkinson's disease who admitted to the outpatient clinic of the rehabilitation hospital were screened and 12 ambulatory volenteers who met the study criteria were included in this study. Patients were evaluated by Hoehn Yahr (HY) scale clinically. Two sessions robotic treadmill training per week during 5 weeks was planned for every patient. Patients were evaluated by the Timed Up and Go (TUG) test, 10 meter walking test (10 MWT), Unified Parkinson's Disease Rating Scale (UPDRS) motor section and Parkinson's Disease Questionnaire-39 (PDQ-39) at the baseline, at the 5 and 12 weeks. Cognitive and emotional states of the patients were assessed by Mini Mental State Examination (MMSE) test and Hospital Anxiety and Depression Scale (HADS) at the baseline. All patients were under medical treatment for the PD in this study and drug treatment was not changed during the study. RESULTS: Ten patients completed the study. The mean age was 65.6 ± 6.6 years. Five patients (50%) were women. Disease severity was between the HY stage 1-3. Two patients did not continue the robotic treadmill training after 7 sessions. They also did not want to come for control visits. TUG test, 10 MWT and UPDRS motor subscale scores showed statistically significant improvement after robotic treadmill training (p = 0.02, p = 0.001, p = 0.016). PDQ-39 scores improved significantly after robotic treadmill training (p = 0.03), however, the scores turned back to the baseline level at the 12. week control.
Although the disease in patients with treated PD was more severe than in the untreated group, no significant difference in the thickness of retina was found between the 2 groups. Therefore, we thought that levodopa might have a protective effect on retina in patients with PD.
BACKGROUNDOrganization and management of neurological emergencies differs among hospitals. Some have specialized neurological emergency rooms (ER).OBJECTIVESThe purpose of this study was to determine the characteristics, diagnosis and outcome of patients referred to a specialized emergency neurology clinic.DESIGNProspective, observational study of consecutive patients presenting between March 2014 and July 2014.SETTINGNeurologicaler of a training and research neuropsychiatric hospital.PATIENTS AND METHODSPatients older than 16 years of age with a neurological complaint were assessed by neurological exam, laboratory and imaging tests including brain computed tomography (CT), brain magnetic resonance imaging (MRI), cerebrospinal fluid analysis, electroencephalography or electromyography.MAIN OUTCOME MEASURESTypes of diagnosis.RESULTSOf 4500 patients, 2602 (57.8%) were female, and the mean age was 49.2 (23.6) years. The most common symptom was headache, which presented in 30.8% of all patients. The three most common diagnoses after emergency work-up were headache (27.8%), stroke (20.6%) and peripheral vertigo (13%). In the ER, CT was performed on 65.5% of patients and MRI on 66.9%. After emergency work-up, 72.2% patients were discharged home.CONCLUSIONSNeurological diseases are common, with headache and cerebrovascular diseases being the most frequent diagnosis in this specialized ER. CT and MRI are most often used to diagnose or exclude neurological diseases. Many patients do not require immediate hospitalization. The two most frequent diagnoses for hospitalization were stroke and demyelinating disease.LIMITATIONSAbsence of follow up data on patients discharged home.
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