BACKGROUND:
Gait function is known to be impaired by Parkinson’s disease (PD). The effect of exercise to improve gait has been widely examined, often with special intervention. However, in clinical settings, physiotherapy rarely consists only of gait training.
OBJECTIVE:
To examine whether versatile physiotherapy intervention conducted in accordance with European Physiotherapy Guideline for Parkinson’s Disease (EPGPD) is sufficient to increase gait speed (GS).
METHODS:
Participants (24) with idiopathic PD were randomly enrolled into intervention (IG) and control groups (CG) (
n
= 12, 7 females and 5 males in each group). Sixteen one-hour therapy sessions (twice per week) were conducted for IG. Each session focused on core areas recommended in EPGPD. Participants were assessed twice with 10 weeks between assessments. GS was calculated based on a gait test of Short Physical Performance Battery. Dominant side hip flexion and abduction range of motion (HFLEX & HABD) were measured and Freezing of Gait questionnaire (FOG) was administered.
RESULTS:
Versatile intervention in groups resulted in increase of GS (ES –0.9 [CI{0.1}–{0.4}] m/s) and HFLEX (ES–0.6 [CI{5.9}–{16.6°}]. FOG was reduced (ES –0.41 [CI {–2.8}{–5.5}]). Re-evaluation HABD differed between groups and indicated large ES (
r
= –0.5).
CONCLUSIONS:
Versatile physiotherapy is sufficient to improve GS, range of motion and reduce FOG.
Background. Neurological assessment of a patient with Parkinson's disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE). Results. In women with PD, Kendall's tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.
Changes in handwriting are common in individuals with Parkinson's disease (PD). Improving motor performance by using cueing strategies has become a standard in PD physiotherapy. Th e objective of the study was to identify whether using diff erent paper types (plain, horizontal lined and grid lined) can improve handwriting of individuals with PD. 21 subjects with mild-to-moderate PD and 9 healthy control group members participated. Subjects were given the task of writing two repetitions of one simple and one complex sentence on plain, horizontal lined and grid lined paper. Handwriting speed and size were measured. Results confi rm previous fi ndings stating that individuals with PD write slower and have smaller handwriting compared to healthy controls. Based on the study, it can be concluded that writing on diff erent types of paper does not aff ect writing speed, but does aff ect handwriting size of patients with PD.
The aim of the study was to analyse with Microsoft Kinect (Kinect) the differences in lower limb kinematics during sub-phases of modified Timed Up and Go test (modTUG) in men with Parkinson's disease (PD) compared to healthy age-matched male individuals. Eight men with mild-to-moderate PD (age 67.5±4.5 yrs) and eight healthy men (age 69.8±8.0 yrs) participated. Kinect along with KinectPsyManager (v1.0) and Matlab2016b software was used for data collection. Selected lower limb kinematics and gait speed (GS) were calculated during sittingto-walking (STW) transition while performing modTUG. According to Kinect men with mild to moderate PD did not differ from healthy counterparts in aspects of postural characteristics of STW, with the exception of smaller distance between knees while sitting (p<0.001). Men with PD were found to perform the walking phase of STW transition slower (p<0.01) and with slower GS (p<0.01) comparing to healthy men. In conclusion, compared to healthy men, Kinect detects smaller distance between knees during sitting before transitioning from STW in men with mild to moderate PD. In addition, men with PD also demonstrated slower GS and a longer walking phase of STW transition in comparison to healthy men.
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