Parkinson disease (PD) is one of the most common neurodegenerative diseases. Its main clinical manifestation is movement disorders. The study of innovative objective methods for the diagnosis and rehabilitation of movement disorders in PD is relevant and in demand taking into account the slowly progressive course of the disease and the complex set of symptoms that subsequently forms a characteristic movement pattern. This article provides an example of a personalized rehabilitation assessment of biomechanical manifestations of the gait function of a patient with exacted diagnosis, stage 3.5 PD according to Hoehn and Yahr, by means of the method of three-dimensional motion video analysis using the Vicon Motion Capture Systems soft-hardware complex. The patient has postural and gait disorders. This method was applied after a rehabilitation course based on the activation of lifting the foot from the support surface (“back push”). Changes in the tempo and rhythm parameters of gait in a patient with PD in comparison to a healthy person were revealed: acceleration of walking pace with shortening of the length of single and double step, a decrease in the time of limb advancement, acceleration of the moment of heel rise and a decrease in walking pace. Analysis of the locomotion also revealed a decrease in the amplitude of flexion-extension in the coxofemoral joint, knee joint and tibio-tarsic on the side with more pronounced Parkinsonism. Insufficient knee flexion and hip extension, excessive dorsal flexion of the foot with insufficient plantar flexion were noted. Revealing the last features of locomotion in a particular case allows one to make a plan for a targeted personalized rehabilitation program for a given patient. Thus, the method of three-dimensional video analysis is a valuable diagnostic tool that makes it possible to objectively assess the existing violations of locomotion and identify the targets of rehabilitation.

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The aim of the research is the assessment of cognitive status dynamics during levodopa pharmacotherapy. Material and methods. A new approach was created to assess cognitive status in patients with PD. It allows diagnosing cognitive fluctuations at an early stage at the highest quality level as well as to correct the disorders rationally and timely. The patients were randomized into two groups. In group 1 (n = 25), the assessment of cognitive status was carried out at the “peak” dose of levodopa and in 6 months at the state of levodopa dose “outcome”. In group 2 (n = 25), respectively, on the contrary, the initial assessment of cognitive status was carried out at the “outcome” of levodopa dose and in 6 months later at the “peak”. The study groups were comparable in terms of such parameters as: age, gender, average duration and stage of disease. On average, all the participants by the study time were at 2.5 stage of the disease according to Hoehn and Yahr scale; and the average length of the disease was 5 years. Results. Th e following statistically signifi cant results were obtained: in the fi rst group (peak–outcome) the average values on MMSE scale at the “peak” were 27 points; at the “outcome” they were – 25; MOCA values were 25 and 22 points, respectively; on FAB scale the values were – 16 and 14.5 points, SCOPA-Cog values were 33 and 28 points. In the second group (outcome – peak), the average values on MMSE scale at the “outcome” were 27, at the “peak” – 28, on MOCA scale – 23 and 25.5, respectively, on FAB scale – 16 and 17.5, SCOPA–Cog – 30 and 33. Conclusion. The present study confi rms that cognitive status of patient associated with antiparkinsonian therapy changes depending on the peak of levodopa and its outcome. At the peak of levodopa action, patients show signifi cantly better results on scaling, and at the end of the day, they demonstrate more significant cognitive impairments. A new two-stage method for assessing CF allows diagnosing cognitive impairments at a better level. Such method is necessary for timely initiation of therapy and rational correction of antiparkinsonian treatment.

BACKGROUND. Hypomimia is a distinct symptom of Parkinsons disease manifested by reduced facial expression and slowness of movement in mimic muscles. Clinical aspects of this symptom remain underinvestigated to the date. AIM. Based on correlation analysis, to determine the association between hypomimia, general manifestations of hypokinesia and the quality of life in patients with Parkinsons disease as well as to evaluate the influence of therapy with L-DOPA pharmaceuticals on hypomimia. MATERIAL AND METHODS. Clinical aspects of hypomimia were studied in 30 patients with stage 1.53.0 PD according to Hoehn and Yahr Rating Scale. The mean age of the patients was 69. Analysis of hypomimia was carried out using a proprietary method of computer video-analysis of facial muscle movement in performance of 6 tests: smiling, drawing of the letter O, winking, eyebrow raising, frowning and text reading. The gait function was assessed using the laser analyser of kinematic parameters of gait. Mean step length, step time and gait velocity were evaluated. Manifestations of general hypokinesia were analysed via the Unified Parkinsons Disease Rating Scale licensed by the International Parkinson and Movement Disorder Society. Statistical processing of the data was performed using the IBM SPSS Statistics 23 software package. The Wilcoxon test and the Spearmans correlation coefficient were used. The statistical significance level was set at p 0.05. RESULTS. The correlation between the degree of hypomimia and the severity of general hypokinesia has been confirmed, which determines the prospect in objective analysis of mimics as a possible screening test for general hypokinesia. We have obtained data confirming the association between hypomimia and general hypokinesia: in particular, step time, step length and gait velocity. CONCLUSION. While using the proprietary method of objective hypomimia diagnosis, we have revealed the presence of correlation between manifestations of hypomimia and general hypokinesia. Additionally, manifestations of hypomimia have been found to decrease against the background of dopaminergic therapy.

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