The purpose of the study: is to identify the factors contributing to the occurrence of paradoxical kinesias (PK) in Parkinson’s disease (PD) and to assess their frequency and clinical manifestations (according to the results of interviews). All patients interviewed were divided into two groups. The first group (45 people) — patients without symptoms of dementia, the second group (18 people) — patients with symptoms of dementia. The MMSE assessment was conducted no more than three months before this survey to assess the frequency of PK phenomenon, before the introduction of quarantine restrictions. Patients with PD initially have virtually no idea about the phenomenon of PK, but when informed (individually and in groups) in a group of patients without clinically significant cognitive decline, understanding of the essence and possibilities of PK increases from 6.7% to 88.9% of respondents. Patients with PD, cognitively preserved, note the manifestations of PK in the form of a spontane- ous ability to perform movements faster and more dexterously in 82.2% of observations, with vital movements of posture control, walking, and balance observed in 93.3% of patients, and the per- formance of complex acts in 51.1% of observations. Factors contributing to the manifestation of PK are often (in more than 50.0% of cases) in the group of patients without significant cognitive decline is - rhythm, counting, cues (84.4%), listening to music (93.3% of answers), environment (64.4%), strong emotions (93.3%); communication with certain people (88.9 %; answers); quality of sleep (80.0 %); less frequent, but practically applicable are internal order and conscious control (48.9 %) and visualization of the motor act (40.0 %). The realization of the phenomenon of PK with the help of factors that reveal it can be used in conducting classes on motor rehabilitation, but it is necessary to preserve the cognitive poten- tial of patients. The rehabilitation potential of patients with PD is defined as medium or low level. This level of rehabilitation potential is generally sufficient for the implementation of the developed individual rehabilitation programs.

The purpose of the study: is to objec- tively evaluate the effectiveness of non- drug rehabilitation programs for patients with Parkinson’s disease (PD) based on in- dicators of specific neurotrophic factors. Sixty-one patients with PD: study group — 33 patients, comparison group — 28 people. There were 33 patients in the ex- perimental group and 28 in the compari- son group. The patients of the experi- mental group did daily physical exercises for two months, unlike the representatives of the comparison group. Patients of both groups were examined for the serum level of the neurotrophic fac- tors: glial cell line-derived neurotrophic factor (GDNF) and cerebral dopamine neurotrophic factor (CDNF) In patients with PD of the comparison group, the synchronous dynamics of CDNF and GDNF indicators occurred and char- acterized the individual course of the dis- ease. On the other hand, in the experimental group, asynchrony of changes of these neuro- trophic factors in blood serum was observed under conditions of physical exertion. Summarizing the data obtained, it is nec- essary to consider many factors that can af- fect the level of neurotrophic factors. There is probably a genetically determined hetero- geneity of the Parkinson’s disease pheno- type, which is also expressed by the features of the synchronous dynamics of CDNF and GDNF parameters. It follows that the initial assessment of these parameters in patients with PD is optimal to identify those for whom motor rehabilitation will cause a long and stable positive effect and ensure the course of the disease according to a favourable type. The multidirectional and asynchrony of changes in neurotrophic factors in blood serum under conditions of physical exer- tion indicates the "sensitivity" of the sys- tem of neurotrophic factors to rehabilitation measures, even if they are used for a short time. Since long-term rehabilitation programs provide positive dynamics in the design of neurotrophic factors, a sufficient dura- tion and regularity of non-drug rehabilitation programs are advisable.