Objective: to assess the effectiveness of the impact of physical therapy on the level of kinesiophobia, somatic markers of sarcopenia and indicators of the of fall risk in elderly people with Parkinson's disease. Methods. The study involved 57 elderly people diagnosed with Parkinson's disease in combination with sarcopenia. They were divided into two groups: 1 (they were engaged according to the principles of polyclinic rehabilitation) and 2 (they were engaged according to the developed program of physical therapy for 6 months, rehabilitation training was carried out three times a week). The aim of the program was to decrease the level of kinesiophobia and increase the compliance of patients with the implementation of active methods of physical therapy (kinesitherapy) and, thus, to maintain general physical activity; increasing muscle strength and flexibility; facilitating the initiation of movements; improving joint mobility; maintaining correct posture; improving walking and maintaining balance; prevention of pain syndromes and contractures; prevention of respiratory disorders; adaptation to the changed conditions of daily activity. The physical therapy program was created taking into account the specifics of each comorbid condition using functional training on the Prosedos platform, therapeutic exercises, massage, elements of occupational therapy, nutrition correction, patient education. We consistently achieved individual short- and long-term goals of rehabilitation in the SMART-format within the patient-centered rehabilitation model. This increased compliance and helped to select such elements of functional training, which made it possible to individually adjust the most affected movements in each patient, and interfere with normal functioning. The control group consisted of 24 people without signs of sarcopenia and Parkinson's disease. The effectiveness of the program was assessed by the dynamics of the Tampa Kinesiophobia Scale, Fall efficacy scale, grip strength, The Short Physical Performance Battery, Timed Up and Go test, Berg Balance Scale. Patients were examined twice - before and after rehabilitation measures (with an interval of 6 months). Results. Elderly patients with Parkinson's disease and sarcopenia were found to have a high level of kinesiophobia, muscle weakness, impaired static and dynamic balance and, as a consequence, a high fall risk. The developed program of physical therapy caused a statistically significant better effect on the state of kinesiophobia, markers of sarcopenia and the fall risk in comparison with the general outpatient program for all the studied parameters (p <0.05). Persons of group 1 found a statistically significant improvement in their repeated results on the parameters of the balance subscale SPPB, TUG-test, Berg Balance Scale (p <0.05), without reaching the corresponding levels of the control group (p> 0.05). For all the studied parameters, during the repeated examination, the persons of group 2 showed a statistically significant improvement relative to the initial indicator (p <0.05) and repeated parameters of the OG1 (p <0.05), without reaching any level of the control group (p> 0.05). Conclusions. Elderly patients with comorbidity Parkinson's disease and sarcopenia require the development of physical therapy programs taking into account and correcting the specificity of each disease, the presence of kinesiophobia and a high fall risk, which will increase the overall efficiency of recovery processes.

Purpose: to evaluate the effectiveness of the effect of physical therapy on the indicators and severity of locomotive syndrome in elderly patients with Parkinson’s disease and sarcopenia. Material and methods: 57 elderly people with Parkinson’s disease in combination with sarcopenia were examined. They were divided into two groups: group 1 (followed the principles of standard protocols of outpatient rehabilitation) and group 2 (followed the physical therapy program, which was developed in terms of patient-centered model of rehabilitation taking into account the specifics of each comorbid condition with the use of functional training on the «Prosedos» platform, therapeutic exercises, massage, occupational therapy, nutrition correction, and patient education). The control group consisted of 24 elderly people without signs of sarcopenia and Parkinson’s disease. The effectiveness of the program was evaluated by the dynamics of 25-question Geriatric Locomotive Function Scale, Dynamic Gait Index, Functional Gait Assessment, Activities Balance Confidence Scale, Modified Parkinson Activity Scale. Results: Elderly patients with Parkinson’s disease and sarcopenia were diagnosed with locomotive syndrome stage 2 (according to the 25-question Geriatric Locomotive Function Scale), which manifested itself as a high risk of falling and deteriorating dynamic balance (according to Dynamic Gait Index, Functional Gait Assessment), decreased confidence in maintaining balance during activities (according to Activities Balance Confidence Scale), violation of activities of daily living (according to Modified Parkinson Activity Scale); it was statistically significantly worse than in their peers (p<0.05). The developed program of physical therapy led to a statistically significant (p<0.05) improvement of all studied parameters of locomotive syndrome in comparison with baseline and the condition of patients who received standard restorative correction. Conclusions: Elderly patients with comorbid pathology (Parkinson’s disease and sarcopenia) need new physical therapy programs considering the specifics of each disease and its correcting, the presence of locomotive syndrome to improve social and domestic activity of patients and reduce health risks associated with geriatric syndromes – falls and frailty.

The purpose of the study was to assess the effectiveness of the impact of physical therapy on physical status and activities of daily living in elderly people with Parkinson's disease and senile asthenia. Materials and methods. The study involved 57 elderly people diagnosed with Parkinson's disease in combination with frailty. They were divided into two groups: group 1 – they were engaged according to the principles of polyclinic rehabilitation, and group 2 – they were engaged according to the developed program of physical therapy for 6 months, rehabilitation training was carried out three times a week. The aim of the program was to increase physical status and activities of daily living of patients with the implementation of active methods of physical therapy (kinesitherapy) and, thus, to maintain general physical activity; to increase muscle strength and flexibility; to facilitate the initiation of movements; to improve joint mobility; to maintain correct posture; to improve walking and maintain balance; to prevent pain syndromes and contractures; to prevent respiratory disorders; to adapt to the changed conditions of daily activity. The physical therapy program was created taking into account the specifics of each comorbid condition using functional training on the Prosedos platform, therapeutic exercises, massage, elements of occupational therapy, nutrition correction, patient education. We consistently achieved individual short- and long-term goals of rehabilitation in the SMART-format within the patient-centered rehabilitation model. This helped to select such elements of functional training, which made it possible to individually adjust the most affected movements in each patient, and interfere with normal functioning. The control group consisted of 24 people without signs of frailty and Parkinson's disease. The effectiveness of the program was assessed by the dynamics of the 6-minute walk test (distance traveled, level of fatigue according to the Borg scale), Mini-Balance Evaluation Systems Test, Barthel Activities of daily living Index, Lawton Instrumental activities of daily living Scale. Patients were examined twice – before and after rehabilitation measures (with an interval of 6 months). Results and discussion. In elderly patients with Parkinson's disease and sarcopenia, deterioration of physical status (expressed fatigue and a short distance according to the results of the 6-minute test), violation of indicators of static and dynamic balance and, as a result, violation of performance of instrumental and basic activities of daily life were found (p <0.05 of the parameters of the control group). The developed program of physical therapy caused a statistically significant better effect on the studied indicators of functioning and activities of daily life compared to the general polyclinic program for all studied indicators (р <0.05). Conclusion. Elderly patients with the comorbidity of Parkinson's disease and frailty need the development of physical therapy programs taking into account and correcting the specifics of each disease, which will increase the overall efficiency of recovery processes and improve the performance of activities of daily life