Analyzing the effects of PDSAFEx™ on the motor symptoms of Parkinson’s disease: A retrospective study

Abstract

BACKGROUND:The cardinal motor symptoms of Parkinson's disease (PD) include postural instability, bradykinesia, tremor and rigidity. The overall Unified Parkinson's Disease Rating Scale (UPDRS-III) indicates, the gold-standard treatment for PD (dopaminergic-therapy) is very effective in improving these symptoms. However, recent research indicated that 2 of the 4 cardinal symptoms of PD (balance and tremor) remain unimproved by dopaminergic-therapy. This prompts the investigation of other alternative and adjunct treatments such as exercise rehabilitation. Unfortunately, like drug studies, exercise studies often focus on overall symptom improvement yet fail to monitor changes to specific symptoms. This may be problematic for individuals with different symptomatic phenotypes. If tremor/balance were the main concern, then adjunct therapies may be critically important when these symptoms may be dopa-resistant. Thus, it is important for all therapies to examine individual symptomatic-improvement. Interestingly, recent studies show PDSAFEx™ (a sensory integration therapy) to have a significantly improve motor symptoms in comparison to traditional exercise ( 14). Yet, the effects of PDSAFEx™ on individual PD symptoms is unknown. OBJECTIVE: To explore the effects of PDSAFEx™ on PD symptoms in adjunct to medications. METHODS: UPDRS-III scores of 229 cases were retrospectively examined and analysed in SPSS using Wilcoxon pairs singed-rank test to evaluate specific symptom-improvements. RESULTS: PDSAFEx™ was confirmed to improve overall motor symptoms (p = 0.0001), but more importantly a significant improvement to tremor (p < 0.00001) and balance (p < 0.00001) were also identified.

A randomised controlled trial on effectiveness and feasibility of sport climbing in Parkinson’s disease

“…A possible explanation for this long-term positive effect on tremor could be found in a general reduction of the participants’ stress level during and after climbing 79 . A similar effect on tremor has been shown in studies on mindfulness and yoga training, in which the authors attribute the effect to improved body awareness and sensory feedback through physical exercise and the components of resistance training 14 – 16 , 61 , 80 .…”

“…Numerous studies on treadmill training, Nordic walking, cycling and resistance training have already revealed significant positive effects in this respect 1 , 6 – 13 . Nearly all types of exercise yield general therapeutic benefits, nevertheless, certain types of exercise are particularly effective on PD symptoms in the targeted body parts 14 – 16 . Although there is some evidence of carry-over effects to other parts of the body when one body part is trained 8 , it is generally accepted that the area being trained benefits the most.…”

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

“…First, washout benefits were rarely accounted for. 2,3,[15][16][17][18][19][20] Most studies only included a short washout period, and while these studies can conclude immediate improvements may be achievable, lasting effects of exercise may be missed. It has been suggested that a sufficient washout period (∼more than 8 weeks) must be employed to account for any potential long-term impact of treatment.…”

“…[11][12][13] Similarly, sensory exercise can target potential executive function and sensory deficits that may underlie the motor symptoms of PD. [15][16][17][18][19][20] Sensory exercise is low intensity and requires participants to complete exercise with their eyes closed. 16 Previous studies have suggested sensory allows for sustained levels of dopamine in the basal ganglia, improving overall disease severity of PD.…”

Sensory Attenuation in Sport and Rehabilitation: Perspective from Research in Parkinson’s Disease

“…People with Parkinson’s Disease (PD) face debilitating symptoms that often begin years before disease diagnosis [ 1 ], worsen over time and significantly affect quality of life. Dopamine replacement therapy is used to treat PD and can be effective for long periods [ 2 ], though it does not improve all cardinal symptoms of this neurodegenerative disorder [ 3 ], with high levels of wearing off over time and considerable dissatisfaction among patients [ 2 ]. While techniques such as deep brain stimulation can be employed with relative success [ 4 ], they are still associated with significant shortfalls [ 5 ], not least of which are the narrow inclusion criteria deemed necessary for high efficacy [ 6 ], and the significant investment in time required for effective stimulator titration.…”