Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms

Saba, Roberta Arb; Maia, Débora Palma; Cardoso, Francisco; Borges, Vanderci; Andrade, Luiz Augusto Franco de; Ferraz, Henrique Ballalai; Barbosa, Egberto Reis; Rieder, Carlos Roberto de Mello; Silva, Delson José da; Chien, Hsin Fen; Capato, Tamine; Rosso, Ana Lucia; Lima, Carlos Frederico Leite de Souza; Bezerra, José Marcelo Ferreia; Nicaretta, Denise Hack; Barsottini, Orlando Graziani Póvoas; Godeiro-Júnior, Clécio; Barcelos, Lorena Broseghini; Cury, Rubens Gisbert; Spitz, Mariana; Silva, Sônia Maria Cesar de Azevedo; Coletta, Marcus Vinicius Della

doi:10.1590/0004-282x-anp-2021-0219

Cited by 15 publications

(22 citation statements)

References 104 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Two guideline reviews emphasized the high level of evidence of cueing techniques using real feedback to improve gait performance. 3,6 We also found some studies using devices as compensation strategies to improve gait in PD such as visual laser cues, 40 rhythmical auditory cues provided by a metronome, 41 and tactile cues. 42 Some studies used VR to interact three-dimensional virtual environment.…”

Section: Resultsmentioning

confidence: 76%

“…The positive effects of the cues on gait performance (speed, cadence, step length, and stride) are well recognized and supported by a robust level of evidence. 3,6 External cues, such as auditory and visual ones, are used to bypass and compensate for the brain's abnormal internal cueing mechanisms that cause deficiencies in movement planning and execution in PD. 2 These compensation strategies (or cueing techniques) delivered by physiotherapists, such as multimodal training, may provide feedback, repetition, and high challenges and can be used to correct temporal aspects of gait, improve balance and walking speed and prevent freezing episodes.…”

Section: Real-time Feedback and Cueing Techniques (Auditory Visual An...mentioning

confidence: 99%

“…2 Although many resources are available for the management of PD motor symptoms, gait impairment only partially benefits from antiparkinsonian drug treatment and surgical intervention. 1,3 Assistive Technology (AT) is an umbrella term covering the systems and services related to the delivery of assistive products (AP) and services, enabling, and promoting the inclusion and participation of persons with disability, aging populations, and people with non-communicable diseases. Therefore, the use of AP may maintain or improve PD patients' functioning and independence, thereby promoting their well-being (WHO assistive -https://www.who.int/health-topics/assistive-technology#tab=tab_1).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assisted technology in Parkinson's disease gait: what's up?

Capato,

Chen,

Miranda

et al. 2024

Arq Neuropsiquiatr

View full text Add to dashboard Cite

Background Gait disturbances are prevalent and debilitating symptoms, diminishing mobility and quality of life for Parkinson's disease (PD) individuals. While traditional treatments offer partial relief, there is a growing interest in alternative interventions to address this challenge. Recently, a remarkable surge in assisted technology (AT) development was witnessed to aid individuals with PD. Objective To explore the burgeoning landscape of AT interventions tailored to alleviate PD-related gait impairments and describe current research related to such aim. Methods In this review, we searched on PubMed for papers published in English (2018-2023). Additionally, the abstract of each study was read to ensure inclusion. Four researchers searched independently, including studies according to our inclusion and exclusion criteria. Results We included studies that met all inclusion criteria. We identified key trends in assistive technology of gait parameters analysis in PD. These encompass wearable sensors, gait analysis, real-time feedback and cueing techniques, virtual reality, and robotics. Conclusion This review provides a resource for guiding future research, informing clinical decisions, and fostering collaboration among researchers, clinicians, and policymakers. By delineating this rapidly evolving field's contours, it aims to inspire further innovation, ultimately improving the lives of PD patients through more effective and personalized interventions.

show abstract

Section: Resultsmentioning

confidence: 76%

Section: Real-time Feedback and Cueing Techniques (Auditory Visual An...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assisted technology in Parkinson's disease gait: what's up?

Capato,

Chen,

Miranda

et al. 2024

Arq Neuropsiquiatr

View full text Add to dashboard Cite

show abstract

“…Based on this review, we propose an algorithm as a guide for the treatment of motor symptoms in PD Figure 1 , Moreover, it is important to mention three recently published guidelines with recommendations concerning the treatment of PD: the Canadian guideline 4 , the Brazilian guideline of the Movement Disorders Scientific Department of the Brazilian Academy of Neurology 74 and the American Academy of Neurology guideline 75 . They review the current evidence of available treatment options for PD.…”

Section: An Algorithm For the Treatment Of Motor Symptoms Of Pd And R...mentioning

confidence: 99%

How I treat Parkinson's disease

Barbosa

Limongi

Chien

et al. 2022

Arq. Neuro-Psiquiatr.

Self Cite

View full text Add to dashboard Cite

Background: Parkinson’s disease (PD) is a complex neurodegenerative condition. Treatment strategies through all stages of disease progression could affect quality of life and influence the development of future complications, making it crucial for the clinician to be on top of the literature. Objective: This paper reviews the current treatment of PD, from early to advanced stages. Methods: A literature review was conducted focusing on the treatment of PD, in the different stages of progression. Results: Every individual with a new diagnosis of PD should be encouraged to start exercising regularly. In the early stage, treatment should focus on using the lowest dose of levodopa or combination therapy that provides maximum functional capacity, and does not increase the risk of complications, such as peak dose dyskinesias and impulse control disorders. At the moderate and advanced stages, motor fluctuations and complications of treatment dominate the picture, making quality of life one important issue. Rehabilitation programs can improve motor symptoms and should be offered to all patients at any stage of disease progression. Conclusion: Many factors need to be considered when deciding on the best treatment strategy for PD, such as disease progression, presence of risk factors for motor and behavioral complications, potential side effects from dopaminergic therapy and phenotypical variabilities. Treatment should focus on functional capacity and quality of life throughout the whole disease course.

show abstract

Levodopa Equivalent Daily Dosage: Geographical Variations and Real‐Life Modules in Parkinson's Disease

Kukkle,

Kalia,

Habib

et al. 2024

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundThe Levodopa Equivalent Daily Dosage (LEDD) calculation algorithms help in capturing and harmonization of Parkinson's Disease (PD) therapies. Analyzing these updates is essential for validating their effectiveness.ObjectiveTo assess updated LEDD conversion factors in capturing the newer therapies in PD and therapy modules in different geographical cohorts.MethodsData were sourced from 10 Centers from 6 countries representing 2 different continents. The study compared the LEDD conversion factors proposed by Tomlinson et al and Jost et al, alongside investigating demographic disparities.ResultsThe analysis involved 2943 subjects; 87% (n = 2577) met the UK Brain Bank criteria for PD. The LEDD differed significantly across methodologies (Tomlinson vs. Jost, 598 mg vs 610 mg, P < 0.0001). Geographical disparities highlighted variations in PD onset age (P < 0.0001). Jost and Tomlinson's calculations demonstrated consistency within but significant differences across countries (P < 0.0001).Age at onset revealed statistically significant differences in LEDD requirements (P < 0.0001), which were particularly higher in 21–50 years (718 mg vs 566 mg). This subgroup also demonstrated increased usage of non‐Levodopa therapies (P < 0.0001). Men exhibited higher total LEDD (P = 0.001). 34% reported dyskinesia, associated with higher LEDD (756 mg, P < 0.0001). Surgically treated patients also had higher LEDD (P < 0.0001) and a significant difference between Jost and Tomlinson dosages (761 mg vs716mg) reflecting the incorporation of newer therapeutic molecules.ConclusionThis analysis delineates the importance of updated LEDD algorithms and intricacies in the landscape of PD treatment, underscored by geographical, age‐related, and gender‐specific variations, in real‐life management scenarios.

show abstract

Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms

Cited by 15 publications

References 104 publications

Assisted technology in Parkinson's disease gait: what's up?

Assisted technology in Parkinson's disease gait: what's up?

How I treat Parkinson's disease

Levodopa Equivalent Daily Dosage: Geographical Variations and Real‐Life Modules in Parkinson's Disease

Contact Info

Product

Resources

About