scholarly journals Crossover versus Stabilometric Platform for the Treatment of Balance Dysfunction in Parkinson’s Disease: A Randomized Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
G. Frazzitta ◽  
F. Bossio ◽  
R. Maestri ◽  
G. Palamara ◽  
R. Bera ◽  
...  

Balance dysfunctions are a major challenge in the treatment of Parkinson’s disease (PD). Previous studies have shown that rehabilitation can play a role in their treatment. In this study, we have compared the efficacy of two different devices for balance training: stabilometric platform and crossover. We have enrolled 60 PD patients randomly assigned to two groups. The first one (stabilometric group) performed a 4-week cycle of balance training, using the stabilometric platform, whereas the second one (crossover group) performed a 4-week cycle of balance training, using the crossover. The outcome measures used were Unified Parkinson’s Disease Rating Scale (UPDRS) part II, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Six Minutes Walking Test (6MWT). Results showed that TUG, BBS, and UPDRS II improved in both groups. There was not difference in the efficacy of the two balance treatments. Patients in both groups improved also the meters walked in the 6MWT at the end of rehabilitation, but the improvement was better for patients performing crossover training. Our results show that the crossover and the stabilometric platform have the same effect on balance dysfunction of Parkinsonian patients, while crossover gets better results on the walking capacity.

Sensors ◽  
2019 ◽  
Vol 19 (9) ◽  
pp. 2101 ◽  
Author(s):  
Francesco Serio ◽  
Cosimo Minosa ◽  
Matteo De Luca ◽  
Pierguido Conte ◽  
Giovanni Albani ◽  
...  

Background: For people with Parkinson’s disease (PD), falls are a critical point. Focal vibration training (FVT) may represent a valid tool to improve postural performances and reduce the risk of falls. The aim of this study was to evaluate the efficacy of FVT to improve the postural stability in PD patients. Methods: Since October 2015, 55 consecutive PD patients have been selected (T0) for an approach including FVT associated with a rehabilitative protocol (RP); after eight weeks (T1), those patients showing a relevant improvement in the clinical rating scales ((Timed Up and Go (TUG), Tinetti, Unified Parkinson’s disease rating scale (UPDRS) Part III, Berg Balance scale (BBS) and falls rate scale), continued with the FVT protocol (FVTRP group). The remaining patients continued with only the RP (RP group). In July 2018, we have extrapolated the data of the last clinical visit (T2) to observe any differences in the rate of falls. Results: The FVTRP group shows a decrement in the rate of falls from 2.1 to 1.25 (p 0.036) and a stability of the levodopa equivalent daily dosage (LEDD). The RP group shows an increment of LEDD and stability in falls. Conclusions: FVT has been confirmed as a valid tool to enhance the effect of the rehabilitation protocol aimed at postural training.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Lorena R. S. Almeida ◽  
Guilherme T. Valença ◽  
Nádja N. Negreiros ◽  
Elen B. Pinto ◽  
Jamary Oliveira-Filho

Falls can be considered a disabling feature in Parkinson’s disease. We aimed to identify risk factors for falling, testing simultaneously the ability of disease-specific and balance-related measures. We evaluated 171 patients, collecting demographic and clinical data, including standardized assessments with the Unified Parkinson’s Disease Rating Scale (UPDRS), activities of daily living (ADL) and motor sections, modified Hoehn and Yahr Scale, Schwab and England, eight-item Parkinson’s Disease Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale-International (FES-I), Berg Balance Scale, Dynamic Gait Index, Functional Reach, and Timed Up and Go. ROC curves were constructed to determine the cutoff scores for all measures. Variables withP<0.1entered a logistic regression model. The prevalence of recurrent falls was 30% (95% CI 24%–38%). In multivariate analysis, independent risk factors for recurrent falls were (P<0.05) levodopa equivalent dose (OR = 1.283 per 100 mg increase; 95% CI = 1.092–1.507), UPDRS-ADL > 16 points (OR = 10.0; 95% CI = 3.6–28.3), FES-I > 30 points (OR = 6.0; 95% CI = 1.6–22.6), and Berg ≤ 48 points (OR = 3.9; 95% CI = 1.2–12.7).We encourage the utilization of these modifiable risk factors in the screening of fall risk.


2009 ◽  
Vol 67 (3b) ◽  
pp. 831-835 ◽  
Author(s):  
Paula L. Scalzo ◽  
Isabella C. Nova ◽  
Mônica R. Perracini ◽  
Daniel R.C. Sacramento ◽  
Francisco Cardoso ◽  
...  

Background: Changes in balance occur with the progression of Parkinson's disease (PD). OBJECTIVE: To validate the Brazilian version of the Berg Balance Scale (BBS) for PD patients, determining its reliability and internal consistency and correlating it with PD-specific instruments. METHOD: We evaluated 53 patients (M/F 37/16, mean age±SD, 62±7.9 years) with PD (mean±SD, 7.8±4.4 years). Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England Scale (S&E), Hoehn and Yahr Staging Scale (HY) and BBS were used to assess patients. Statistical analyses for inter-rater reliability, internal consistency and correlations among BBS, UPDRS, S&E and HY were performed. RESULTS: The mean scores±SD on UPDRS and BBS were, respectively, 41.6±17.8 and 47.2±8.2. The median on S&E and HY scales were 80% and 2.5, respectively. The BBS presented a high intra-class correlation coefficient (ICC=0.84) and internal consistency (Cronbrach's α=0.92). There was a statistically significant correlation between BBS and disease duration (r s= -0.520, p<0.001), UPDRS subscales II and III (r s= -0.467, p=0.011; r s= -0.374, p=0.046, respectively), stage of disease (HY; r s= -0.507, p<0.001) and the activities of daily living (S&E; r s=0.492, p<0.001). CONCLUSION: The BBS is a promising tool for the assessment of balance in PD, correlating with the stage of disease and the level of independence.


2020 ◽  
Author(s):  
Krishnan V. Chakravarthy ◽  
Rahul Chaturvedi ◽  
Takashi Agari ◽  
Hirokazu Iwamuro ◽  
Rajiv Reddy ◽  
...  

Abstract Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%.Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.


2012 ◽  
Vol 70 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Paula Luciana Scalzo ◽  
Carolina Reis Flores ◽  
Juliana Rúbia Marques ◽  
Simone Cristina de Oliveira Robini ◽  
Antônio Lúcio Teixeira

Parkinson's disease (PD) is characterized by motor symptoms that cause the decline of functional capacity and affect the quality of life (QoL). Objective: To evaluate the impact of changes in balance and walking capacity on the PD. Methods: The instruments used were: Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr Scale (HY), Schwab and England scale (SE), quality of life questionnaire (PDQ-39), Berg balance Scale (BBS) and six-minute walk test (6MWT). Results: Thirty-six patients with mean disease duration of 7.3 years were assessed. Lower scores on the BBS and shorter distances walked during the 6MWT correlated with a poorer perception of QoL. This correlation occurred at the expense of the mobility and daily living activities domains. Conclusion: Our results indicated that the impairment in balance while performing functional activities and the reduction in walking capacity are important factors that negatively affect the perception of QoL in PD patients.


2020 ◽  
Author(s):  
Krishnan V. Chakravarthy ◽  
Rahul Chaturvedi ◽  
Takashi Agari ◽  
Hirokazu Iwamuro ◽  
Rajiv Reddy ◽  
...  

Abstract Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS). Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG). Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%. Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Anina Vogler ◽  
Jorina Janssens ◽  
Thomas Nyffeler ◽  
Stephan Bohlhalter ◽  
Tim Vanbellingen

Background. Freezing of Gait (FOG) is a disabling parkinsonian symptom. The Freezing of Gait Questionnaire (FOG-Q) reliably detects FOG in patients with Parkinson’s disease (PD).Objectives. The aim of this study was to develop a German translated version of the FOG-Q and to assess its validity.Methods. The translation was accomplished using forward-backward-translation. The construct validity of the FOG-Q was examined in twenty-seven German native speaking PD patients. Convergent validity was assessed by correlating the FOG-Q with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) II-III, the Parkinson Disease Questionnaire 39 (PDQ-39), and the Timed Up and Go Test (TUG). Divergent validity was assessed by correlating the FOG-Q with the MDS-UPDRS I. The internal consistency was measured using Cronbach’s alpha (Cα).Results. A good internal structure of the FOG-Q was found (Cα=0.83). Significant moderate correlations between the FOG-Q and the MDS-UPDRS item 2.13 (freezing) (rs=0.568,P=0.002) and between the FOG-Q and the PDQ-39 subscale mobility (rs=0.516,P=0.006) were found. The lack of correlation with the MDS-UPDRS I demonstrated good divergent validity.Conclusion. The German FOG-Q is a valid tool to assess FOG in German native speaking PD patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Maryam Mehdizadeh ◽  
Pablo Martinez-Martin ◽  
Seyed-Amirhasan Habibi ◽  
Seyed-Mohammad Fereshtehnejad ◽  
Amirabas Abasi ◽  
...  

Purpose. Since fear of falling may be one of the main problems in people with Parkinson’s disease (PD), its assessment with valid tools is necessary in both drug phases. This study was carried out to investigate the psychometric attributes of the Fall Efficacy Scale-International (FES-I) in people with PD, both in On and Off phases. Methods. One hundred twenty-four patients with PD (mean age ± standard deviation, 60.33 ± 12.59 years) were assessed with the FES-I, both in On- and Off-drug phases. Dimensionality, internal consistency, and test-retest reliability were, respectively, explored by means of factor analysis, Cronbach’s alpha, and Intraclass Correlation Coefficient. Convergent validity of FES-I was established with Visual Analog Scale-Fear of Falling, Berg Balance Scale, and Functional Reach Test. Parkinson’s Disease Questionnaire-39 and Unified Parkinson Disease Rating Scale-Activities of Daily Living were also applied. Discriminative validity was tested between patients with and without a history of falling. Results. Factor analysis showed two factors for On- and one factor for Off-drug phase. Internal consistency (α = 0.96, On phase; 0.98, Off phase) and test-retest reliability (0.94; 0.91) were satisfactory in both drug phases. There was a moderate/high correlation (rS = |0.50–0.70|) between FES-I and Visual Analog Scale-Fear of Falling, Berg Balance Scale, and Functional Reach Test. Parkinson’s Disease Questionnaire-39 and Unified Parkinson Disease Rating Scale-Activities of Daily Living were achieved in both drug phases too. The sensitivity of FES-I to discriminate Parkinson’s disease with and without falls showed moderate effect size in both phases. Conclusion. This study verified that FES-I is unidimensional, reliable, and valid to measure the Fear of Falling during On- and Off-drug phases in people with PD.


2020 ◽  
Vol 13 (4) ◽  
pp. 235-240
Author(s):  
Rayra Mendes da Costa ◽  
Tássia Magnabosco Sisconeto ◽  
Lucas Resende Sousa ◽  
Giselle Helena Tavares ◽  
Ana Carolina Kanitz

Objective: The aim of the study was to conduct a systematic review evaluating the effects of physical exercise on balance and motor symptoms of Parkinson’s Disease. Method: The search was carried out on the PubMed, Scielo and PEDro databases. The articles were evaluated by two independent researchers, following the criteria: presenting a control group, having more than eight weeks of intervention, assessing motor symptoms (Unified Parkinson’s Disease Rating Scale and Parkinson’s Disease Questionnaire -39) and balance (Timed Up and Go and Berg Scale). Results: The search resulted in 1377 articles, of which 11 were included in the study. The total number of participants was 925, in which 545 were allocated in the intervention groups and 380 in the control groups. The strength training and balance, performed alone or in combination, are highlighted in improvements related to balance. Exercise, regardless of type, improves motor symptoms. Conclusions: Thus, physical exercise has a positive effect on both balance and motor symptoms of Parkinson’s Disease, strength and balance modalities stand out.


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