The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Thera...The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Therapy is highly relevant to the treatment of Parkinson’s disease through deep brain stimulation. Originally wearable and wireless systems for quantifying Parkinson’s disease involved the use a smartphone to quantify hand tremor. Although originally novel, the smartphone has notable issues as a wearable application for quantifying movement disorder tremor. The smartphone has evolved in a pathway that has made the smartphone progressively more cumbersome to mount about the dorsum of the hand. Furthermore, the smartphone utilizes an inertial sensor package that is not certified for medical analysis, and the trial data access a provisional Cloud computing environment through an email account. These concerns are resolved with the recent development of a conformal wearable and wireless inertial sensor system. This conformal wearable and wireless system mounts to the hand with the profile of a bandage by adhesive and accesses a secure Cloud computing environment through a segmented wireless connectivity strategy involving a smartphone and tablet. Additionally, the conformal wearable and wireless system is certified by the FDA of the United States of America for ascertaining medical grade inertial sensor data. These characteristics make the conformal wearable and wireless system uniquely suited for the quantification of Parkinson’s disease treatment through deep brain stimulation. Preliminary evaluation of the conformal wearable and wireless system is demonstrated through the differentiation of deep brain stimulation set to “On” and “Off” status. Based on the robustness of the acceleration signal, this signal was selected to quantify hand tremor for the prescribed deep brain stimulation settings. Machine learning classification using the Waikato Environment for Knowledge Analysis (WEKA) was applie展开更多
Objective: In the manuscript titled “Liquid subcutaneous Levodopa-Carbidopa ND0612 effects on motor symptoms in individuals with Parkinson’s Disease: A systematic review and meta-analysis”, the objective was to con...Objective: In the manuscript titled “Liquid subcutaneous Levodopa-Carbidopa ND0612 effects on motor symptoms in individuals with Parkinson’s Disease: A systematic review and meta-analysis”, the objective was to conduct a systematic review with meta-analysis to investigate the effects ND0612 24-hour dosing regimen has on motor symptoms in individuals with Parkinson’s Disease (PD). Introduction: ND0612 is a novel minimally invasive continuous subcutaneous delivery system of liquid Levodopa-Carbidopa being investigated for the treatment of PD in individuals experiencing motor symptoms. Methods: A systematic literature search was conducted in PubMed, Cochrane, and EBSCO databases to identify randomized controlled trials investigating the effects of ND0612 on motor symptoms in individuals with PD. Outcomes included the Unified Parkinson’s Disease Rating Scale (UPDRS) Part II and Part III scores. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation approach. Meta-analysis was performed using a random effects model with the DerSimonian and Laird method to estimate the effects of the ND0612 24-hour dosing regimen on UPDRS Part II and Part III scores. Results: Three studies were included in our review. There were statistically significant reductions in UPDRS Part II scores (mean difference (MD) −3.299;95% confidence interval (CI) −3.438, −3.159) and in UPDRS Part III scores (MD −12.695;95% CI −24.428, −0.962) in the ND0612 24-hour dosing regimen. Results were based on very low certainty of evidence. Conclusion: Based on very low certainty evidence, the ND0612 24-hour dosing regimen is effective at improving motor symptoms in individuals with PD. Our findings suggest that ND0612 is more effective at improving UPDRS Part II and Part III scores in individuals with PD than other pharmacological and non-pharmacological treatments, warranting further study.展开更多
Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical imp...Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.展开更多
Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects a...Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).展开更多
Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to ...Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to conduct a systematic review with meta-analysis to investigate the effects that Rasagiline has on motor and non-motor symptoms in individuals with PD. Introduction: Rasagiline is a second-generation monoamine oxidase-B (MAO-B) inhibitor used both as monotherapy and adjunctive therapy for Parkinsons Disease (PD). Methods: A systematic literature search and meta-analysis were performed with randomized control trials that investigated the effects of Rasagiline on motor and non-motor symptoms in individuals with PD. The systematic search was conducted in PubMed, Cochrane, and EBSCO databases. Methodological quality was assessed using the Cochrane Grading Recommendations Assessment, Development and Evaluation approach. Results: Fourteen studies were included in our review. There were trivial to small and statistically significant improvements in motor symptoms for individuals with PD treated with Rasagiline compared to placebo. Non-motor symptoms showed no significant improvement with Rasagiline compared to placebo in five of six meta-analyses. Results were based on very low to moderate certainty of evidence. Conclusion: 1 mg/day Rasagiline significantly improved Parkinsonian motor symptoms in individuals with PD compared with placebo. For all outcomes, the 1 mg/day Rasagiline group was favored over the placebo group.展开更多
Parkinson’s disease (PD) is a slowly progressive, age-related, second most common neurodegenerative disorder after Alzheimer’s disease of unknown etiology. Dopamine replacement therapies were introduced five decades...Parkinson’s disease (PD) is a slowly progressive, age-related, second most common neurodegenerative disorder after Alzheimer’s disease of unknown etiology. Dopamine replacement therapies were introduced five decades ago and still remain the mainstay of treatment for Parkinson’s disease. However, with long-term treatment with L-dopa, more than 50% of patients were found to develop motor response complications approximately after 4 - 5 years of initiation of continuous treatment, in 80% of patients treated for 10 years, and in nearly 100% patients with young-onset disease. The complications of long–term treatment with levodopa include-motor fluctuations, dyskinesias, and nonmotor fluctuations are such as mood disturbance, cognitive dysfunction, dysautonomia and pain. Till date, there are various therapeutic approaches having been developed for the treatment of advanced PD comprising Pharmacotherapy, neurotrophic factors, surgical procedures such as DBS, cell-based therapies and gene therapies. The pharmacological and surgical therapies are only aiming to improve the symptoms of PD, but none are proven to have a significant effect on the underlying disease process with respect to either slowing disease progression or restoring the affected dopaminergic neurons. Although there is no cure for PD, Gene based therapy has significant prospective advantages over the conventional treatment modalities for PD, as it could theoretically be used to preserve or restore dopaminergic neurons affected by PD through the action of neurotrophic factors or alternatively increase the availability of enzymes required for dopamine synthesis. All commonly employed PD therapies focus on the amelioration of symptoms and do not cure disease. In this review only we summarize the newer therapeutic strategies for the treatment of PD such as anti-inflammatories, neurotrophic factors, neurosurgical procedures (DBS), cell based therapies and gene therapies.展开更多
Parkinson’s disease manifests in movement disorder symptoms, such as hand tremor. There exists an assortment of therapy interventions. In particular deep brain stimulation offers considerable efficacy for the treatme...Parkinson’s disease manifests in movement disorder symptoms, such as hand tremor. There exists an assortment of therapy interventions. In particular deep brain stimulation offers considerable efficacy for the treatment of Parkinson’s disease. However, a considerable challenge is the convergence toward an optimal configuration of tuning parameters. Quantified feedback from a wearable and wireless system consisting of an accelerometer and gyroscope can be enabled through a novel software application on a smartphone. The smartphone with its internal accelerometer and gyroscope can record the quantified attributes of Parkinson’s disease and tremor through mounting the smartphone about the dorsum of the hand. The recorded data can be then wirelessly transmitted as an email attachment to an Internet derived resource for subsequent post-processing. The inertial sensor data can be consolidated into a feature set for machine learning classification. A multilayer perceptron neural network has been successfully applied to attain considerable classification accuracy between deep brain stimulation “On” and “Off” scenarios for a subject with Parkinson’s disease. The findings establish the foundation for the broad objective of applying wearable and wireless systems for the development of closed-loop optimization of deep brain stimulation parameters in the context of cloud computing with machine learning classification.展开更多
Parkinson’s disease is not a lifelong disease. Although modern medicine cannot cure Parkinson’s disease, I found that traditional Chinese medicine can cure Parkinson’s disease. However, because of the misunderstand...Parkinson’s disease is not a lifelong disease. Although modern medicine cannot cure Parkinson’s disease, I found that traditional Chinese medicine can cure Parkinson’s disease. However, because of the misunderstanding of the treatment ideas of most of Chinese doctors, they failed to achieve the goal of curing Parkinson’s disease. There are differences not only in understanding and treating Parkinson’s disease between traditional Chinese medicine and modern medicine, but also in understanding within the Chinese medicine community. Because they have not been able to cure Parkinson’s disease, they draw the conclusions from modern medicine and also believe that Parkinson’s disease is an incurable lifelong disease. This paper deeply explores the problems existing in modern medicine and traditional Chinese medicine, puts forward new ideas for understanding and treating Parkinson’s disease, and explores the correct way to understand and cure Parkinson’s disease for the medical community to overcome Parkinson’s disease.展开更多
Quality of life encompasses physical, psychological and social aspects of health. Apart from motor symptoms (physical aspects), Parkinson’s disease (PD) is also closely related with various non-motor symptoms (psycho...Quality of life encompasses physical, psychological and social aspects of health. Apart from motor symptoms (physical aspects), Parkinson’s disease (PD) is also closely related with various non-motor symptoms (psychological and social aspects) that can undermine quality of life greatly, even in early stages of the disease. Most research studies in this field focus on analysis of motor symptoms in PD sufferers. Although benefits of physical activity for the psychosocial quality of life are well-known, they have been mostly neglected in case of the people suffering from PD. Numerous studies clearly show that training programs can ameliorate the quality of life as far as non-motor functions in PD sufferers are concerned. The only psychological aspects of the disease related to the effects of exercise that have been researched so far are depression and cognitive functions. Depression is the most common denominator of poor quality of life, while dementia often accompanies the Parkinson’s disease. Studies have shown positive effects of exercise on the social life of those suffering from the disease, especially in case of group exercise. Studying psychological and social aspects of such chronic conditions as PD is of utmost importance for monitoring the patient’s adjustment to the disease, functioning with it, as well as the overall well-being and satisfaction with life. Thus far, the results have been pointing towards improvement of the quality of life. Exercise is a readily available method of treatment in case of PD, especially if applied in the early stages of the disease. In addition to reviewing the existing studies on the relation between exercise and quality of life of the patients, this paper will also focus on the way the psychological and social aspects of PD are influenced by exercise.展开更多
Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of...Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of lysosomes, mitochondria and synaptic transport difficulties influenced by genetic and idiopathic factors. Worldwide, PD has a prevalence of 2-3% in people over the age of 65. To date, there is no certified, effective treatment for PD. Aim: The aims of this research were: (i) to present, on the basis of recent advances in molecular genetics and epigenetics, the genomic aspects and challenges of gene therapy trials for PD;(ii) to outline the ethical principles applicable to therapeutic trials for PD. Method: A systematic literature review was carried out to identify relevant articles reporting on genomic aspects and gene therapy in PD from 2001 to October 2023. The search was conducted in French and/or English in three databases: PubMed, Google Scholar and Science Direct. PRISMA guidelines were used in this systematic review. Results: A total of thirty-three publications were selected. An inductive thematic analysis revealed that numerous genetic mutations (SNCA, Parkin, PINK1, DJ-1, LRRK2, ATP13A2, VPS35, Parkin/PRKN, PINK1, DJ1/PARK7) and epigenetic events such as the action of certain miRNAs (miR-7, miR-153, miR-133b, miR-124, miR-137) are responsible for the onset of PD, and that genetic therapy for this pathology raises ethical questions that need to be elucidated in the light of the bioethical principles of autonomy, beneficence, non-maleficence and justice. Conclusion: There is no zero risk in biotechnology. Then, it will be necessary to assess all the potential risks of Parkinson disease’s gene therapy to make the right decision. It is therefore essential to pursue research and, with the guidance of ethics, to advance treatment options and meet the challenges of brain manipulation and its impact on human identity. The golden rule of medicine remains: “Primum non nocere”.展开更多
Parkinson’s disease is neurodegenerative in nature and associated with characteristic movement disorders, such as hand tremor. Wireless accelerometer applications may advance the quality of care for Parkinson’s dise...Parkinson’s disease is neurodegenerative in nature and associated with characteristic movement disorders, such as hand tremor. Wireless accelerometer applications may advance the quality of care for Parkinson’s disease patients. The acceleration waveform of the respective hand tremor can be recorded and stored for post-processing and progressive status tracking. A wireless accelerometer configuration for monitoring Parkinson’s disease hand tremor is presented. The proposed configuration is envisioned to be conducted with the assistance of a caregiver. For initial engineering proof of concept simulated Parkinson’s disease tremor is recorded through a wireless accelerometer node and contrasted to a statically positioned and tandem activated wireless accelerometer node. Statistical significance is acquired regarding the quantification of the simulated Parkinson’s disease tremor acceleration waveform and statically positioned acceleration waveform, while demonstrating a considerable degree of accuracy, consistency, and reliability.展开更多
Parkinson’s disease is a growing medical concern as societies, such as the United States of America, become progressively aged. Therapy strategies exist for the amelioration of Parkinson’s disease symptoms, and the ...Parkinson’s disease is a growing medical concern as societies, such as the United States of America, become progressively aged. Therapy strategies exist for the amelioration of Parkinson’s disease symptoms, and the quantification of attributes, such as hand tremor, can provide valuable feedback. Wearable and wireless accelerometer systems for monitoring Parkinson’s disease patients have been progressively advanced over the course of the past half-decade. In particular, wireless accelerometer nodes and smartphones, such as the iPhone, hold promise for optimizing therapy strategy by providing convenient quantified feedback. This perspective review addresses the current advances in wearable and wireless accelerometer systems for monitoring Parkinson’s disease patients and forecasts for the near future.展开更多
Background: Given the limited benefits of current treatments for Parkinson’s disease (PD), inter-ventions that might provide supplementary benefits would be of value. The traditional Chinese medicine practice of Tai ...Background: Given the limited benefits of current treatments for Parkinson’s disease (PD), inter-ventions that might provide supplementary benefits would be of value. The traditional Chinese medicine practice of Tai Chi has been said to improve some aspects of PD, particularly imbalance. Methods: Preliminary randomized, controlled, and rater-blinded clinical trial of Tai Chi, focusing on its effects on global motor, daily function, mood and quality of life. Subjects continued their standard medical therapy and were randomly assigned to Tai Chi (16 weekly classes, expert trainer, practice at home between classes) or no Tai Chi (control group) in a 2:1 ratio. The primary outcome measure was the total motor score of the Unified Parkinson’s Disease Rating Scale (UPDRS) and this was scored by an experienced rater who was blinded to the treatment assignment. The same rater scored the Schwab and England Activities of Daily Living Scale. The patient-completed Geriatric Depression Scale, PD (quality of life) Questionnaire-39, and fall diary were also analyzed. Results: 44 subjects participated with 29 assigned to Tai Chi and 15 serving as controls. Tai Chi was well-tolerated. Seven subjects withdrew prior to completion (2 from Tai Chi, 5 from control). We found no significant difference between treatment groups in the change in scores from baseline to end of intervention for any of the scales. Trends toward a benefit of Tai Chi were observed for individual UPDRS items (depression, finger tapping, hand movements, posture). Conclusions: Tai Chi does not appear to improve global measures in patients with PD. The practice may have benefits for PD, but these appear to be largely restricted to specific motor tasks and perhaps mood rather than being a global functional response. More study is needed to clarify and establish efficacy.展开更多
Background: We desired relevant information from patients with Parkinson’s disease (PD) and their caregivers for help in planning a long-term support program. Methods: We compared 3 ap-proaches: 1) a standard needs a...Background: We desired relevant information from patients with Parkinson’s disease (PD) and their caregivers for help in planning a long-term support program. Methods: We compared 3 ap-proaches: 1) a standard needs assessment questionnaire, the Camberwell assessment of need in the elderly, 2) an open-ended listing of needs, and 3) participation in a narrative medicine program in which health care professionals were involved. Results: On the questionnaire, patients reported physical needs as the most important while their caregivers were more concerned about psychological needs. The open-ended listings revealed additional needs, particularly access to re-liable information about PD and to opportunities to participate in clinical research. The narrative medicine process yielded a number of new insights and proposed solutions, particularly related to the heterogeneity of needs across individuals, the importance of providing hope, and the fact that caregivers expressed that their needs had been largely neglected. Participation in the narrative medicine sessions led to an increase in measured empathy by health care professionals, an im-provement in measured depression among PD patients, but a worsening of measured depression among the caregivers. Conclusions: We have identified important needs and potential solutions to be considered in providing long-term support to patients with PD and their caregivers.展开更多
Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson’s disease. Relevance: Physical therapy treatment of...Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson’s disease. Relevance: Physical therapy treatment of persons with Parkinson’s disease (PD) has traditionally focused on lessening the impact of disease severity by improving quality of life and functional capacity. Research has shown that quality of life in persons with PD is not only significantly affected by motor symptoms, but also by the presence of defined non-motor symptoms such as cerebrovascular perfusion, cardiovascular dysfunction, and cognitive impairment. This study seeks to determine a causative effect among these non-motor symptoms with the intention to better manage cognitive impairment in persons with PD. Methods: A literature search was conducted utilizing the following databases: Scopus, PubMed, and CINAHL. After evaluating and grading studies using the Downs and Black Checklist, a total of seven studies remained for the final review. Results: Five common domains of cognition emerged throughout the seven studies: executive function, attention, verbal memory and fluency, visual memory, and working memory. Considering the articles reviewed, a relationship between cerebrovascular and cardiovascular deficiency and cognitive impairment in persons with PD was established. Conclusions: Persons with PD and certain cerebrovascular and cardiovascular risk factors, including orthostatic hypotension and systemic hypertension, should be referred to appropriate professionals for comprehensive neuropsychological testing secondary to an increased risk for more severe cognitive deficit.展开更多
Background: Lack of serum vitamin D3 is related to PD (Parkinson’s disease). Currently a valid place for vitamin D3 deficiency in Parkinson disease (PD) has been anticipated. The aim of present research was to evalua...Background: Lack of serum vitamin D3 is related to PD (Parkinson’s disease). Currently a valid place for vitamin D3 deficiency in Parkinson disease (PD) has been anticipated. The aim of present research was to evaluate insufficiency of D3 (vitamin) in subjects with PD (Parkinson’s disease). Many of physiological functions connected with higher risk of illness are maintained by vitamin D, which also plays significant task in pathogenesis of calcium homeostasis and skeletal ailments. It forecasts hazard of persistent ailments like malignancy, CVS conditions, and T2DM. Continuous insufficiency of this vitamin may lead to PD. Method: This was a cross sectional study. Conducted at People’s Medical College Hospital, Nawabshah during period of Jan. 2014-Dec. 2016, the sample size of 243 subjects clinically diagnosed as PD was enlisted. Inclusion criteria were all male and female subjects aged >50 years, clinically diagnosed Parkinson’s disease enlisted in research. Results: In 151 (62.1%) subjects, vitamin D3 levels were <30 ng/ml while in 92 (37.9%) subjects, vitamin D3 values were normal (30 - 150 ng/ml) (p = 0.000). Conclusion: Considerably low levels of vitamin D3 were seen in Parkinson’s disease. Our information sustains a legitimate part of vitamin D insufficiency in PD.展开更多
Parkinson’s disease was first formally identified by British physician James Parkinson in 1817 as “The Shaking Palsy”. L-DOPA (3,4-dihydroxy-phenyl-L-alanine) has been considered as a gold-standard treatment for Pa...Parkinson’s disease was first formally identified by British physician James Parkinson in 1817 as “The Shaking Palsy”. L-DOPA (3,4-dihydroxy-phenyl-L-alanine) has been considered as a gold-standard treatment for Parkinson’s disease. The world market for L-DOPA is about 250 t/year and the total market volume is about $101 billion per year. The present review summarizes the different biological sources for the production of L-DOPA. The process for L-DOPA production from different biological sources has advantages over the chemical methods such as, enantiometrically pure L-DOPA, less incubation time and cost effective method. L-DOPA is found naturally in certain plant foods, particularly broad beans which found to replenish brain levels of L-DOPA even more quickly, and for longer periods, than conventional medication.展开更多
Objective: To compare 8-month effects ofmedical treatment plusrehabilitation on UPDRS scores ofparkinsonian patientswith that ofmedical treatment withoutrehabilitation.Design: Longtudinal randomized study. Participant...Objective: To compare 8-month effects ofmedical treatment plusrehabilitation on UPDRS scores ofparkinsonian patientswith that ofmedical treatment withoutrehabilitation.Design: Longtudinal randomized study. Participants:27 parkinsonian patients (69.50 ± 10.34 years). We divided our patient into two groups: control group (n = 9, received only medication therapy) and experiment- tal group (n = 18, received physiccal therapy and medication therapy). Intervention:The 8-month exercise interventions were twice-weekly 90-min sessions in group. UPDRS scales were measured before and after the interventions. Results: Two- factor ANOVA analyses revealed a significant main effect fromrehabilitation (p 0.05). Post-hoc analysis shows that UPDRS motor increased in control group (+37%) meanwhile decreased in experimental group (–17%). UPDRS ADL increased significantly more in control group (+26%) than experimental group (+5%).UPDRS total increased in control group (+33%) meanwhile decreased in experimental group(–11%). Conclusions:The results of the study suggest that exercise interventions should be a necessary ongoing adjunct toparkinson’s diseasemedication.展开更多
Objective: To evaluate the efficacy of Nintendo Wii training in quality of life in Parkinson’s disease (PD) patients when compared to traditional physical therapy (PT). Methods: A randomized, single-blinded trial wit...Objective: To evaluate the efficacy of Nintendo Wii training in quality of life in Parkinson’s disease (PD) patients when compared to traditional physical therapy (PT). Methods: A randomized, single-blinded trial with 2 parallel arms was performed in a referral center for movement disorders in North-eastern, Brazil. Forty-four PD outpatients that fulfilled the eligibility criteria with mild to moderate motor impairment were randomized. Both groups executed a warm up session for 10 minutes that consisted of trunk flexion, extension and rotation, associated with upper and lower limbs stretching. The PT group followed a program that consisted of trunk and limb mobilisation, balance, muscle strengthening, rhythmic movement, postural alignment, double-task execution, bimanual tasks, and gait training. The Nintendo Wii group executed a sequence of tasks according to a previously established protocol, with similar training exercises. Duration of exercises was 40 minutes per session, 3 days per week for 4 weeks. The primary endpoint was the total score obtained in the Parkinson’s disease quality of life questionnaire (PDQ-39) translated from English to Brazilian Portuguese by Oxford outcomes. Secondary endpoints were the scores achieved by each group in the following domains of PDQ-39 scale: mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort. Assessments were performed before and after intervention in both groups with subjects in the “on” period. Results: Subjects in the Nintendo Wii group showed greater improvement in the PDQ-39 total score when compared to PT group (p = 0.01). Also, significant differences were observed in ADL, stigma, social support and communication when comparing subjects before and after intervention in the Nintendo Wii group (p < 0.05). Conclusions: The results achieved in this trial suggest that rehabilitation using Nintendo Wii may have beneficial effects in quality of life of PD subjects, when compared展开更多
The rate of progression of Parkinson’s Disease (PD) varies among individuals living with the disease. How- ever, there comes a time, later in the course of the disease, when most patients with PD develop balance impa...The rate of progression of Parkinson’s Disease (PD) varies among individuals living with the disease. How- ever, there comes a time, later in the course of the disease, when most patients with PD develop balance impair- ments and falls. Unfortunately, these symptoms do not respond well to dopaminergic medications or deep brain stimulation.展开更多
文摘The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Therapy is highly relevant to the treatment of Parkinson’s disease through deep brain stimulation. Originally wearable and wireless systems for quantifying Parkinson’s disease involved the use a smartphone to quantify hand tremor. Although originally novel, the smartphone has notable issues as a wearable application for quantifying movement disorder tremor. The smartphone has evolved in a pathway that has made the smartphone progressively more cumbersome to mount about the dorsum of the hand. Furthermore, the smartphone utilizes an inertial sensor package that is not certified for medical analysis, and the trial data access a provisional Cloud computing environment through an email account. These concerns are resolved with the recent development of a conformal wearable and wireless inertial sensor system. This conformal wearable and wireless system mounts to the hand with the profile of a bandage by adhesive and accesses a secure Cloud computing environment through a segmented wireless connectivity strategy involving a smartphone and tablet. Additionally, the conformal wearable and wireless system is certified by the FDA of the United States of America for ascertaining medical grade inertial sensor data. These characteristics make the conformal wearable and wireless system uniquely suited for the quantification of Parkinson’s disease treatment through deep brain stimulation. Preliminary evaluation of the conformal wearable and wireless system is demonstrated through the differentiation of deep brain stimulation set to “On” and “Off” status. Based on the robustness of the acceleration signal, this signal was selected to quantify hand tremor for the prescribed deep brain stimulation settings. Machine learning classification using the Waikato Environment for Knowledge Analysis (WEKA) was applie
文摘Objective: In the manuscript titled “Liquid subcutaneous Levodopa-Carbidopa ND0612 effects on motor symptoms in individuals with Parkinson’s Disease: A systematic review and meta-analysis”, the objective was to conduct a systematic review with meta-analysis to investigate the effects ND0612 24-hour dosing regimen has on motor symptoms in individuals with Parkinson’s Disease (PD). Introduction: ND0612 is a novel minimally invasive continuous subcutaneous delivery system of liquid Levodopa-Carbidopa being investigated for the treatment of PD in individuals experiencing motor symptoms. Methods: A systematic literature search was conducted in PubMed, Cochrane, and EBSCO databases to identify randomized controlled trials investigating the effects of ND0612 on motor symptoms in individuals with PD. Outcomes included the Unified Parkinson’s Disease Rating Scale (UPDRS) Part II and Part III scores. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation approach. Meta-analysis was performed using a random effects model with the DerSimonian and Laird method to estimate the effects of the ND0612 24-hour dosing regimen on UPDRS Part II and Part III scores. Results: Three studies were included in our review. There were statistically significant reductions in UPDRS Part II scores (mean difference (MD) −3.299;95% confidence interval (CI) −3.438, −3.159) and in UPDRS Part III scores (MD −12.695;95% CI −24.428, −0.962) in the ND0612 24-hour dosing regimen. Results were based on very low certainty of evidence. Conclusion: Based on very low certainty evidence, the ND0612 24-hour dosing regimen is effective at improving motor symptoms in individuals with PD. Our findings suggest that ND0612 is more effective at improving UPDRS Part II and Part III scores in individuals with PD than other pharmacological and non-pharmacological treatments, warranting further study.
文摘Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.
文摘Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).
文摘Objective: In the manuscript titled Monoamine Oxidase-B Inhibitor Rasagiline Effects on Motor and Non-Motor Symptoms in Individuals with Parkinsons Disease: A Systematic Review and Meta-Analysis, the objective was to conduct a systematic review with meta-analysis to investigate the effects that Rasagiline has on motor and non-motor symptoms in individuals with PD. Introduction: Rasagiline is a second-generation monoamine oxidase-B (MAO-B) inhibitor used both as monotherapy and adjunctive therapy for Parkinsons Disease (PD). Methods: A systematic literature search and meta-analysis were performed with randomized control trials that investigated the effects of Rasagiline on motor and non-motor symptoms in individuals with PD. The systematic search was conducted in PubMed, Cochrane, and EBSCO databases. Methodological quality was assessed using the Cochrane Grading Recommendations Assessment, Development and Evaluation approach. Results: Fourteen studies were included in our review. There were trivial to small and statistically significant improvements in motor symptoms for individuals with PD treated with Rasagiline compared to placebo. Non-motor symptoms showed no significant improvement with Rasagiline compared to placebo in five of six meta-analyses. Results were based on very low to moderate certainty of evidence. Conclusion: 1 mg/day Rasagiline significantly improved Parkinsonian motor symptoms in individuals with PD compared with placebo. For all outcomes, the 1 mg/day Rasagiline group was favored over the placebo group.
文摘Parkinson’s disease (PD) is a slowly progressive, age-related, second most common neurodegenerative disorder after Alzheimer’s disease of unknown etiology. Dopamine replacement therapies were introduced five decades ago and still remain the mainstay of treatment for Parkinson’s disease. However, with long-term treatment with L-dopa, more than 50% of patients were found to develop motor response complications approximately after 4 - 5 years of initiation of continuous treatment, in 80% of patients treated for 10 years, and in nearly 100% patients with young-onset disease. The complications of long–term treatment with levodopa include-motor fluctuations, dyskinesias, and nonmotor fluctuations are such as mood disturbance, cognitive dysfunction, dysautonomia and pain. Till date, there are various therapeutic approaches having been developed for the treatment of advanced PD comprising Pharmacotherapy, neurotrophic factors, surgical procedures such as DBS, cell-based therapies and gene therapies. The pharmacological and surgical therapies are only aiming to improve the symptoms of PD, but none are proven to have a significant effect on the underlying disease process with respect to either slowing disease progression or restoring the affected dopaminergic neurons. Although there is no cure for PD, Gene based therapy has significant prospective advantages over the conventional treatment modalities for PD, as it could theoretically be used to preserve or restore dopaminergic neurons affected by PD through the action of neurotrophic factors or alternatively increase the availability of enzymes required for dopamine synthesis. All commonly employed PD therapies focus on the amelioration of symptoms and do not cure disease. In this review only we summarize the newer therapeutic strategies for the treatment of PD such as anti-inflammatories, neurotrophic factors, neurosurgical procedures (DBS), cell based therapies and gene therapies.
文摘Parkinson’s disease manifests in movement disorder symptoms, such as hand tremor. There exists an assortment of therapy interventions. In particular deep brain stimulation offers considerable efficacy for the treatment of Parkinson’s disease. However, a considerable challenge is the convergence toward an optimal configuration of tuning parameters. Quantified feedback from a wearable and wireless system consisting of an accelerometer and gyroscope can be enabled through a novel software application on a smartphone. The smartphone with its internal accelerometer and gyroscope can record the quantified attributes of Parkinson’s disease and tremor through mounting the smartphone about the dorsum of the hand. The recorded data can be then wirelessly transmitted as an email attachment to an Internet derived resource for subsequent post-processing. The inertial sensor data can be consolidated into a feature set for machine learning classification. A multilayer perceptron neural network has been successfully applied to attain considerable classification accuracy between deep brain stimulation “On” and “Off” scenarios for a subject with Parkinson’s disease. The findings establish the foundation for the broad objective of applying wearable and wireless systems for the development of closed-loop optimization of deep brain stimulation parameters in the context of cloud computing with machine learning classification.
文摘Parkinson’s disease is not a lifelong disease. Although modern medicine cannot cure Parkinson’s disease, I found that traditional Chinese medicine can cure Parkinson’s disease. However, because of the misunderstanding of the treatment ideas of most of Chinese doctors, they failed to achieve the goal of curing Parkinson’s disease. There are differences not only in understanding and treating Parkinson’s disease between traditional Chinese medicine and modern medicine, but also in understanding within the Chinese medicine community. Because they have not been able to cure Parkinson’s disease, they draw the conclusions from modern medicine and also believe that Parkinson’s disease is an incurable lifelong disease. This paper deeply explores the problems existing in modern medicine and traditional Chinese medicine, puts forward new ideas for understanding and treating Parkinson’s disease, and explores the correct way to understand and cure Parkinson’s disease for the medical community to overcome Parkinson’s disease.
文摘Quality of life encompasses physical, psychological and social aspects of health. Apart from motor symptoms (physical aspects), Parkinson’s disease (PD) is also closely related with various non-motor symptoms (psychological and social aspects) that can undermine quality of life greatly, even in early stages of the disease. Most research studies in this field focus on analysis of motor symptoms in PD sufferers. Although benefits of physical activity for the psychosocial quality of life are well-known, they have been mostly neglected in case of the people suffering from PD. Numerous studies clearly show that training programs can ameliorate the quality of life as far as non-motor functions in PD sufferers are concerned. The only psychological aspects of the disease related to the effects of exercise that have been researched so far are depression and cognitive functions. Depression is the most common denominator of poor quality of life, while dementia often accompanies the Parkinson’s disease. Studies have shown positive effects of exercise on the social life of those suffering from the disease, especially in case of group exercise. Studying psychological and social aspects of such chronic conditions as PD is of utmost importance for monitoring the patient’s adjustment to the disease, functioning with it, as well as the overall well-being and satisfaction with life. Thus far, the results have been pointing towards improvement of the quality of life. Exercise is a readily available method of treatment in case of PD, especially if applied in the early stages of the disease. In addition to reviewing the existing studies on the relation between exercise and quality of life of the patients, this paper will also focus on the way the psychological and social aspects of PD are influenced by exercise.
文摘Background: Parkinson’s disease (PD) is a complex, multifactorial neurodegenerative disorder with a pathophysiology deriving from the synergy of abnormal aggregation of neuroinflammation, synuclein and dysfunction of lysosomes, mitochondria and synaptic transport difficulties influenced by genetic and idiopathic factors. Worldwide, PD has a prevalence of 2-3% in people over the age of 65. To date, there is no certified, effective treatment for PD. Aim: The aims of this research were: (i) to present, on the basis of recent advances in molecular genetics and epigenetics, the genomic aspects and challenges of gene therapy trials for PD;(ii) to outline the ethical principles applicable to therapeutic trials for PD. Method: A systematic literature review was carried out to identify relevant articles reporting on genomic aspects and gene therapy in PD from 2001 to October 2023. The search was conducted in French and/or English in three databases: PubMed, Google Scholar and Science Direct. PRISMA guidelines were used in this systematic review. Results: A total of thirty-three publications were selected. An inductive thematic analysis revealed that numerous genetic mutations (SNCA, Parkin, PINK1, DJ-1, LRRK2, ATP13A2, VPS35, Parkin/PRKN, PINK1, DJ1/PARK7) and epigenetic events such as the action of certain miRNAs (miR-7, miR-153, miR-133b, miR-124, miR-137) are responsible for the onset of PD, and that genetic therapy for this pathology raises ethical questions that need to be elucidated in the light of the bioethical principles of autonomy, beneficence, non-maleficence and justice. Conclusion: There is no zero risk in biotechnology. Then, it will be necessary to assess all the potential risks of Parkinson disease’s gene therapy to make the right decision. It is therefore essential to pursue research and, with the guidance of ethics, to advance treatment options and meet the challenges of brain manipulation and its impact on human identity. The golden rule of medicine remains: “Primum non nocere”.
文摘Parkinson’s disease is neurodegenerative in nature and associated with characteristic movement disorders, such as hand tremor. Wireless accelerometer applications may advance the quality of care for Parkinson’s disease patients. The acceleration waveform of the respective hand tremor can be recorded and stored for post-processing and progressive status tracking. A wireless accelerometer configuration for monitoring Parkinson’s disease hand tremor is presented. The proposed configuration is envisioned to be conducted with the assistance of a caregiver. For initial engineering proof of concept simulated Parkinson’s disease tremor is recorded through a wireless accelerometer node and contrasted to a statically positioned and tandem activated wireless accelerometer node. Statistical significance is acquired regarding the quantification of the simulated Parkinson’s disease tremor acceleration waveform and statically positioned acceleration waveform, while demonstrating a considerable degree of accuracy, consistency, and reliability.
文摘Parkinson’s disease is a growing medical concern as societies, such as the United States of America, become progressively aged. Therapy strategies exist for the amelioration of Parkinson’s disease symptoms, and the quantification of attributes, such as hand tremor, can provide valuable feedback. Wearable and wireless accelerometer systems for monitoring Parkinson’s disease patients have been progressively advanced over the course of the past half-decade. In particular, wireless accelerometer nodes and smartphones, such as the iPhone, hold promise for optimizing therapy strategy by providing convenient quantified feedback. This perspective review addresses the current advances in wearable and wireless accelerometer systems for monitoring Parkinson’s disease patients and forecasts for the near future.
文摘Background: Given the limited benefits of current treatments for Parkinson’s disease (PD), inter-ventions that might provide supplementary benefits would be of value. The traditional Chinese medicine practice of Tai Chi has been said to improve some aspects of PD, particularly imbalance. Methods: Preliminary randomized, controlled, and rater-blinded clinical trial of Tai Chi, focusing on its effects on global motor, daily function, mood and quality of life. Subjects continued their standard medical therapy and were randomly assigned to Tai Chi (16 weekly classes, expert trainer, practice at home between classes) or no Tai Chi (control group) in a 2:1 ratio. The primary outcome measure was the total motor score of the Unified Parkinson’s Disease Rating Scale (UPDRS) and this was scored by an experienced rater who was blinded to the treatment assignment. The same rater scored the Schwab and England Activities of Daily Living Scale. The patient-completed Geriatric Depression Scale, PD (quality of life) Questionnaire-39, and fall diary were also analyzed. Results: 44 subjects participated with 29 assigned to Tai Chi and 15 serving as controls. Tai Chi was well-tolerated. Seven subjects withdrew prior to completion (2 from Tai Chi, 5 from control). We found no significant difference between treatment groups in the change in scores from baseline to end of intervention for any of the scales. Trends toward a benefit of Tai Chi were observed for individual UPDRS items (depression, finger tapping, hand movements, posture). Conclusions: Tai Chi does not appear to improve global measures in patients with PD. The practice may have benefits for PD, but these appear to be largely restricted to specific motor tasks and perhaps mood rather than being a global functional response. More study is needed to clarify and establish efficacy.
文摘Background: We desired relevant information from patients with Parkinson’s disease (PD) and their caregivers for help in planning a long-term support program. Methods: We compared 3 ap-proaches: 1) a standard needs assessment questionnaire, the Camberwell assessment of need in the elderly, 2) an open-ended listing of needs, and 3) participation in a narrative medicine program in which health care professionals were involved. Results: On the questionnaire, patients reported physical needs as the most important while their caregivers were more concerned about psychological needs. The open-ended listings revealed additional needs, particularly access to re-liable information about PD and to opportunities to participate in clinical research. The narrative medicine process yielded a number of new insights and proposed solutions, particularly related to the heterogeneity of needs across individuals, the importance of providing hope, and the fact that caregivers expressed that their needs had been largely neglected. Participation in the narrative medicine sessions led to an increase in measured empathy by health care professionals, an im-provement in measured depression among PD patients, but a worsening of measured depression among the caregivers. Conclusions: We have identified important needs and potential solutions to be considered in providing long-term support to patients with PD and their caregivers.
文摘Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson’s disease. Relevance: Physical therapy treatment of persons with Parkinson’s disease (PD) has traditionally focused on lessening the impact of disease severity by improving quality of life and functional capacity. Research has shown that quality of life in persons with PD is not only significantly affected by motor symptoms, but also by the presence of defined non-motor symptoms such as cerebrovascular perfusion, cardiovascular dysfunction, and cognitive impairment. This study seeks to determine a causative effect among these non-motor symptoms with the intention to better manage cognitive impairment in persons with PD. Methods: A literature search was conducted utilizing the following databases: Scopus, PubMed, and CINAHL. After evaluating and grading studies using the Downs and Black Checklist, a total of seven studies remained for the final review. Results: Five common domains of cognition emerged throughout the seven studies: executive function, attention, verbal memory and fluency, visual memory, and working memory. Considering the articles reviewed, a relationship between cerebrovascular and cardiovascular deficiency and cognitive impairment in persons with PD was established. Conclusions: Persons with PD and certain cerebrovascular and cardiovascular risk factors, including orthostatic hypotension and systemic hypertension, should be referred to appropriate professionals for comprehensive neuropsychological testing secondary to an increased risk for more severe cognitive deficit.
文摘Background: Lack of serum vitamin D3 is related to PD (Parkinson’s disease). Currently a valid place for vitamin D3 deficiency in Parkinson disease (PD) has been anticipated. The aim of present research was to evaluate insufficiency of D3 (vitamin) in subjects with PD (Parkinson’s disease). Many of physiological functions connected with higher risk of illness are maintained by vitamin D, which also plays significant task in pathogenesis of calcium homeostasis and skeletal ailments. It forecasts hazard of persistent ailments like malignancy, CVS conditions, and T2DM. Continuous insufficiency of this vitamin may lead to PD. Method: This was a cross sectional study. Conducted at People’s Medical College Hospital, Nawabshah during period of Jan. 2014-Dec. 2016, the sample size of 243 subjects clinically diagnosed as PD was enlisted. Inclusion criteria were all male and female subjects aged >50 years, clinically diagnosed Parkinson’s disease enlisted in research. Results: In 151 (62.1%) subjects, vitamin D3 levels were <30 ng/ml while in 92 (37.9%) subjects, vitamin D3 values were normal (30 - 150 ng/ml) (p = 0.000). Conclusion: Considerably low levels of vitamin D3 were seen in Parkinson’s disease. Our information sustains a legitimate part of vitamin D insufficiency in PD.
文摘Parkinson’s disease was first formally identified by British physician James Parkinson in 1817 as “The Shaking Palsy”. L-DOPA (3,4-dihydroxy-phenyl-L-alanine) has been considered as a gold-standard treatment for Parkinson’s disease. The world market for L-DOPA is about 250 t/year and the total market volume is about $101 billion per year. The present review summarizes the different biological sources for the production of L-DOPA. The process for L-DOPA production from different biological sources has advantages over the chemical methods such as, enantiometrically pure L-DOPA, less incubation time and cost effective method. L-DOPA is found naturally in certain plant foods, particularly broad beans which found to replenish brain levels of L-DOPA even more quickly, and for longer periods, than conventional medication.
文摘Objective: To compare 8-month effects ofmedical treatment plusrehabilitation on UPDRS scores ofparkinsonian patientswith that ofmedical treatment withoutrehabilitation.Design: Longtudinal randomized study. Participants:27 parkinsonian patients (69.50 ± 10.34 years). We divided our patient into two groups: control group (n = 9, received only medication therapy) and experiment- tal group (n = 18, received physiccal therapy and medication therapy). Intervention:The 8-month exercise interventions were twice-weekly 90-min sessions in group. UPDRS scales were measured before and after the interventions. Results: Two- factor ANOVA analyses revealed a significant main effect fromrehabilitation (p 0.05). Post-hoc analysis shows that UPDRS motor increased in control group (+37%) meanwhile decreased in experimental group (–17%). UPDRS ADL increased significantly more in control group (+26%) than experimental group (+5%).UPDRS total increased in control group (+33%) meanwhile decreased in experimental group(–11%). Conclusions:The results of the study suggest that exercise interventions should be a necessary ongoing adjunct toparkinson’s diseasemedication.
文摘Objective: To evaluate the efficacy of Nintendo Wii training in quality of life in Parkinson’s disease (PD) patients when compared to traditional physical therapy (PT). Methods: A randomized, single-blinded trial with 2 parallel arms was performed in a referral center for movement disorders in North-eastern, Brazil. Forty-four PD outpatients that fulfilled the eligibility criteria with mild to moderate motor impairment were randomized. Both groups executed a warm up session for 10 minutes that consisted of trunk flexion, extension and rotation, associated with upper and lower limbs stretching. The PT group followed a program that consisted of trunk and limb mobilisation, balance, muscle strengthening, rhythmic movement, postural alignment, double-task execution, bimanual tasks, and gait training. The Nintendo Wii group executed a sequence of tasks according to a previously established protocol, with similar training exercises. Duration of exercises was 40 minutes per session, 3 days per week for 4 weeks. The primary endpoint was the total score obtained in the Parkinson’s disease quality of life questionnaire (PDQ-39) translated from English to Brazilian Portuguese by Oxford outcomes. Secondary endpoints were the scores achieved by each group in the following domains of PDQ-39 scale: mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort. Assessments were performed before and after intervention in both groups with subjects in the “on” period. Results: Subjects in the Nintendo Wii group showed greater improvement in the PDQ-39 total score when compared to PT group (p = 0.01). Also, significant differences were observed in ADL, stigma, social support and communication when comparing subjects before and after intervention in the Nintendo Wii group (p < 0.05). Conclusions: The results achieved in this trial suggest that rehabilitation using Nintendo Wii may have beneficial effects in quality of life of PD subjects, when compared
文摘The rate of progression of Parkinson’s Disease (PD) varies among individuals living with the disease. How- ever, there comes a time, later in the course of the disease, when most patients with PD develop balance impair- ments and falls. Unfortunately, these symptoms do not respond well to dopaminergic medications or deep brain stimulation.
