Parkinson's disease(PD) is a common neurodegenerative disease characterized by bradykinesia, tremor, rigidity, and postural instability. Motor disorders are composite and combined, adversely affecting the patient&...Parkinson's disease(PD) is a common neurodegenerative disease characterized by bradykinesia, tremor, rigidity, and postural instability. Motor disorders are composite and combined, adversely affecting the patient's health. Tremor and rigidity are correlated with worsening manual dexterity as well as postural changes such as akinesia and camptocormia. Moreover, gait alteration as well as postural instability, with consequent impairment in balance, increase the risk of falls. It is well known that these symptoms respond poorly to pharmacologic therapy in PD patients. Physical therapy is the most effective non-pharmacological aid to PD patients. Available data in the literature indicate that any rehabilitation protocol has to focus on: cognitive movement strategies, cueing strategies, and improved physical capacity and balance. Different training programs for PD patients have been designed and evaluated but only specific training strategies, tailored and individualized for each patient, may produce improvements in gait speed and stride length, decrease motor and balance symptoms and improve quality of life. Furthermore, aerobic training may improve muscle trophism, strength and mobility. It seems reasonable to state that tailoredphysical activity is a valid tool to be included in the therapeutic program of PD patients, considering that this approach may ameliorate the symptoms as well as the overall physical incapacity, reduce the risk of falls and injuries, and ultimately improve quality of life.展开更多
Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typ...Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typical symptoms. More general nonspecific symptoms including dizziness have also been described to predate the typical PD signs for several years. All subjects were selected among patients in the Willis Hospital (Pusan, South of Korea), with complaints of diz-ziness from September 2009 to September 2010 and the baseline neurological screening and clinical ENT examination, to which the results were within the normal range. At baseline, 113 participants underwent neurological screening and provided information on dizziness. Of those participants, 103 were enrolled including 63 subjects in the control group. We used posturography. It allows quantitative assessment of vestibular-spinal component of body balance. The parame-ter of average speed of pressure center displacement to the lateral plan (VMX) and antero-posterior plan (VMY), which presented statistically significant differences between the groups except VMX with closed eyes. (p = 0.008 and p = 0.012, with closed eyes). With open eyes, only VMY showed significant difference between the groups (p = 0.010). In this study, the patients with dizziness and subjective complaints related to typical clinical signs of PD complaints presented higher instability in the orthostatic position than the control group of patients with dizziness and without such complaint. It could suggest that dizziness may be one symptom of preclinical PD and progress to overt postural instability. It is believed that a stepwise approach with a simple and inexpensive initial screening test of preclinical PD is required.展开更多
Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of...Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of a Pilates exercise program on postural stability and balance confidence in people with IPD. Ten IPD patients (Hoehn & Yahr Stage 1-3) with a history of falls or nearfalls had the following assessments before and after completion of a 6-week supervised Pilates exercise program: Activities-Specific Balance Confidence Scale (ABC);Berg Balance Scale (BBS);Schwab and England Scale (SES);Unified Parkinson’s Disease Rating Scale (UPDRS);pull-test;timed-up-and-go (TUG);5-metre walk;static and dynamic posturography. There were significant improvements in BBS score, 5-metre walk time and TUG after the training program, as well as improvement trends in some posturographic measures. Participants also reported improved balance confidence with Activities of Daily Living (ADLs). Our findings suggest that Pilates therapy can be beneficial in IPD and warrants further evaluation in a larger study.展开更多
文摘Parkinson's disease(PD) is a common neurodegenerative disease characterized by bradykinesia, tremor, rigidity, and postural instability. Motor disorders are composite and combined, adversely affecting the patient's health. Tremor and rigidity are correlated with worsening manual dexterity as well as postural changes such as akinesia and camptocormia. Moreover, gait alteration as well as postural instability, with consequent impairment in balance, increase the risk of falls. It is well known that these symptoms respond poorly to pharmacologic therapy in PD patients. Physical therapy is the most effective non-pharmacological aid to PD patients. Available data in the literature indicate that any rehabilitation protocol has to focus on: cognitive movement strategies, cueing strategies, and improved physical capacity and balance. Different training programs for PD patients have been designed and evaluated but only specific training strategies, tailored and individualized for each patient, may produce improvements in gait speed and stride length, decrease motor and balance symptoms and improve quality of life. Furthermore, aerobic training may improve muscle trophism, strength and mobility. It seems reasonable to state that tailoredphysical activity is a valid tool to be included in the therapeutic program of PD patients, considering that this approach may ameliorate the symptoms as well as the overall physical incapacity, reduce the risk of falls and injuries, and ultimately improve quality of life.
文摘Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typical symptoms. More general nonspecific symptoms including dizziness have also been described to predate the typical PD signs for several years. All subjects were selected among patients in the Willis Hospital (Pusan, South of Korea), with complaints of diz-ziness from September 2009 to September 2010 and the baseline neurological screening and clinical ENT examination, to which the results were within the normal range. At baseline, 113 participants underwent neurological screening and provided information on dizziness. Of those participants, 103 were enrolled including 63 subjects in the control group. We used posturography. It allows quantitative assessment of vestibular-spinal component of body balance. The parame-ter of average speed of pressure center displacement to the lateral plan (VMX) and antero-posterior plan (VMY), which presented statistically significant differences between the groups except VMX with closed eyes. (p = 0.008 and p = 0.012, with closed eyes). With open eyes, only VMY showed significant difference between the groups (p = 0.010). In this study, the patients with dizziness and subjective complaints related to typical clinical signs of PD complaints presented higher instability in the orthostatic position than the control group of patients with dizziness and without such complaint. It could suggest that dizziness may be one symptom of preclinical PD and progress to overt postural instability. It is believed that a stepwise approach with a simple and inexpensive initial screening test of preclinical PD is required.
文摘Pilates therapy improves core muscle function and axial stability but its effects on balance in idiopathic Parkinson’s disease (IPD) have not been evaluated. The objective of this study was to evaluate the effects of a Pilates exercise program on postural stability and balance confidence in people with IPD. Ten IPD patients (Hoehn & Yahr Stage 1-3) with a history of falls or nearfalls had the following assessments before and after completion of a 6-week supervised Pilates exercise program: Activities-Specific Balance Confidence Scale (ABC);Berg Balance Scale (BBS);Schwab and England Scale (SES);Unified Parkinson’s Disease Rating Scale (UPDRS);pull-test;timed-up-and-go (TUG);5-metre walk;static and dynamic posturography. There were significant improvements in BBS score, 5-metre walk time and TUG after the training program, as well as improvement trends in some posturographic measures. Participants also reported improved balance confidence with Activities of Daily Living (ADLs). Our findings suggest that Pilates therapy can be beneficial in IPD and warrants further evaluation in a larger study.
