Exercise to improve spinal flexibility and function for people with Parkinson's disease: a randomized, controlled trial.
ABSTRACT The effectiveness of an exercise intervention for people in early and midstage Parkinson's disease (stages 2 and 3 of Hoehn and Yahr) in improving spinal flexibility and physical performance in a sample of community-dwelling older people is described.
Fifty-one men and women, aged 55-84 years, identified through advertisement, local support groups, and local neurologists were enrolled into a randomized, controlled trial. Subjects were assigned randomly to an intervention or a usual care arm (i.e., no specific exercise). Of the original 51 participants, 46 completed the randomized, controlled trial. Participants in the exercise arm (n = 23) received individual instruction three times per week for 10 weeks. Participants in the usual care arm (n = 23) were "wait listed" for intervention.
Changes over 10 weeks in spinal flexibility (i.e., functional axial rotation) and physical performance (i.e., functional reach, timed supine to stand) were the primary outcome measures.
MANOVA conducted for the three primary outcome variables demonstrated significant differences (P < or = .05) between the two groups. Further analysis using ANOVA demonstrated significant differences between groups in functional axial rotation and functional reach for the intervention compared with the control group. There was no significant difference in supine to sit time.
Study results demonstrate that improvements in axial mobility and physical performance can be achieved with a 10-week exercise program for people in the early and midstages of PD.
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ABSTRACT: Objective: To determine the effectiveness of kayaking exercises in the management of axial rigidity, improve bed mobility by improving trunk rotation in Parkinson’s patients. Methods: Experimental randomized controlled trail conducted at Physiotherapy department of IPM&R, DUHS and neurology Outpatient Department of Civil Hospital Karachi. Sample size of 48 was calculated with the use of openEpi. After baseline assessment 24 participants were assigned to each Kayaking exercise and general mobility exercise groups. Both groups received treatment for 75 minutes, 6 days a week for 4 weeks. Pre and post treatment measurements were determined by goniometer that assessed the cervical and thoracolumbar rotations whereas bed mobility was assessed by Modified Parkinson’s Activity Scale (MPAS). Results: In Kayaking group mean cervical spine left rotation increased from 32.95+ 9.66 to 47.25 + 10.58, right side cervical spine rotation increased from 34.00 + 10.32 to 47.58 + 11.96, left side thoracolumbar rotation increased from 23.67 + 4.70 to 28.16 + 3.44, right side thoracolumbar rotation increased from 20.79 + 5.34 to 26.45 + 4.62. In control group mean cervical spine left rotation increased from 34.66+ 9.26 to 43.08 + 8.70, right side cervical spine rotation increased from 35.37 + 9.77 to 43.83 + 9.59 , left side thoracolumbar rotation increased from 23.70 + 4.77 to 26.87 + 3.73, right side thoracicolumbar rotation increased from 21.16 + 5.29 to 24.95 + 4.53 (P value <0.001).. Bed mobility on MPAS scale also showed significant improvements (P value <0.001). Conclusion: Both Kayaking and general exercises resulted in significant improvements after 4 weeks of treatment. However, Kayaking exercises were slightly more beneficial than general exercises.Pakistan Journal of Medical Sciences Online 09/2014; 30(5):1094-8. DOI:10.12669/pjms.305.5231 · 0.10 Impact Factor
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ABSTRACT: The present study investigated the effects of physical therapy treatment on gait initiation in patients with Parkinson's disease (PD). Thirteen patients with PD were randomized into a treatment (n = 7) and control (n = 6) group. Participants were assessed for their severity level, using the Modified Hoehn and Yahr scale, and motor evaluation, using the Unified Parkinson's Disease Rating Scale (UPDRS), items III and IV. At pre-and post-assessments, gait initiation was assessed using a gait mat, synchronized with a video camera. The treatment group received a physical therapy training program based on the TrainingBIG™ technique and task-specific concepts, three times per week for four weeks. The control group received no physical therapy treatment. From analysis of the pre-and post-assessment variables, only the treatment group showed a significant decrease in preparatory phase time (p = 0.043) and increase in step length (p = 0.018). In addition, the treatment group had a significant increase in step length (p = .022) at post-assessment when compared to the control group. The present findings demonstrated that physical therapy treatment would be beneficial for patients with PD experiencing gait initiation problems.
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ABSTRACT: Background: Balance training has been demonstrated to improve postural control in patients with Parkinson's disease (PD). The objective of this pilot randomized clinical trial was to investigate whether a balance training program using augmented visual feedback is feasible, safe, and more effective than conventional balance training in improving postural control in patients with PD. Methods: Thirty-three patients with idiopathic PD participated in a five-week training program consisting of ten group treatment sessions of 60 min. Participants were randomly allocated to (1) an experimental group who trained on workstations consisting of interactive balance games with explicit augmented visual feedback (VFT), or (2) a control group receiving conventional training. Standing balance, gait, and health status were assessed at entry, at six weeks, and at twelve weeks follow-up. Results: Sixteen patients were allocated to the control group and seventeen to the experimental group. The program was feasible to apply and took place without adverse events. Change scores for all balance measures favored VFT, but the change in the primary outcome measure, i.e. the Functional Reach test, did not differ between groups (t(28) = -0.116, p = .908). No other differences between groups were statistically significant. Conclusions: VFT proved to be a feasible and safe approach to balance therapy for patients with PD. In this proof-of-concept study VFT was not superior over conventional balance training although observed trends mostly favored VFT. These trends approached clinical relevance only in few cases: increasing the training load and further optimization of VFT may strengthen this effect. Trial registration: Controlled Trials, ISRCTN47046299.Parkinsonism & Related Disorders 12/2014; 20(12):1352–1358. DOI:10.1016/j.parkreldis.2014.09.022 · 4.13 Impact Factor