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Harvey M, Weston KL, Gray WK, O'Callaghan A, Oates LL, Davidson R, Walker RW. High-intensity interval training in people with Parkinson's disease: a randomized, controlled feasibility trial. Clin Rehabil 2018; 33:428-438. [PMID: 30514114 DOI: 10.1177/0269215518815221] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES: To investigate whether people with Parkinson's disease can exercise at a high-intensity across a 12-week intervention and to assess the impact of the intervention on cardiorespiratory fitness. DESIGN: This is a randomized, controlled, feasibility study with waiting list control. Assessors were blinded to group allocation. SETTING: The intervention took place at an exercise centre and assessments at a district general hospital. SUBJECTS: This study included 20 people with idiopathic Parkinson's disease. INTERVENTION: A total of 36 exercise sessions over 12 weeks, with each session lasting ~45 minutes, were conducted. MAIN MEASURES: The main measures were maximal heart rates achieved during exercise, recruitment rate, attendance, drop-out, change in peak oxygen consumption, cardiac output, cognitive function and quality of life. The study was considered technically feasible if participants achieved ⩾85% of maximal heart rate during exercise. RESULTS: There were 12 male and 8 female participants; they had a mean age of 68.5 years (standard deviation 6.825). Two participants were of Hoehn and Yahr stage I, 11 stage II and 7 stage III. In all, 17 participants completed the intervention. The median (interquartile range) proportion of repetitions delivered across the intervention which met our high-intensity criterion was 80% (67% to 84%). Mean peak heart rate was 88.8% of maximal. Peak oxygen consumption increased by 2.8 mL kg-1 min-1 in the intervention group and 1.5 mL kg-1 min-1 in the control group after 12 weeks of exercise. We estimate that a fully powered randomized controlled trial would require 30 participants per group. CONCLUSION: High-intensity interval exercise is feasible in people with Parkinson's disease. Improvements in cardiorespiratory function are promising.
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Affiliation(s)
- Marguerite Harvey
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK
| | - Kathryn L Weston
- 2 School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - William K Gray
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK
| | - Ailish O'Callaghan
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK.,3 Cumberland Infirmary, North Cumbria University Hospitals NHS Trust, Carlisle, UK
| | - Lloyd L Oates
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK
| | - Richard Davidson
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK
| | - Richard W Walker
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Tyne and Wear, UK.,4 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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What makes a group fitness program for people with Parkinson’s disease endure? A mixed-methods study of multiple stakeholders. Complement Ther Med 2018; 41:320-327. [DOI: 10.1016/j.ctim.2018.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/23/2022] Open
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Physical Activity, Fatigue, and Sleep in People with Parkinson's Disease: A Secondary per Protocol Analysis from an Intervention Trial. PARKINSONS DISEASE 2018; 2018:1517807. [PMID: 30258564 PMCID: PMC6146558 DOI: 10.1155/2018/1517807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/16/2018] [Accepted: 07/05/2018] [Indexed: 11/17/2022]
Abstract
Symptoms of Parkinson's can result in low physical activity and poor sleep patterns which can have a detrimental effect on a person's quality of life. To date, studies looking into exercise interventions for people with Parkinson's (PwP) for symptom management are promising but inconclusive. The aim of this study is to estimate the effect of a clearly defined exercise prescription on general physical activity levels, fatigue, sleep, and quality of life in PwP. Method. PwP randomised into either an exercise group (29; 16 males, 13 females; mean age 67 years (7.12)) or a control handwriting group (36; 19 males; 17 females; mean age 67 years (5.88)) as part of a larger trial were included in this substudy if they had completed a 6-month weekly exercise programme (intervention group) and had complete objective physical activity data (intervention and control group). Sleep and fatigue were recorded from self-reported measures, and physical activity levels measured through the use of accelerometers worn 24 hours/day over a seven-day testing period at baseline and following the 24-week intervention. A Wilcoxon's test followed by a Mann-Whitney post hoc analysis was used, and effect sizes were calculated. Results. Participants showed a significant increase in time spent in sedentary and light activities during the overnight period postintervention in both exercise and handwriting groups (p < 0.05) with a moderate effect found for the change in sedentary and light activities in the overnight hours for both groups, over time (0.32 and 0.37-0.38, resp.). There was no impact on self-reported fatigue or sleep. Conclusion. The observed moderate effect on sedentary and light activities overnight could suggest an objective improvement in sleep patterns for individuals participating in both exercise and handwriting interventions. This supports the need for further studies to investigate the role of behavioural interventions for nonmotor symptoms.
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van der Kolk NM, de Vries NM, Penko AL, van der Vlugt M, Mulder AA, Post B, Alberts JL, Bloem BR. A remotely supervised home-based aerobic exercise programme is feasible for patients with Parkinson's disease: results of a small randomised feasibility trial. J Neurol Neurosurg Psychiatry 2018; 89:1003-1005. [PMID: 28607121 DOI: 10.1136/jnnp-2017-315728] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/09/2017] [Accepted: 05/14/2017] [Indexed: 01/09/2023]
Affiliation(s)
- Nicolien M van der Kolk
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Nienke M de Vries
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Amanda L Penko
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
| | - Maureen van der Vlugt
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anton A Mulder
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bart Post
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA.,Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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Fishel SC, Hotchkiss ME, Brown SA. The impact of LSVT BIG therapy on postural control for individuals with Parkinson disease: A case series. Physiother Theory Pract 2018; 36:834-843. [DOI: 10.1080/09593985.2018.1508260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sarah C. Fishel
- Department of Physical Therapy, Ithaca College – Center for Health Sciences, Ithaca, New York, USA
| | - Megan E. Hotchkiss
- Department of Physical Therapy, Ithaca College – Center for Health Sciences, Ithaca, New York, USA
| | - Samantha A. Brown
- Department of Physical Therapy, Ithaca College – Center for Health Sciences, Ithaca, New York, USA
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Wilkins HM, Morris JK. New Therapeutics to Modulate Mitochondrial Function in Neurodegenerative Disorders. Curr Pharm Des 2018; 23:731-752. [PMID: 28034353 DOI: 10.2174/1381612822666161230144517] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mitochondrial function and energy metabolism are impaired in neurodegenerative diseases. There is evidence for these functional declines both within the brain and systemically in Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis. Due to these observations, therapeutics targeted to alter mitochondrial function and energy pathways are increasingly studied in pre-clinical and clinical settings. METHODS The goal of this article was to review therapies with specific implications on mitochondrial energy metabolism published through May 2016 that have been tested for treatment of neurodegenerative diseases. RESULTS We discuss implications for mitochondrial dysfunction in neurodegenerative diseases and how this drives new therapeutic initiatives. CONCLUSION Thus far, treatments have achieved varying degrees of success. Further investigation into the mechanisms driving mitochondrial dysfunction and bioenergetic failure in neurodegenerative diseases is warranted.
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Affiliation(s)
- Heather M Wilkins
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jill K Morris
- University of Kansas School of Medicine, University of Kansas Alzheimer's Disease Center MS 6002, 3901 Rainbow Blvd, Kansas City, KS 66160. United States
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Lamont RM, Daniel HL, Payne CL, Brauer SG. Accuracy of wearable physical activity trackers in people with Parkinson's disease. Gait Posture 2018; 63:104-108. [PMID: 29729611 DOI: 10.1016/j.gaitpost.2018.04.034] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this study was to determine the accuracy of the Fitbit Charge HR™ and Garmin vívosmart® HR in measuring steps and reflecting intensity of activity in people with Parkinson's disease (PD). METHODS Thirty-three people with mild-moderate PD performed six, two-minute indoor walks at their self-selected walking pace, and at target cadences of 60, 80, 100, 120 and 140 beats/min. A 500 m outdoor walk with terrain challenges was also performed. Step count was recorded by the two wrist-worn activity trackers (Fitbit Charge HR™ and Garmin vívosmart® HR) and compared to an accelerometer (ActivPAL3™). Intensity was recorded by a portable breath-by-breath gas analyser (VO2), heart rate and Borg scale. RESULTS Both commercial activity trackers had low error (<3%) and moderate to high consistency at self-selected pace both indoors and outdoors (ICC 0.88-0.97; p < 0.05) compared to the ActivPAL3™. The Garmin recorded low error (<5%) and high agreement (ICCs > 0.68; p < 0.001) for all target cadences ≥80steps/min. The Fitbit had higher error was less consistent for all target cadences ≥80steps/min. Cadence measured by the Fitbit and Garmin weakly reflected increases in heart rate (ICCs 0.27-0.28; p < 0.05), and did not reflect VO2 or Borg (ICCs 0.08-0.15, p > 0.05). CONCLUSION The Garmin device was more accurate at reflecting step count across a broader range of walking cadences than the Fitbit, but neither strongly reflected intensity of activity. While not intended to replace research grade devices, these wrist-worn devices may be a clinically useful adjunct to exercise therapy to increase physical activity in people with PD.
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Affiliation(s)
- Robyn M Lamont
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Australia.
| | - Hannah L Daniel
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Caitlyn L Payne
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Sandra G Brauer
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Australia
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108
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Ramaswamy B, Jones J, Carroll C. Exercise for people with Parkinson's: a practical approach. Pract Neurol 2018; 18:399-406. [PMID: 29858216 DOI: 10.1136/practneurol-2018-001930] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 11/04/2022]
Abstract
Exercise is key to a healthy and productive life. For people with Parkinson's, exercise has reported benefits for controlling motor and non-motor symptoms alongside the use of pharmacological intervention. For example, exercise prolongs independent mobility and improves sleep, mood, memory and quality of life, all further enhanced through socialisation and multidisciplinary team support. Recent research suggests that optimally prescribed exercise programmes following diagnosis may alter neurophysiological processes, possibly slowing symptom progression.Given its benefits, professionals should encourage and motivate people with Parkinson's to exercise regularly from the time of diagnosis and provide guidance on what exercise to do. We provide examples of how the growing body of evidence on exercise for people with Parkinson's is revolutionising the services they are provided. We also highlight new resources available to help the wider support network (people such as volunteers, partners and friends of people with Parkinson's) with an interest in exercise promote a consistent message on the benefits of exercise.
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Affiliation(s)
- Bhanu Ramaswamy
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - Julie Jones
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Camille Carroll
- Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK
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110
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Mattson MP, Moehl K, Ghena N, Schmaedick M, Cheng A. Intermittent metabolic switching, neuroplasticity and brain health. Nat Rev Neurosci 2018; 19:63-80. [PMID: 29321682 PMCID: PMC5913738 DOI: 10.1038/nrn.2017.156] [Citation(s) in RCA: 287] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
During evolution, individuals whose brains and bodies functioned well in a fasted state were successful in acquiring food, enabling their survival and reproduction. With fasting and extended exercise, liver glycogen stores are depleted and ketones are produced from adipose-cell-derived fatty acids. This metabolic switch in cellular fuel source is accompanied by cellular and molecular adaptations of neural networks in the brain that enhance their functionality and bolster their resistance to stress, injury and disease. Here, we consider how intermittent metabolic switching, repeating cycles of a metabolic challenge that induces ketosis (fasting and/or exercise) followed by a recovery period (eating, resting and sleeping), may optimize brain function and resilience throughout the lifespan, with a focus on the neuronal circuits involved in cognition and mood. Such metabolic switching impacts multiple signalling pathways that promote neuroplasticity and resistance of the brain to injury and disease.
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Affiliation(s)
- Mark P Mattson
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland 21224, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Keelin Moehl
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland 21224, USA
| | - Nathaniel Ghena
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland 21224, USA
| | - Maggie Schmaedick
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland 21224, USA
| | - Aiwu Cheng
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, Maryland 21224, USA
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Kelly NA, Wood KH, Allendorfer JB, Ford MP, Bickel CS, Marstrander J, Amara AW, Anthony T, Bamman MM, Skidmore FM. High-Intensity Exercise Acutely Increases Substantia Nigra and Prefrontal Brain Activity in Parkinson's Disease. Med Sci Monit 2017; 23:6064-6071. [PMID: 29273705 PMCID: PMC5747933 DOI: 10.12659/msm.906179] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Pathologic alterations in resting-state brain activity patterns exist among individuals with Parkinson’s disease (PD). Since physical exercise alters resting-state brain activity in non-PD populations and improves PD symptoms, we assessed the acute effect of exercise on resting-state brain activity in exercise-trained individuals with PD. Material/Methods Resting-state functional magnetic resonance imaging (fMRI) was collected twice for 17 PD participants at the conclusion of an exercise intervention. The acute effect of exercise was examined for PD participants using the amplitude of low frequency fluctuation (ALFF) before and after a single bout of exercise. Correlations of clinical variables (i.e., PDQ-39 quality of life and MDS-UPDRS) with ALFF values were examined for the exercise-trained PD participants. Results An effect of acute exercise was observed as an increased ALFF signal within the right ventromedial prefrontal cortex (PFC), left ventrolateral PFC, and bilaterally within the substantia nigra (SN). Quality of life was positively correlated with ALFF values within the vmPFC and vlPFC. Conclusions Given the role of the SN and PFC in motor and non-motor symptoms in PD, the acute increases in brain activity within these regions, if repeated frequently over time (i.e., exercise training), may serve as a potential mechanism underlying exercise-induced PD-specific clinical benefits.
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Affiliation(s)
- Neil A Kelly
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kimberly H Wood
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jane B Allendorfer
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthew P Ford
- Department of Physical Therapy, Samford University, Birmingham, AL, USA
| | - C Scott Bickel
- Department of Physical Therapy, Samford University, Birmingham, AL, USA
| | - Jon Marstrander
- Department of Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amy W Amara
- Department of Physical Therapy, University of Alabama, Birmingham, AL, USA
| | - Thomas Anthony
- Department of Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcas M Bamman
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
| | - Frank M Skidmore
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
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Hunter H, Lovegrove C, Haas B, Freeman J, Gunn H. Experiences of people with Parkinson's disease and their views of physical activity interventions: a qualitative systematic review protocol. ACTA ACUST UNITED AC 2017; 15:2619-2623. [DOI: 10.11124/jbisrir-2016-003288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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113
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McDonnell MN, Rischbieth B, Schammer TT, Seaforth C, Shaw AJ, Phillips AC. Lee Silverman Voice Treatment (LSVT)-BIG to improve motor function in people with Parkinson's disease: a systematic review and meta-analysis. Clin Rehabil 2017; 32:607-618. [PMID: 28980476 DOI: 10.1177/0269215517734385] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The technique called Lee Silverman Voice Treatment (LSVT)-LOUD has previously been used to improve voice quality in people with Parkinson's disease. The objective of this study was to assess the effectiveness of an alternate intervention, LSVT-BIG (signifying big movements), to improve functional mobility. DESIGN Systematic review with meta-analysis of randomized trials. DATA SOURCES Medline, Embase, CINAHL, AgeLine, Scopus and Cochrane Library were searched from inception to September 2017 using multiple search terms related to Parkinson's disease and LSVT-BIG. REVIEW METHOD Two researchers searched the literature for studies of the LSVT-BIG intervention of 16 sessions, delivered by a certified instructor over four weeks, to any other intervention. Outcomes related to functional ability were included. Study quality was appraised using the Cochrane Risk of Bias tool. RESULTS Four studies were included, reporting on three randomized trials of 84 participants with mild Parkinson's disease. Compared to physiotherapy exercises, or a shorter training protocol, there was a significant improvement in motor function assessed with the Unified Parkinson's Disease Rating Scale part III (mean difference = -3.20, 95% confidence interval = -5.18 to -1.23) and a trend towards faster Timed Up and Go performance (mean difference = -0.47, 95% confidence interval = -0.99 to 0.06) and 10-metre walk test (mean difference = -0.53, 95% confidence interval = -1.07 to 0.01). CONCLUSION Compared to shorter format LSVT-BIG or general exercise, LSVT-BIG was more effective at improving motor function. This provides preliminary, moderate quality evidence that amplitude-oriented training is effective in reducing motor impairments for people with mild Parkinson's disease.
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Affiliation(s)
- Michelle N McDonnell
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia.,2 Stroke and Rehabilitation Research Group, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia.,3 Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA, Australia
| | - Briony Rischbieth
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Tenille T Schammer
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Chantel Seaforth
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Alex J Shaw
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Anna C Phillips
- 1 School of Health Sciences, University of South Australia, Adelaide, SA, Australia
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Flach A, Jaegers L, Krieger M, Bixler E, Kelly P, Weiss EP, Ahmad SO. Endurance exercise improves function in individuals with Parkinson’s disease: A meta-analysis. Neurosci Lett 2017; 659:115-119. [DOI: 10.1016/j.neulet.2017.08.076] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/30/2017] [Accepted: 08/31/2017] [Indexed: 11/25/2022]
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115
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Physiotherapy in Parkinson's Disease: Building ParkinsonNet in Czechia. PARKINSONS DISEASE 2017; 2017:8921932. [PMID: 28611932 PMCID: PMC5458379 DOI: 10.1155/2017/8921932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/19/2017] [Indexed: 11/28/2022]
Abstract
Objective We conducted a questionnaire survey to investigate the availability and quality of physiotherapy (PT) for Parkinson's disease (PD). Background Despite evidence about the benefits of PT, there is no data regarding its use in Czechia. Methods Questionnaires were sent to 368 PD patients seen in a single movement disorders centre within two years (inclusion criteria: idiopathic PD, Hoehn and Yahr stage <5, and residence in Prague) and to 211 physical therapists (PTs) registered in Prague. The patient questionnaire evaluated limitations in 6 core areas and in activities of daily living and inquired about experience with PT. The PTs questionnaire evaluated knowledge about PD, number of PD patients treated yearly, and details of therapy. Results Questionnaires were returned by 248 patients and 157 PTs. PT was prescribed to 70/248 patients. The effects were satisfactory in 79% and lasted >3 months in 60/64. About half of the PTs have no experience with PD patients, 26% reported <3, and 5% see >10 yearly. The most widely used techniques were neurodevelopmental treatments. Conclusion Present PD healthcare model in Czechia is suboptimal (low PT prescription, non-evidence-based PT). Implementation of European PT Guidelines for PD and the introduction of an efficient model of care are needed.
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116
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Ramazzina I, Bernazzoli B, Costantino C. Systematic review on strength training in Parkinson's disease: an unsolved question. Clin Interv Aging 2017; 12:619-628. [PMID: 28408811 PMCID: PMC5384725 DOI: 10.2147/cia.s131903] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The purpose of this study was to investigate the effectiveness of strength training, performed against a different resistance from body weight, in improving motor and nonmotor symptoms in patients with Parkinson’s disease (PD). The following electronic databases were searched: PubMed, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science. The review was conducted and reported in accordance with the PRISMA statement. Thirteen high-quality randomized controlled trials were included. Strength training performed against external resistance is well tolerated and appears to be a suitable physical activity to improve both physical parameters and quality of life parameters of PD subjects. However, although the study intervention included strength training, only a few selected studies assessed the improvement of muscle strength. Despite the encouraging results, it is difficult to establish a correlation between strength training and the improvements made. Our review highlights the lack of common intent in terms of study design and the presence of different primary and secondary outcomes. Accordingly, further studies are needed to support the beneficial effects of different types of strength training in PD subjects and to underline the superiority of strength training in PD patients with respect to other training.
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Affiliation(s)
- Ileana Ramazzina
- Department of Biomedical, Biotechnological and Translational Sciences
| | - Benedetta Bernazzoli
- Department of Clinical and Experimental Medicine, Graduate School of Rehabilitation and Physical Medicine, University of Parma, Parma, Italy
| | - Cosimo Costantino
- Department of Biomedical, Biotechnological and Translational Sciences
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Kakde N, Metri KG, Varambally S, Nagaratna R, Nagendra HR. Development and validation of a yoga module for Parkinson disease. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2017; 14:/j/jcim.ahead-of-print/jcim-2015-0112/jcim-2015-0112.xml. [PMID: 28343166 DOI: 10.1515/jcim-2015-0112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/17/2017] [Indexed: 11/15/2022]
Abstract
Background Parkinson's disease (PD), a progressive neurodegenerative disease, affects motor and nonmotor functions, leading to severe debility and poor quality of life. Studies have reported the beneficial role of yoga in alleviating the symptoms of PD; however, a validated yoga module for PD is unavailable. This study developed and validated an integrated yoga module(IYM) for PD. Methods The IYM was prepared after a thorough review of classical yoga texts and previous findings. Twenty experienced yoga experts, who fulfilled the inclusion criteria, were selected validating the content of the IYM. A total of 28 practices were included in the IYM, and each practice was discussed and rated as (i) not essential, (ii) useful but not essential, and (iii) essential; the content validity ratio (CVR) was calculated using Lawshe's formula. Results Data analysis revealed that of the 28 IYM practices, 21 exhibited significant content validity (cut-off value: 0.42, as calculated by applying Lawshe's formula for the CVR). Conclusions The IYM is valid for PD, with good content validity. However, future studies must determine the feasibility and efficacy of the developed module.
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118
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Rahbek MA, Mikkelsen EE, Overgaard K, Vinge L, Andersen H, Dalgas U. Exercise in myasthenia gravis: A feasibility study of aerobic and resistance training. Muscle Nerve 2017; 56:700-709. [PMID: 28085204 DOI: 10.1002/mus.25552] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION It has not been established whether progressive resistance training (PRT) and aerobic training (AT) are feasible and efficient in myasthenia gravis (MG). METHODS Fifteen subjects with generalized MG (Myasthenia Gravis Foundation of America (MGFA) clinical classification II-IV) were randomly assigned to 20 training sessions during 8 weeks of either PRT or AT. Feasibility was evaluated based on adherence, drop-out rate, adverse events, and Quantitative Myasthenia Gravis (QMG) score. RESULTS Twelve subjects (MGFA II, n = 11; MGFA III, n=1) completed the intervention with a mean adherence of 95 % ± 8. One dropout (PRT) could potentially be related to PRT. Both groups reported adverse events, including bulbar symptoms (n = 2) and increased fatigue (n = 3), but no change in QMG score was observed in either group. The PRT group showed increases in maximal strength and functional capacity. CONCLUSIONS Eight weeks of moderate to high intensity AT and PRT were feasible for most patients with mild MG. Maximal strength and functional capacity increased in the PRT group. Muscle Nerve 56: 700-709, 2017.
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Affiliation(s)
- Martin Amadeus Rahbek
- Section for Sport Science, Department of Public Health, Aarhus University, Denmark, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Erik Elgaard Mikkelsen
- Section for Sport Science, Department of Public Health, Aarhus University, Denmark, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Kristian Overgaard
- Section for Sport Science, Department of Public Health, Aarhus University, Denmark, Dalgas Avenue 4, 8000, Aarhus C, Denmark
| | - Lotte Vinge
- Department of Neurology, Aarhus University Hospital, Noerrebrogade, 44, 8000 Aarhus C, Denmark
| | - Henning Andersen
- Department of Neurology, Aarhus University Hospital, Noerrebrogade, 44, 8000 Aarhus C, Denmark
| | - Ulrik Dalgas
- Section for Sport Science, Department of Public Health, Aarhus University, Denmark, Dalgas Avenue 4, 8000, Aarhus C, Denmark
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Collett J, Franssen M, Meaney A, Wade D, Izadi H, Tims M, Winward C, Bogdanovic M, Farmer A, Dawes H. Phase II randomised controlled trial of a 6-month self-managed community exercise programme for people with Parkinson's disease. J Neurol Neurosurg Psychiatry 2017; 88:204-211. [PMID: 27837101 DOI: 10.1136/jnnp-2016-314508] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/26/2016] [Accepted: 10/21/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Evidence for longer term exercise delivery for people with Parkinson's disease (PwP) is deficient. AIM Evaluate safety and adherence to a minimally supported community exercise intervention and estimate effect sizes (ES). METHODS 2-arm parallel phase II randomised controlled trial with blind assessment. PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames valley, UK, and randomised (1:1) to intervention (exercise) or control (handwriting) groups, via a concealed computer-generated list. Groups received a 6-month, twice weekly programme. Exercise was undertaken in community facilities (30 min aerobic and 30 min resistance) and handwriting at home, both were delivered through workbooks with monthly support visits. Primary outcome was a 2 min walk, with motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS III), fitness, health and well-being measured. RESULTS Between December 2011 and August 2013, n=53 (n=54 analysed) were allocated to exercise and n=52 (n=51 analysed) to handwriting. N=37 adhered to the exercise, most attending ≥1 session/week. Aerobic exercise was performed in 99% of attended sessions and resistance in 95%. Attrition and adverse events (AEs) were similar between groups, no serious AEs (n=2 exercise, n=3 handwriting) were related, exercise group-related AEs (n=2) did not discontinue intervention. Largest effects were for motor symptoms (2 min walk ES=0.20 (95% CI -0.44 to 0.45) and MDS-UPDRS III ES=-0.30 (95% CI 0.07 to 0.54)) in favour of exercise over the 12-month follow-up period. Some small effects were observed in fitness and well-being measures (ES>0.1). CONCLUSIONS PwP exercised safely and the possible long-term benefits observed support a substantive evaluation of this community programme. TRIAL REGISTRATION NUMBER NCT01439022.
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Affiliation(s)
- Johnny Collett
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK
| | - Marloes Franssen
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andy Meaney
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK
| | - Derick Wade
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK.,Oxford Centre for Enablement, Oxford University Hospitals, Oxford, UK
| | - Hooshang Izadi
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK.,Department of Mechanical Engineering and Mathematical Sciences, Oxford Brookes University, Oxford, UK
| | - Martin Tims
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK
| | - Charlotte Winward
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK.,Department of Infectious Disease, Churchill Hospital, Oxford University Hospitals, Oxford, UK
| | | | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Helen Dawes
- Movement Science Group, OxINAHR, Oxford Brookes University, Oxford, UK.,Department of Clinical Neurology, University of Oxford, Oxford, UK
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Rehabilitation in progressive supranuclear palsy: Effectiveness of two multidisciplinary treatments. PLoS One 2017; 12:e0170927. [PMID: 28158197 PMCID: PMC5291505 DOI: 10.1371/journal.pone.0170927] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND to date, there are no medical or surgical treatments for progressive supranuclear palsy (PSP). It is possible to speculate that patients with PSP could benefit from rehabilitative treatments designed for Parkinson's disease, including the use of robot-assisted walking training. OBJECTIVE to evaluate whether the use of the robotic device Lokomat® is superior in PSP patients to the use of treadmill with visual cues and auditory feedbacks (treadmill-plus) in the context of an aerobic, multidisciplinary, intensive, motor-cognitive and goal-based rehabilitation treatment (MIRT) conceived for Parkinsonian patients. METHODS we enrolled twenty-four PSP patients. Twelve subjects underwent a 4-week MIRT exploiting the use of the treadmill-plus (MIRT group). Twelve subjects underwent the same treatment, but replacing the treadmill-plus with Lokomat® (MIRT-Lokomat group). Subjects were evaluated with clinical and functional scales at admission and discharge. The primary outcomes were the total PSP Rating Scale (PSPRS) score and its "limb" and "gait" sub-scores. Secondary outcomes were Berg Balance Scale (BBS), Six Minutes Walking test (6MWT) and the number of falls. RESULTS total PSPRS, PSPRS-gait sub-score, BBS, 6MWT and number of falls improved significantly in both groups (p ≤ 0.003 all, except 6MWT, p = 0.032 and p = 0.018 in MIRT-Lokomat and MIRT group respectively). The PSPRS-limb sub-score improved significantly only in the MIRT group (p = 0.002). A significant difference between groups was observed only for total PSPRS, indicating a slightly better improvement for patients in the MIRT group (p = 0.047). No differences between groups were revealed for the other outcomes, indicating that the effect of rehabilitation was similar in both groups. CONCLUSIONS Lokomat® training, in comparison with treadmill-plus training, does not provide further benefits in PSP patients undergoing MIRT. Our findings suggest the usefulness of an aerobic, multidisciplinary, intensive, motor-cognitive and goal-based approach for the rehabilitation of patients suffering from such a complex disease as PSP. TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov, NCT02109393.
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Dong J, Cui Y, Li S, Le W. Current Pharmaceutical Treatments and Alternative Therapies of Parkinson's Disease. Curr Neuropharmacol 2016; 14:339-55. [PMID: 26585523 PMCID: PMC4876590 DOI: 10.2174/1570159x14666151120123025] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/16/2015] [Accepted: 10/09/2015] [Indexed: 01/01/2023] Open
Abstract
Over the decades, pharmaceutical treatments, particularly dopaminergic (DAergic) drugs have been considered as the main therapy against motor symptoms of Parkinson's disease (PD). It is proposed that DAergic drugs in combination with other medications, such as monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, anticholinergics and other newly developed non-DAergic drugs can make a better control of motor symptoms or alleviate levodopa-induced motor complications. Moreover, non-motor symptoms of PD, such as cognitive, neuropsychiatric, sleep, autonomic and sensory disturbances caused by intrinsic PD pathology or drug-induced side effects, are gaining increasing attention and urgently need to be taken care of due to their impact on quality of life. Currently, neuroprotective therapies have been investigated extensively in pre-clinical studies, and some of them have been subjected to clinical trials. Furthermore, non-pharmaceutical treatments, including deep brain stimulation (DBS), gene therapy, cell replacement therapy and some complementary managements, such as Tai chi, Yoga, traditional herbs and molecular targeted therapies have also been considered as effective alternative therapies to classical pharmaceutics. This review will provide us updated information regarding the current drugs and non-drugs therapies for PD.
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Affiliation(s)
| | | | | | - Weidong Le
- Neurology and Director of Center for Translational Research of Neurological Diseases, 1st Affiliated Hospital, Dalian Medical University, Dalian 116021, Liaoning Province, China.
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Therapies for Parkinson’s diseases: alternatives to current pharmacological interventions. J Neural Transm (Vienna) 2016; 123:1279-1299. [DOI: 10.1007/s00702-016-1603-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/25/2016] [Indexed: 12/12/2022]
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Müller T. Emerging approaches in Parkinson's disease - adjunctive role of safinamide. Ther Clin Risk Manag 2016; 12:1151-60. [PMID: 27536120 PMCID: PMC4977086 DOI: 10.2147/tcrm.s86393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ongoing neuronal death in Parkinson’s disease (PD) causes an altered neurotransmission of various biogenic amines, particularly dopamine. As these changes do not follow a distinct pattern, they vary individually, and are differently pronounced. As a result, a heterogeneous onset of motor and nonmotor features occurs in each patient with PD during the whole course of the disease. PD actually describes a set of distinct diseases that manifest themselves in clinical syndromes with certain similarities but also great differences. This clinical picture responds to drugs with a broad spectrum of modes of actions better than to compounds with an exclusive focus on specific receptor subtypes. Therefore, safinamide is an ideal candidate for treatment of patients with PD, since its pharmacological profile includes reversible monoamine oxidase-B inhibition, blockade of voltage-dependent sodium channels, modulation of calcium channels, and inhibition of glutamate release. Safinamide is applied only once daily. Its oral dose ranges from 50 to 100 mg. Safinamide was well tolerated and safe in the clinical development program that demonstrated the amelioration of motor symptoms and OFF phenomena by safinamide when combined with dopamine agonists or levodopa. In the real world of maintenance of patients with PD, effects of safinamide application resemble therapy with classical monoamine oxidase inhibitors or amantadine in combination with other dopamine-substituting drugs. Safinamide is becoming increasingly available in the EU despite complex approval and pricing scenarios.
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Affiliation(s)
- Thomas Müller
- Department of Neurology, Alexianer St Joseph Hospital Berlin-Weißensee, Berlin, Germany
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Delextrat A, Bateman J, Esser P, Targen N, Dawes H. The potential benefits of Zumba Gold® in people with mild-to-moderate Parkinson’s: Feasibility and effects of dance styles and number of sessions. Complement Ther Med 2016; 27:68-73. [DOI: 10.1016/j.ctim.2016.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/13/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022] Open
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Tang BL. Sirtuins as modifiers of Parkinson's disease pathology. J Neurosci Res 2016; 95:930-942. [DOI: 10.1002/jnr.23806] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 05/31/2016] [Accepted: 06/07/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Bor Luen Tang
- Department of Biochemistry; Yong Loo Lin School of Medicine, National University of Singapore; Singapore
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore; Singapore
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Subramanian L, Morris MB, Brosnan M, Turner DL, Morris HR, Linden DEJ. Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson's Disease: Randomized Trial. Front Behav Neurosci 2016; 10:111. [PMID: 27375451 PMCID: PMC4896907 DOI: 10.3389/fnbeh.2016.00111] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/23/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient's own brain activity to self-regulate brain networks which in turn could lead to a change in behavior and clinical symptoms. The objective was to determine the effect of NF and motor training (MOT) alone on motor and non-motor functions in Parkinson's Disease (PD) in a 10-week small Phase I randomized controlled trial. METHODS Thirty patients with Parkinson's disease (PD; Hoehn and Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with MOT. Group 2 (MOT: 15 patients) received MOT alone. The primary outcome measure was the Movement Disorder Society-Unified PD Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention "off-medication". The secondary outcome measures were the "on-medication" MDS-UPDRS, the PD Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks. RESULTS Patients in the NF group were able to upregulate activity in the supplementary motor area (SMA) by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the "off-medication" state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8). The improvement in the intervention group meets the minimal clinically important difference which is also on par with other non-invasive therapies such as repetitive Transcranial Magnetic Stimulation (rTMS). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group. INTERPRETATION This Phase I study suggests that NF combined with MOT is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.
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Affiliation(s)
- Leena Subramanian
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff UniversityCardiff, UK
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff UniversityCardiff, UK
| | - Monica Busse Morris
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff UniversityCardiff, UK
| | - Meadhbh Brosnan
- Trinity College Institute of Neuroscience, Trinity CollegeDublin, Ireland
- Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Duncan L. Turner
- Neurorehabilitation Unit, School of Health, Sport and Bioscience, University of East LondonLondon, UK
| | - Huw R. Morris
- Department of Clinical Neuroscience, Institute of Neurology, University College LondonLondon, UK
| | - David E. J. Linden
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff UniversityCardiff, UK
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff UniversityCardiff, UK
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Lopes JBP, Lameira de Melo GE, Lazzari RD, Santos CA, Franco de Moura RC, Dumont AJL, Braun LAF, Duarte NAC, Pareira RB, Miziara IM, Oliveira CS. Measures used for the evaluation of balance in individuals with Parkinson's disease: a systematic review. J Phys Ther Sci 2016; 28:1936-42. [PMID: 27390451 PMCID: PMC4932092 DOI: 10.1589/jpts.28.1936] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/15/2016] [Indexed: 01/29/2023] Open
Abstract
[Purpose] The present literature review was conducted on the use of different measures for the evaluation of balance in patients with Parkinson's disease. [Materials and Methods] The PubMed, Bireme, SciELO, Lilacs, and PEDro electronic databases were searched for relevant studies. [Results] The searches initially led to the retrieval of 3,623 articles, 540 of which were potentially eligible after limiting the search to clinical trials published in the last five years. A total of 264 duplicates were removed, and 276 articles were excluded based on their titles and abstracts. The full texts of 84 articles were analyzed, and only those with a PEDro score higher than four points (n=25) were included in the review. [Conclusion] Different methods, such as scales, tests, and equipment, are used for the evaluation of balance in patients with Parkinson's disease. More than one measure has been employed in most studies, and there is no consensus on a single precise measure for the evaluation of balance in this population.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rodolfo Borges Pareira
- School of Postural and Manual Therapy, Salgado Institute of
Integral Health, Paraná, Brazil
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128
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Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments? BRAIN IMPAIR 2016. [DOI: 10.1017/brimp.2016.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.
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Abstract
Over the past 60 years, a large number of selective neurotoxins were discovered and developed, making it possible to animal-model a broad range of human neuropsychiatric and neurodevelopmental disorders. In this paper, we highlight those neurotoxins that are most commonly used as neuroteratologic agents, to either produce lifelong destruction of neurons of a particular phenotype, or a group of neurons linked by a specific class of transporter proteins (i.e., dopamine transporter) or body of receptors for a specific neurotransmitter (i.e., NMDA class of glutamate receptors). Actions of a range of neurotoxins are described: 6-hydroxydopamine (6-OHDA), 6-hydroxydopa, DSP-4, MPTP, methamphetamine, IgG-saporin, domoate, NMDA receptor antagonists, and valproate. Their neuroteratologic features are outlined, as well as those of nerve growth factor, epidermal growth factor, and that of stress. The value of each of these neurotoxins in animal modeling of human neurologic, neurodegenerative, and neuropsychiatric disorders is discussed in terms of the respective value as well as limitations of the derived animal model. Neuroteratologic agents have proven to be of immense importance for understanding how associated neural systems in human neural disorders may be better targeted by new therapeutic agents.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, Box 500, 430 50, Gothenburg, Sweden.
| | - Richard M Kostrzewa
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, PO Box 70577, Johnson City, TN, 37614, USA
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Archer T, Kostrzewa RM. Exercise and Nutritional Benefits in PD: Rodent Models and Clinical Settings. Curr Top Behav Neurosci 2016; 29:333-351. [PMID: 26728168 DOI: 10.1007/7854_2015_409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Physical exercise offers a highly effective health-endowering activity as has been evidence using rodent models of Parkinson's disease (PD). It is a particularly useful intervention in individuals employed in sedentary occupations or afflicted by a neurodegenerative disorder, such as PD. The several links between exercise and quality-of-life, disorder progression and staging, risk factors and symptoms-biomarkers in PD all endower a promise for improved prognosis. Nutrition provides a strong determinant for disorder vulnerability and prognosis with fish oils and vegetables with a mediterranean diet offering both protection and resistance. Three factors determining the effects of exercise on disorder severity of patients may be presented: (i) Exercise effects upon motor impairment, gait, posture and balance, (ii) Exercise reduction of oxidative stress, stimulation of mitochondrial biogenesis and up-regulation of autophagy, and (iii) Exercise stimulation of dopamine (DA) neurochemistry and trophic factors. Running-wheel performance, as measured by distance run by individual mice from different treatment groups, was related to DA-integrity, indexed by striatal DA levels. Finally, both nutrition and exercise may facilitate positive epigenetic outcomes, such as lowering the dosage of L-Dopa required for a therapeutic effect.
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Affiliation(s)
- Trevor Archer
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
| | - Richard M Kostrzewa
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, 37604, USA
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Picelli A, Herman T, Paul SS, King LA. Rehabilitation Procedures in the Management of Parkinson's Disease. PARKINSON'S DISEASE 2015; 2015:824056. [PMID: 26798550 PMCID: PMC4699042 DOI: 10.1155/2015/824056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 11/16/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurological, Biomedical and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Talia Herman
- Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, 64239 Tel Aviv, Israel
| | - Serene S. Paul
- Department of Physical Therapy, University of Utah, Salt Lake City, UT 84108, USA
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Laurie A. King
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
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