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Fabbri M, Barbosa R, Rascol O. Off-time Treatment Options for Parkinson's Disease. Neurol Ther 2023; 12:391-424. [PMID: 36633762 PMCID: PMC10043092 DOI: 10.1007/s40120-022-00435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
Motor fluctuations (MF) are deemed by patients with Parkinson's disease (PD) as the most troublesome disease feature resulting from the increasing impairment in responsiveness to dopaminergic drug treatments. MF are characterized by the loss of a stable response to levodopa over the nychthemeron with the reappearance of motor (and non-motor) parkinsonian clinical signs at various moments during the day and night. They normally appear after a few years of levodopa treatment and with a variable, though overall increasing severity, over the disease course. The armamentarium of first-line treatment options has widened in the last decade with new once-a-daily compounds, including a catechol O-methyltransferase inhibitor - Opicapone-, two MAO-B inhibitors plus channel blocker - Zonisamide and Safinamide and one amantadine extended-release formulation - ADS5012. In addition to apomorphine injection or oral levodopa dispersible tablets, which have been available for a long time, new on-demand therapies such as apomorphine sublingual or levodopa inhaled formulations have recently shown efficacy as rescue therapies for Off-time treatment. When the management of MF becomes difficult in spite of oral/on-demand options, more complex therapies should be considered, including surgical, i.e. deep brain stimulation, or device-aided therapies with pump systems delivering continuous subcutaneous or intestinal levodopa or subcutaneous apomorphine formulation. Older and less commonly used ablative techniques (radiofrequency pallidotomy) may also be effective while there is still scarce data regarding Off-time reduction using a new lesional approach, i.e. magnetic resonance-guided focused ultrasound. The choice between the different advanced therapies options is a shared decision that should consider physician opinion on contraindication/main target symptom, patients' preference, caregiver's availability together with public health systems and socio-economic environment. The choice of the right/first add-on treatment is still a matter of debate as well as the proper time for an advanced therapy to be considered. In this narrative review, we discuss all the above cited aspects of MF in patients with PD, including their phenomenology, management, by means of pharmacological and advanced therapies, on-going clinical trials and future research and treatment perspectives.
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Affiliation(s)
- Margherita Fabbri
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.
| | - Raquel Barbosa
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.,Department of Neurology, Hospital de Egas Moniz Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa, Lisbon, Portugal
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
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Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 1:CD013856. [PMID: 36602886 PMCID: PMC9815433 DOI: 10.1002/14651858.cd013856.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear. OBJECTIVES To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs). SEARCH METHODS An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. MAIN RESULTS We included 156 RCTs with a total of 7939 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 71 (3196 participants), and 55 (3283 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (71 studies; 3196 participants) suggests that dance has a moderate beneficial effect on the severity of motor signs (mean difference (MD) -10.32, 95% confidence interval (CI) -15.54 to -4.96; high confidence), and aqua-based, gait/balance/functional, and multi-domain training might have a moderate beneficial effect on the severity of motor signs (aqua-based: MD -7.77, 95% CI -13.27 to -2.28; gait/balance/functional: MD -7.37, 95% CI -11.39 to -3.35; multi-domain: MD -6.97, 95% CI -10.32 to -3.62; low confidence). The evidence also suggests that mind-body training and endurance training might have a small beneficial effect on the severity of motor signs (mind-body: MD -6.57, 95% CI -10.18 to -2.81; endurance: MD -6.43, 95% CI -10.72 to -2.28; low confidence). Flexibility training might have a trivial or no effect on the severity of motor signs (MD 2.01, 95% CI -4.82 to 8.98; low confidence). The evidence is very uncertain about the effects of strength/resistance training and "Lee Silverman Voice training BIG" (LSVT BIG) on the severity of motor signs (strength/resistance: MD -6.97, 95% CI -11.93 to -2.01; LSVT BIG: MD -5.49, 95% CI -14.74 to 3.62; very low confidence). Quality of life The evidence from the NMA (55 studies; 3283 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -14.98, 95% CI -23.26 to -6.52; moderate confidence). The evidence also suggests that endurance training might have a moderate beneficial effect, and that gait/balance/functional and multi-domain training might have a small beneficial effect on QoL (endurance: MD -9.16, 95% CI -15.68 to -2.82; gait/balance/functional: MD -5.64, 95% CI -10.04 to -1.23; multi-domain: MD -5.29, 95% CI -9.34 to -1.06; low confidence). The evidence is very uncertain about the effects of mind-body training, gaming, strength/resistance training, dance, LSVT BIG, and flexibility training on QoL (mind-body: MD -8.81, 95% CI -14.62 to -3.00; gaming: MD -7.05, 95% CI -18.50 to 4.41; strength/resistance: MD -6.34, 95% CI -12.33 to -0.35; dance: MD -4.05, 95% CI -11.28 to 3.00; LSVT BIG: MD 2.29, 95% CI -16.03 to 20.44; flexibility: MD 1.23, 95% CI -11.45 to 13.92; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types. AUTHORS' CONCLUSIONS We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD.
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Affiliation(s)
- Moritz Ernst
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Lieker
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Caro-Valenzuela
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Cryns
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Resarch, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Ambulatory Assessment in Psychology, Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Dolan C, McDermott A. The impact of Covid-19 restrictions in Ireland on symptom severity in mild to moderate Parkinson's disease. Br J Occup Ther 2023; 86:20-25. [PMID: 38603229 PMCID: PMC9557271 DOI: 10.1177/03080226221120477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
Introduction The COVID pandemic and public health restrictions significantly impacted those living with neurological conditions such as Parkinson's Disease due to the curtailment of therapies. Patients attending a single centre movement disorders clinic reported reduced physical activity and quality of life during the pandemic. This study aimed to assess the impact of pandemic restrictions on Parkinson's Disease symptom severity in people with mild to moderate Parkinson's Disease. Method A cross-sectional study design with a convenience sample of 20 people living with mild to moderate Parkinson's Disease was adopted. A telephone survey questionnaire was completed to measure changes in symptom severity on the 14 most common Parkinson's Disease symptoms. Data were analysed using descriptive statistics. Results Nineteen participants completed the survey. Participants frequently reported a decline in nine symptoms of Parkinson's Disease; bradykinesia, rigidity, walking, sleep, mood, memory, quality of life and fatigue. Nil changes in freezing were reported. No change was reported in the nonmotor symptoms of constipation, speech and pain in 75, 65 and 95% of participants, respectively. Conclusion Findings of this study acknowledge the negative impact of restrictions on the motor and nonmotor symptoms of Parkinson's Disease. Flexibility to access and delivery of service should be considered to mitigate any future potential restrictions.
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104
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Oosterwegel MJ, Krijthe JH, den Brok MGHE, van den Heuvel L, Richard E, Heskes T, Bloem BR, Evers LJW. The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis. Front Neurol 2023; 14:1138546. [PMID: 37122316 PMCID: PMC10130532 DOI: 10.3389/fneur.2023.1138546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Background Currently available treatment options for Parkinson's disease are symptomatic and do not alter the course of the disease. Recent studies have raised the possibility that cardiovascular risk management may slow the progression of the disease. Objectives We estimated the effect of baseline cardiovascular risk factors on the progression of Parkinson's disease, using measures for PD-specific motor signs and cognitive functions. Methods We used data from 424 de novo Parkinson's disease patients and 199 age-matched controls from the observational, multicenter Parkinson's Progression Markers Initiative (PPMI) study, which included follow-up of up to 9 years. The primary outcome was the severity of PD-specific motor signs, assessed with the MDS-UPDRS part III in the "OFF"-state. The secondary outcome was cognitive function, measured with the Montreal Cognitive Assessment, Symbol Digit Modalities Test, and Letter-Number Sequencing task. Exposures of interest were diabetes mellitus, hypertension, body mass index, cardiovascular event history and hypercholesterolemia, and a modified Framingham risk score, measured at baseline. The effect of each of these exposures on disease progression was modeled using linear mixed models, including adjustment for identified confounders. A secondary analysis on the Tracking Parkinson's cohort including 1,841 patients was performed to validate our findings in an independent patient cohort. Results Mean age was 61.4 years, and the average follow-up was 5.5 years. We found no statistically significant effect of any individual cardiovascular risk factor on the MDS-UPDRS part III progression (all 95% confidence intervals (CIs) included zero), with one exception: in the PD group, the estimated effect of a one-point increase in body mass index was 0.059 points on the MDS-UPDRS part III per year (95% CI: 0.017 to 0.102). We found no evidence for an effect of any of the exposures on the rate of change in cognitive functioning in the PD group. Similar results were observed for the Tracking Parkinson's cohort (all 95% CIs overlapped with PPMI), but the 95% CI of the effect of body mass index on the MDS-UPDRS part III progression included zero. Conclusions Based on this analysis of two large cohorts of de novo PD patients, we found no evidence to support clinically relevant effects of cardiovascular risk factors on the clinical progression of Parkinson's disease.
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Affiliation(s)
- Max J. Oosterwegel
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, Netherlands
- *Correspondence: Max J. Oosterwegel
| | - Jesse H. Krijthe
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
| | - Melina G. H. E. den Brok
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Neurology, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands
| | - Lieneke van den Heuvel
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Edo Richard
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Neurology, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands
| | - Tom Heskes
- Department of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, Netherlands
| | - Bastiaan R. Bloem
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Luc J. W. Evers
- Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, Netherlands
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Magaña JC, Deus CM, Giné-Garriga M, Montané J, Pereira SP. Exercise-Boosted Mitochondrial Remodeling in Parkinson's Disease. Biomedicines 2022; 10:biomedicines10123228. [PMID: 36551984 PMCID: PMC9775656 DOI: 10.3390/biomedicines10123228] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a movement disorder characterized by the progressive degeneration of dopaminergic neurons resulting in dopamine deficiency in the striatum. Given the estimated escalation in the number of people with PD in the coming decades, interventions aimed at minimizing morbidity and improving quality of life are crucial. Mitochondrial dysfunction and oxidative stress are intrinsic factors related to PD pathogenesis. Accumulating evidence suggests that patients with PD might benefit from various forms of exercise in diverse ways, from general health improvements to disease-specific effects and, potentially, disease-modifying effects. However, the signaling and mechanism connecting skeletal muscle-increased activity and brain remodeling are poorly elucidated. In this review, we describe skeletal muscle-brain crosstalk in PD, with a special focus on mitochondrial effects, proposing mitochondrial dysfunction as a linker in the muscle-brain axis in this neurodegenerative disease and as a promising therapeutic target. Moreover, we outline how exercise secretome can improve mitochondrial health and impact the nervous system to slow down PD progression. Understanding the regulation of the mitochondrial function by exercise in PD may be beneficial in defining interventions to delay the onset of this neurodegenerative disease.
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Affiliation(s)
- Juan Carlos Magaña
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, 08022 Barcelona, Spain
| | - Cláudia M. Deus
- CNC—Center for Neuroscience and Cell Biology, CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- Correspondence: (C.M.D.); (J.M.)
| | - Maria Giné-Garriga
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, 08022 Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
| | - Joel Montané
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, 08022 Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
- Correspondence: (C.M.D.); (J.M.)
| | - Susana P. Pereira
- CNC—Center for Neuroscience and Cell Biology, CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, 4150-564 Porto, Portugal
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106
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Zajac JA, Cavanaugh JT, Baker T, Duncan RP, Fulford D, Girnis J, LaValley M, Nordahl T, Porciuncula F, Rawson KS, Saint-Hilaire M, Thomas CA, Earhart GM, Ellis TD. Does clinically measured walking capacity contribute to real-world walking performance in Parkinson's disease? Parkinsonism Relat Disord 2022; 105:123-127. [PMID: 36423521 PMCID: PMC9722599 DOI: 10.1016/j.parkreldis.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/05/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The study examined how clinically measured walking capacity contributes to real-world walking performance in persons with Parkinson's disease (PD). METHODS Cross-sectional baseline data (n = 82) from a PD clinical trial were analyzed. The 6-Minute Walk Test (6MWT) and 10-Meter Walk Test (10MWT) were used to generate capacity metrics of walking endurance and fast gait speed, respectively. An activity monitor worn for seven days was used to generate performance metrics of mean daily steps and weekly moderate intensity walking minutes. Univariate linear regression analyses were used to examine associations between each capacity and performance measure in the full sample and less and more active subgroups. RESULTS Walking capacity significantly contributed to daily steps in the full sample (endurance: R2=.13, p < .001; fast gait speed: R2=.07, p = .017) and in the less active subgroup (endurance: R2 =.09, p = .045). Similarly, walking capacity significantly contributed to weekly moderate intensity minutes in the full sample (endurance: R2=.13, p < .001; fast gait speed: R2=.09, p = .007) and less active subgroup (endurance: R2 = .25, p < .001; fast gait speed: R2 =.21, p = .007). Walking capacity did not significantly contribute to daily steps or moderate intensity minutes in the more active subgroup. CONCLUSIONS Walking capacity contributed to, but explained a relatively small portion of the variance in, real-world walking performance. The contribution was somewhat greater in less active individuals. The study adds support to the idea that clinically measured walking capacity may have limited benefit for understanding real-world walking performance in PD. Factors beyond walking capacity may better account for actual walking behavior.
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Affiliation(s)
- Jenna A Zajac
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA.
| | - James T Cavanaugh
- Department of Physical Therapy, University of New England, Portland, ME, USA
| | - Teresa Baker
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Ryan P Duncan
- Program in Physical Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Neurology, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Daniel Fulford
- Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Jaimie Girnis
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | | | - Timothy Nordahl
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Franchino Porciuncula
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Kerri S Rawson
- Program in Physical Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Marie Saint-Hilaire
- Department of Neurology, Parkinson's Disease and Movement Disorders Center, Boston University, Boston, MA, USA
| | - Cathi A Thomas
- Department of Neurology, Parkinson's Disease and Movement Disorders Center, Boston University, Boston, MA, USA
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Neurology, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Neuroscience, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Terry D Ellis
- Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
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107
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Gallou-Guyot M, Nuic D, Mandigout S, Compagnat M, Welter ML, Daviet JC, Perrochon A. Effectiveness of home-based rehabilitation using active video games on quality of life, cognitive and motor functions in people with Parkinson's disease: a systematic review. Disabil Rehabil 2022; 44:8222-8233. [PMID: 34982599 DOI: 10.1080/09638288.2021.2022780] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE We summarized the effectiveness of home-based active video game interventions on physical and cognitive functions, as well as quality of life in adults with Parkinson's disease. We also assessed the feasibility, safety, adherence, and retention of benefits of these interventions. METHOD We searched studies in eight databases from 1st March to 30th November 2020. Two authors independently performed the selection, data extraction and risk of bias evaluation (PROSPERO ID: CRD42020178138). RESULTS Nine studies were included in this systematic review (412 participants). All in all, home-based active video games were found effective in improving gait and balance functions in people with Parkinson's disease, equivalent to usual care and conventional therapy. No conclusion can be drawn on cognition and quality of life. Home-based active video games seemed feasible, safe, and were enjoyed by people with Parkinson's disease. The optimal dose, the need for supervision and the retention of benefits of these interventions are still to be determined. These results should be interpreted carefully, considering the limited number of included studies and their small sample sizes, the widespread heterogeneity of included studies and their medium average methodological quality. CONCLUSION Future research should focus on the effects of home-based active video games on impairments specific to Parkinson's disease, such as falls, freezing of gait and attention, as well as the dose, need for supervision and retention of the benefits of these interventions.IMPLICATIONS FOR REHABILITATIONHome-based active video games are effective in improving motor functions in people with PD.No conclusion can be drawn regarding cognition in people with PD.No conclusion can be drawn regarding quality of life in people with PD.Home-based active video games seem feasible and safe, and are enjoyed by people with PD.The dose, need for control and retention of the benefits still need to be determined.
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Affiliation(s)
- M Gallou-Guyot
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - D Nuic
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Mandigout
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
| | - M Compagnat
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - M L Welter
- Institut du Cerveau, Sorbonne Université, CNRS UMR 7225, INSERM 1127, Hôpital de la Pitié-Salpêtrière, Paris, France.,Département de Neurophysiologie, CHU Rouen, Rouen, France
| | - J C Daviet
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France.,Pôle Neurosciences tête et cou, Service de Médecine Physique et de Réadaptation, Hôpital Rebeyrol, CHU Limoges, Limoges, France
| | - A Perrochon
- Laboratoire Handicap, Activités Vieillissement, Autonomie, Environnement (HAVAE, EA 6310), Faculté des Sciences et Techniques, Université de Limoges, Limoges, France
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108
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Li F, Wang D, Ba X, Liu Z, Zhang M. The comparative effects of exercise type on motor function of patients with Parkinson's disease: A three-arm randomized trial. Front Hum Neurosci 2022; 16:1033289. [PMID: 36530197 PMCID: PMC9751317 DOI: 10.3389/fnhum.2022.1033289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/20/2022] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Yang-ge dancing is a culturally specific exercise in which people are required to perform motor skills in coordination with rhythmic music. As an integrated exercise with both physical (decelerating the progression of aged-related motor function degeneration) and mental benefits, it has gained great popularity in China, especially among middle-aged and older adults. It remains largely unknown whether Yang-ge dancing (YG) can effectively improve main symptoms of Parkinson's disease (PD), while conventional exercise rehabilitation program has been recommended in the hospital setting. To this end, this study aimed to investigate the comparative effects of exercise therapy on motor function of PD patients. MATERIALS AND METHODS A sample of 51 PD patients were randomly assigned to Yang-ge dancing, conventional exercise, or conventional exercise with music. Participants in each group performed 60 min per session, five sessions per week of interventions for 4 weeks. All the participants were assessed using the Unified Parkinson's Disease Rating Scale-motor examination, Berg balance test, timed up and go test, and Purdue pegboard test. Motor performances were examined before and after intervention. RESULTS All the three groups were benefited from exercise. Compared to conventional exercise, the Yang-ge dancing and conventional exercise with music had additional positive effects in mobility with reference to baseline.In addition, compared to the two conventional exercise groups (either with/without music), the Yang-ge dancing further enhanced manual dexterity. CONCLUSION Exercise with rhythmic auditory stimulation optimized mobility in PD, while YG dance specifically contributed to improvement in manual dexterity. CLINICAL TRIAL REGISTERATION [https://clinicaltrials.gov/], identifier [ChiCTR2200061252].
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Affiliation(s)
- Fang Li
- Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Dongyu Wang
- Department of Neurology, The Center Hospital of Jinzhou, Jinzhou, China
| | - Xiaohong Ba
- Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Zhan Liu
- Department of Physical Education and Health Education, Springfield College, Springfield, MA, United States
| | - Meiqi Zhang
- Department of Physical Education and Health Education, Springfield College, Springfield, MA, United States
- Learning-Based Recovery Center, Yale University, New Haven, CT, United States
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109
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Afraie M, Moradi G, Mohammadzedeh P, Azami M, Riyahifar S, Moradi Y. COVID-19 and Parkinson’s disease: a systematic review and meta-analysis. Acta Neurol Belg 2022:10.1007/s13760-022-02141-6. [PMCID: PMC9668237 DOI: 10.1007/s13760-022-02141-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022]
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110
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Gaßner H, Friedrich J, Masuch A, Jukic J, Stallforth S, Regensburger M, Marxreiter F, Winkler J, Klucken J. The Effects of an Individualized Smartphone-Based Exercise Program on Self-defined Motor Tasks in Parkinson Disease: Pilot Interventional Study. JMIR Rehabil Assist Technol 2022; 9:e38994. [PMID: 36378510 PMCID: PMC9709672 DOI: 10.2196/38994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/10/2022] [Accepted: 09/07/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Bradykinesia and rigidity are prototypical motor impairments of Parkinson disease (PD) highly influencing everyday life. Exercise training is an effective treatment alternative for motor symptoms, complementing dopaminergic medication. High frequency training is necessary to yield clinically relevant improvements. Exercise programs need to be tailored to individual symptoms and integrated in patients' everyday life. Due to the COVID-19 pandemic, exercise groups in outpatient setting were largely reduced. Developing remotely supervised solutions is therefore of significant importance. OBJECTIVE This pilot study aimed to evaluate the feasibility of a digital, home-based, high-frequency exercise program for patients with PD. METHODS In this pilot interventional study, patients diagnosed with PD received 4 weeks of personalized exercise at home using a smartphone app, remotely supervised by specialized therapists. Exercises were chosen based on the patient-defined motor impairment and depending on the patients' individual capacity (therapists defined 3-5 short training sequences for each participant). In a first education session, the tailored exercise program was explained and demonstrated to each participant and they were thoroughly introduced to the smartphone app. Intervention effects were evaluated using the Unified Parkinson Disease Rating Scale, part III; standardized sensor-based gait analysis; Timed Up and Go Test; 2-minute walk test; quality of life assessed by the Parkinson Disease Questionnaire; and patient-defined motor tasks of daily living. Usability of the smartphone app was assessed by the System Usability Scale. All participants gave written informed consent before initiation of the study. RESULTS In total, 15 individuals with PD completed the intervention phase without any withdrawals or dropouts. The System Usability Scale reached an average score of 72.2 (SD 6.5) indicating good usability of the smartphone app. Patient-defined motor tasks of daily living significantly improved by 40% on average in 87% (13/15) of the patients. There was no significant impact on the quality of life as assessed by the Parkinson Disease Questionnaire (but the subsections regarding mobility and social support improved by 14% from 25 to 21 and 19% from 15 to 13, respectively). Motor symptoms rated by Unified Parkinson Disease Rating Scale, part III, did not improve significantly but a descriptive improvement of 14% from 18 to 16 could be observed. Clinically relevant changes in Timed Up and Go test, 2-minute walk test, and sensor-based gait parameters or functional gait tests were not observed. CONCLUSIONS This pilot interventional study presented that a tailored, digital, home-based, and high-frequency exercise program over 4 weeks was feasible and improved patient-defined motor activities of daily life based on a self-developed patient-defined impairment score indicating that digital exercise concepts may have the potential to beneficially impact motor symptoms of daily living. Future studies should investigate sustainability effects in controlled study designs conducted over a longer period.
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Affiliation(s)
- Heiko Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
- Digital Health Systems, Fraunhofer Institute for Integrated Circuits (IIS), Erlangen, Germany
| | - Jana Friedrich
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Alisa Masuch
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Jelena Jukic
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Sabine Stallforth
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
- Medical Valley, Digital Health Application Center GmbH, Bamberg, Germany
| | - Martin Regensburger
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Franz Marxreiter
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Jochen Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Erlangen, Germany
- Digital Health Systems, Fraunhofer Institute for Integrated Circuits (IIS), Erlangen, Germany
- Medical Valley, Digital Health Application Center GmbH, Bamberg, Germany
- Digital Medicine Group, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Digital Medicine Group, Department of Precision Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Digital Medicine Group, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
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111
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Rosenfeldt AB, Miller Koop M, Penko AL, Hastilow K, Zimmerman E, Schindler D, Alberts JL. Community-based high-intensity cycling improves disease symptoms in individuals with Parkinson's disease: A six-month pragmatic observational study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6122-e6134. [PMID: 36214623 PMCID: PMC10092122 DOI: 10.1111/hsc.14049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Participation in supervised, laboratory-based aerobic exercise protocols holds promise in slowing the progression of Parkinson's disease (PD). Gaps remain regarding exercise adherence and effectiveness of laboratory protocols translated to community-based programs. The aim of the project was to monitor exercise behaviour and evaluate its effect on disease progression over a 6 month period in people with PD participating in a community-based Pedalling for Parkinson's (PFP) cycling program. A pragmatic, observational study design was utilised to monitor exercise behaviour at five community sites. The Movement Disorders Society-Unified Parkinson's disease Rating Scale Motor III (MDS-UPDRS-III) and other motor and non-motor outcomes were gathered at enrollment and following 6 months of exercise. Attendance, heart rate, and cadence data were collected for each exercise session. On average, people with PD (N = 41) attended nearly 65% of the offered PFP classes. Average percent of age-estimated maximum heart rate was 69.3 ± 11.9%; average cadence was 74.9 ± 9.0 rpms. The MDS-UPDRS III significantly decreased over the 6-month exercise period (37.2 ± 11.7 to 33.8 ± 11.7, p = 0.001) and immediate recall significantly improved (42.3 ± 12.4 to 47.1 ± 12.7, p = 0.02). Other motor and non-motor metrics did not exhibit significant improvement. Participants who attended ~74% or more of available PFP classes experienced the greatest improvement in MDS-UPDRS III scores; of those who attended less than 74% of classes, cycling greater than or equal to 76 rpms lead to improvement. Attendance and exercise intensity data indicated that a laboratory-based exercise protocol can be successfully translated to a community setting. Consistent attendance and pedalling at a relatively high cadence may be key variables to PD symptom mitigation. Improvement in clinical ratings coupled with lack of motor and non-motor symptom progression over 6 months provides rationale for further investigation of the real-world, disease-modifying potential of aerobic exercise for people with PD.
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Affiliation(s)
- Anson B. Rosenfeldt
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Mandy Miller Koop
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Amanda L. Penko
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Karissa Hastilow
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Eric Zimmerman
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - David Schindler
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
| | - Jay L. Alberts
- Department of Biomedical Engineering, Lerner Research InstituteCleveland ClinicClevelandOhioUSA
- Neurological Institute, Center for Neurological RestorationCleveland ClinicClevelandOhioUSA
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112
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Zhen K, Zhang S, Tao X, Li G, Lv Y, Yu L. A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson's disease. NPJ Parkinsons Dis 2022; 8:146. [PMID: 36316416 PMCID: PMC9622812 DOI: 10.1038/s41531-022-00418-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Previous studies have shown that aerobic exercise is an effective way to improve symptoms of Parkinson's disease (PD). The aim of this study [PROSPERO CRD42022340730] was to explore the effects of aerobic exercises on balance, gait, motor function, and quality of life in PD patients. Searches were performed in PubMed, Web of Science, and EBSCO electronic databases. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1287 search records initially identified, 20 studies were considered eligible for systematic review and meta-analysis. There was a significant effect of aerobic exercise on improving timed up and go test [standardized mean difference (SMD), -0.41 (95% CI, -0.61 to -0.22), p < 0.00001], Berg Balance Scale [0.99 (95% CI, 0.76 to 1.23), p < 0.00001], stride/step length [0.32 (95% CI, 0.03 to 0.61), p = 0.03], gait velocity [0.49 (95% CI, 0.20 to 0.78), p = 0.0009], Unified Parkinson's Disease Rating Scale Part-III [-0.40 (95% CI, -0.55 to -0.24), p < 0.00001], and 6-minute walking test [0.35 (95% CI, 0.13 to 0.56), p = 0.002] in people with PD, but not in step cadence [-0.08 (95% CI, -0.43 to 0.27), p = 0.65] and Parkinson's Disease Questionnaire-39 [-0.113 (95% CI, -0.39 to 0.13), p = 0.32]. Aerobic exercise had beneficial effects in improving balance, gait (velocity and stride/step length), and motor function in PD patients. However, aerobic exercise had no significant associations with the step cadence and quality of life in PD patients.
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Affiliation(s)
- Kai Zhen
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Gen Li
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
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113
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Weintraub D, Aarsland D, Biundo R, Dobkin R, Goldman J, Lewis S. Management of psychiatric and cognitive complications in Parkinson's disease. BMJ 2022; 379:e068718. [PMID: 36280256 DOI: 10.1136/bmj-2021-068718] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson's disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Roberta Biundo
- Department of General Psychology, University of Padua, Padua, Italy
- Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer Goldman
- Shirley Ryan AbilityLab, Parkinson's Disease and Movement Disorders, Chicago, IL
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
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114
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Yang G, Dong Q, Yang H, Wang F, Chen L, Tang J, Huang G, Zhao Y. Changes Observed in Potential Key Candidate Genes of Peripheral Immunity Induced by Tai Chi among Patients with Parkinson's Disease. Genes (Basel) 2022; 13:genes13101863. [PMID: 36292747 PMCID: PMC9601924 DOI: 10.3390/genes13101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/04/2022] Open
Abstract
Parkinson’s disease (PD) is a common progressive neurodegenerative disease characterized by motor dysfunction. Although the inhibition of inflammation by Tai Chi has been demonstrated to involve a peripheral cytokine response and may play an important role in improving the motor function of PD patients, the related specific molecular mechanisms of the peripheral immune response to Tai Chi are not fully understood. The microarray dataset ‘GSE124676’ for the peripheral immune response to Tai Chi of PD patients was downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were screened and analyzed using weighted gene co-expression network analysis (WGCNA). A total of 136 DEGs were found in the PD patients after Tai Chi, suggesting an effect of Tai Chi on the peripheral immunity of PD patients. The DEGs are mainly involved in neutrophil activation, T-cell activation, and NOD-like receptor and IL-17 signaling pathways. Furthermore, six key candidate genes (FOS, FOSB, JUNB, ZFP36, CAMP and LCN2) that are involved in peripheral inflammation and the inhibition of inflammation induced by Tai Chi were observed. The results in the present study could be conducive to comprehensively understanding the molecular mechanism involved in the effect of Tai Chi on peripheral inflammation in PD patients and providing novel targets for future advanced research.
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Affiliation(s)
- Guang Yang
- Physical Education Department, Shanghai Jiao Tong University, Shanghai 200042, China
| | - Qun Dong
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Huixin Yang
- Institute of Nation Traditional Sports, Harbin Sport University, Harbin 150006, China
| | - Fan Wang
- Institute of Nation Traditional Sports, Harbin Sport University, Harbin 150006, China
| | - Linwei Chen
- Institute of Nation Traditional Sports, Harbin Sport University, Harbin 150006, China
| | - Junze Tang
- Institute of Nation Traditional Sports, Harbin Sport University, Harbin 150006, China
| | - Guoyuan Huang
- Pott College of Science, Engineering and Education, University of Southern Indiana, Indiana, IN 47712, USA
- Correspondence: (G.H.); (Y.Z.)
| | - Ying Zhao
- Physical Education Department, Shanghai Jiao Tong University, Shanghai 200042, China
- Correspondence: (G.H.); (Y.Z.)
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115
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Patterson CG, Joslin E, Gil AB, Spigle W, Nemet T, Chahine L, Christiansen CL, Melanson E, Kohrt WM, Mancini M, Josbeno D, Balfany K, Griffith G, Dunlap MK, Lamotte G, Suttman E, Larson D, Branson C, McKee KE, Goelz L, Poon C, Tilley B, Kang UJ, Tansey MG, Luthra N, Tanner CM, Haus JM, Fantuzzi G, McFarland NR, Gonzalez-Latapi P, Foroud T, Motl R, Schwarzschild MA, Simuni T, Marek K, Naito A, Lungu C, Corcos DM. Study in Parkinson's disease of exercise phase 3 (SPARX3): study protocol for a randomized controlled trial. Trials 2022; 23:855. [PMID: 36203214 PMCID: PMC9535216 DOI: 10.1186/s13063-022-06703-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To date, no medication has slowed the progression of Parkinson's disease (PD). Preclinical, epidemiological, and experimental data on humans all support many benefits of endurance exercise among persons with PD. The key question is whether there is a definitive additional benefit of exercising at high intensity, in terms of slowing disease progression, beyond the well-documented benefit of endurance training on a treadmill for fitness, gait, and functional mobility. This study will determine the efficacy of high-intensity endurance exercise as first-line therapy for persons diagnosed with PD within 3 years, and untreated with symptomatic therapy at baseline. METHODS This is a multicenter, randomized, evaluator-blinded study of endurance exercise training. The exercise intervention will be delivered by treadmill at 2 doses over 18 months: moderate intensity (4 days/week for 30 min per session at 60-65% maximum heart rate) and high intensity (4 days/week for 30 min per session at 80-85% maximum heart rate). We will randomize 370 participants and follow them at multiple time points for 24 months. The primary outcome is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score (Part III) with the primary analysis assessing the change in MDS-UPDRS motor score (Part III) over 12 months, or until initiation of symptomatic antiparkinsonian treatment if before 12 months. Secondary outcomes are striatal dopamine transporter binding, 6-min walk distance, number of daily steps, cognitive function, physical fitness, quality of life, time to initiate dopaminergic medication, circulating levels of C-reactive protein (CRP), and brain-derived neurotrophic factor (BDNF). Tertiary outcomes are walking stride length and turning velocity. DISCUSSION SPARX3 is a Phase 3 clinical trial designed to determine the efficacy of high-intensity, endurance treadmill exercise to slow the progression of PD as measured by the MDS-UPDRS motor score. Establishing whether high-intensity endurance treadmill exercise can slow the progression of PD would mark a significant breakthrough in treating PD. It would have a meaningful impact on the quality of life of people with PD, their caregivers and public health. TRIAL REGISTRATION ClinicalTrials.gov NCT04284436 . Registered on February 25, 2020.
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Affiliation(s)
- Charity G. Patterson
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Elizabeth Joslin
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
| | - Alexandra B. Gil
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Wendy Spigle
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Todd Nemet
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Lana Chahine
- Department of Neurology, University of Pittsburgh, School of Medicine, 3471 Fifth Avenue, Pittsburgh, PA 15213 USA
| | - Cory L. Christiansen
- Department of Physical Medicine & Rehabilitation, University of Colorado, School of Medicine, Aurora, CO 80217 USA
| | - Ed Melanson
- Division of Endocrinology, Metabolism and Diabetes, and Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado VA Health Care System, Geriatric Research Education and Clinical Center (GRECC), Denver, CO USA
| | - Wendy M. Kohrt
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO USA
- Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VAMC, Aurora, USA
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Road, Portland, OR 97219 USA
| | - Deborah Josbeno
- Department of Physical Therapy, University of Pittsburgh, School of Health and Rehabilitation Sciences, 100 Technology Drive, Suite 500, Pittsburgh, PA 15219 USA
| | - Katherine Balfany
- Department of Physical Medicine & Rehabilitation, University of Colorado, School of Medicine, Aurora, CO 80217 USA
| | - Garett Griffith
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
| | - Mac Kenzie Dunlap
- Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 USA
| | - Guillaume Lamotte
- Movement Disorders Division, Department of Neurology, University of Utah, 175 Medical Dr N, Salt Lake City, UT 84132 USA
| | - Erin Suttman
- Department of Physical Therapy & Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 84115 USA
| | - Danielle Larson
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Chantale Branson
- Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310 USA
| | - Kathleen E. McKee
- Neurosciences Clinical Program, Intermountain Healthcare, 5171 S Cottonwood Street, Suite 810, Murray, UT 84107 USA
| | - Li Goelz
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Cynthia Poon
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Barbara Tilley
- Department of Biostatistics and Data Science, University of Texas Health Science Center School of Public Health, 1200 Pressler Street E835, Houston, TX 77030 USA
| | - Un Jung Kang
- NYU Langone Health, NYU Grossman School of Medicine, 435 E 30th Street, Science Building 1305, New York, NY 10016 USA
| | - Malú Gámez Tansey
- Department of Neuroscience and Neurology, Normal Fixel Institute for Neurological Diseases and College of Medicine, University of Florida, 4911 Newell Road, Gainesville, FL 32610 USA
| | - Nijee Luthra
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, 1651 4th Street, San Francisco, CA 94158 USA
| | - Caroline M. Tanner
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, 1651 4th Street, San Francisco, CA 94158 USA
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, 830 N. University Ave, Ann Arbor, MI 48109 USA
| | - Giamila Fantuzzi
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Nikolaus R. McFarland
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, College of Medicine, University of Florida, Gainesville, FL 32608 USA
| | - Paulina Gonzalez-Latapi
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN 46220 USA
| | - Robert Motl
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, 919 W Taylor Street, Chicago, IL 60612 USA
| | - Michael A. Schwarzschild
- Mass General Institute for Neurodegenerative Disease, Massachusetts General Hospital, Rm 3002, 114 16th Street, Boston, MA 02129 USA
| | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Suite 115, 710 N Lake Shore Drive, Chicago, IL 60611 USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, 60 Temple St, New Haven, CT 06510 USA
| | - Anna Naito
- Parkinson’s Foundation 200 SE 1st Street Suite 800, Miami, FL 33131 USA
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke, NIH, 6001 Executive Blvd, #2188, Rockville, MD 20852 USA
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Science, Northwestern University, Feinberg School of Medicine, Suite 1100, 645 North Michigan Avenue, Chicago, IL 60305 USA
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116
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Physical Activity Coaching via Telehealth for People With Parkinson Disease: A Cohort Study. J Neurol Phys Ther 2022; 46:240-250. [PMID: 36170256 DOI: 10.1097/npt.0000000000000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Physical activity (PA) has many known benefits for people with Parkinson disease (PD); however, many people do not meet recommended levels of frequency or intensity. We designed Engage-PD, a PA coaching program delivered via telehealth and grounded in self-determination theory to promote PA uptake and facilitate exercise self-efficacy in people with Parkinson disease. This study aimed to determine the feasibility and preliminary efficacy of Engage-PD, and to explore whether baseline characteristics were associated with outcomes. METHODS A single cohort of people with PD (n = 62, Hoehn and Yahr I-III) participated in the 3-month Engage-PD program, which consisted of up to 5 telehealth coaching sessions delivered by physical therapists. Feasibility was evaluated based on recruitment and retention rates, along with participants' feedback. Planned and unplanned PA, exercise self-efficacy (ESE), and individualized goals were assessed pre- and post-intervention. Relationships between baseline characteristics and changes in planned PA and ESE were also evaluated. RESULTS Recruitment (62%) and retention (85%) rates were high, and the intervention was well accepted and perceived by the participants. From pre- to postintervention, participants increased planned PA (d = 0.33), ESE (d = 1.20), and individualized goal performance (d = 1.63) and satisfaction (d = 1.70). Participants with lower baseline planned PA experienced greater improvements in planned PA, and those with lower baseline ESE experienced greater improvements in ESE. DISCUSSION AND CONCLUSIONS A telehealth PA coaching program for people with PD was feasible and potentially efficacious. Physical therapist-led coaching may be an important component of a consultative model of care starting early in the disease process.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A393).
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Machado S, Teixeira D, Monteiro D, Imperatori C, Murillo-Rodriguez E, da Silva Rocha FP, Yamamoto T, Amatriain-Fernández S, Budde H, Carta MG, Caixeta L, de Sá Filho AS. Clinical applications of exercise in Parkinson's disease: what we need to know? Expert Rev Neurother 2022; 22:771-780. [PMID: 36168890 DOI: 10.1080/14737175.2022.2128768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Exploring the potential of exercise in the rehabilitation process of patients with Parkinson's (PD) may be an interesting treatment perspective. Exercise-induced responses derived from neurotrophic elements appear to ameliorate the decline in neurodegeneration. Despite this understanding, the literature needs to be updated. AREAS COVERED Our review focuses on: a) the key mechanisms of exercise on PD, highlighting mainly the responses related to neuroplasticity; b) the effects induced by different traditional types of exercise, also highlighting the effects of complementary therapies related to movement; c) the volume of exercise required to support efficient results are explored in the context of PD. Additionally, the proposition of new clinical application strategies in the context of PD will also be determined. EXPERT OPINION It is suggested that different intensities of aerobic exercise be explored for the treatment of PD. The results associated with high intensity seem promising for performance, physiological and clinical parameters, such as BDNF production and cognition. On the other hand, the diversification of tasks and repetition of motor gestures appear as consistent arguments to exercise prescription. Finally, for future investigations, the neuromodulation strategy in association with aerobic exercise appears as a potential inducer of benefits on gait and cognitive function.
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Affiliation(s)
- Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.,Physical Activity Neuroscience Laboratory (LABNAF), Neurodiversity Institute, Queimados-RJ, Brazil.,Intercontinental Neuroscience Research Group, Mérida, Mexico
| | - Diogo Teixeira
- Universidade Lusófona, Faculty of Physical Education and Sport, Lisbon, Portugal; Research Center in Sport, Physical Education, and Exercise and Health (CIDEFES), Lisbon, Portugal
| | - Diogo Monteiro
- ESECS, Polytechnic of Leiria, 2411-901 Leiria, Portugal; Research Center in Sport, Health and Human Development (CIDESD), 5000-558, Vila Real, Portugal.,Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Claudio Imperatori
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Cognitive and Clinical Psychology Laboratory, Department of Human Sciences European University of Rome, Rome, Italy
| | - Eric Murillo-Rodriguez
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico
| | | | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Sandra Amatriain-Fernández
- Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Henning Budde
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Institute for Systems Medicine (ISM) at the Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Mauro Giovanni Carta
- Dipartimento di Sanità Pubblica, Università degli studi di Cagliari, Cagliari, Italy
| | - Leonardo Caixeta
- Neurology and Neuropsychiatry Department of Clinical Medicine, Federal University of Goiás, School of Medicine, Goiânia, Brazil
| | - Alberto Souza de Sá Filho
- Intercontinental Neuroscience Research Group, Mérida, Mexico.,Laboratorio de Neurociencias Moleculares e Integrativas, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mexico.,Department of Physical Education, Paulista University, Goiânia, Brazil
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Cao YT, Wang JJ, Yang YT, Zhu SJ, Zheng LD, Lu WW, Zhu R, Wu T. Effect of home-based exercise programs with e-devices on falls among community-dwelling older adults: a meta-analysis. J Comp Eff Res 2022; 11:1201-1217. [PMID: 36148921 DOI: 10.2217/cer-2022-0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To explore the effectiveness of home-based exercise programs with e-devices (HEPEs) on falls among community-dwelling older adults. Methods: Twelve randomized controlled trials were included in the meta-analysis considering four fall-related outcomes. Results: HEPEs significantly reduced the rate of falls (risk ratio: 0.82; 95% CI: 0.72-0.95; p = 0.006) and improved lower extremity strength (mean difference: -0.94; 95% CI: -1.71 to -0.47; p < 0.001). There was a significant improvement favoring HEPEs on balance if the participants were aged >75 years (mean difference: -0.55; 95% CI: -1.05 to -0.05; p = 0.03), or the intervention duration was at least 16 weeks (mean difference: -0.81; 95% CI: -1.58 to -0.05; p = 0.04). Conclusion: HEPEs demonstrated an overall positive effect on falls among community-dwelling older adults.
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Affiliation(s)
- Yu-Ting Cao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Jian-Jie Wang
- Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Yi-Ting Yang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Shi-Jie Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Liang-Dong Zheng
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Wei-Wei Lu
- Zhongshan Hospital, Fudan University, Shanghai, 200030, China
| | - Rui Zhu
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, 200092, China.,Key Laboratory of Spine & Spinal Cord Injury Repair & Regeneration of the Ministry of Education, Tongji Hospital, School of Medicine, Tongji University, 389 Xincun Road, Shanghai, 200065, China
| | - Tao Wu
- Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
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How Cognitive Reserve should Influence Rehabilitation Choices using Virtual Reality in Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:7389658. [PMID: 36160828 PMCID: PMC9507627 DOI: 10.1155/2022/7389658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/08/2022] [Accepted: 08/25/2022] [Indexed: 11/18/2022]
Abstract
Virtual reality (VR) is used in the rehabilitation of patients with Parkinson's disease (PD) in several studies. In VR trials, the motor, physical characteristics, and the degree of the disease are often well defined, while PD cognitive reserve is not. This systematic review was performed to define a cognitive profile for patients with PD who could best benefit from using VR to enhance functional motor aspects during rehabilitation. PubMed, Cochrane Library, Scopus, and Web of Sciences databases were analysed to identify randomized clinical trials (RCT) and randomized pilot trials that addressed the rehabilitation of motor symptoms in subjects with PD using VR. The included studies used Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA) to evaluate the cognitive aspect. Only articles written in English and with full texts were considered. The risk of bias from all included studies was assessed based on the Cochrane risk-of-bias tool and the PRISMA guideline was considered. Eighteen articles were eligible for review, including three randomized pilot trials. All studies aimed to evaluate the effect of VR on the motor aspects typically affected by PD (balance, postural control, risk of falls, walking, and reaching). The most widely adopted approach has been nonimmersive VR, except for one study that used immersive VR. Both the benefits of physical activity on the motor symptoms of patients with PD and the impact of cognitive reserve during the rehabilitation of these patients were highlighted. The analysis of the results allowed us to outline the ideal cognitive profile of patients with PD who can benefit from the effects of rehabilitation using VR.
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van Munster M, Stümpel J, Thieken F, Ratajczak F, Rascol O, Fabbri M, Clemens T, Czabanowska K, Mestre TA, Pedrosa DJ. The Role of Parkinson Nurses for Personalizing Care in Parkinson’s Disease: A Systematic Review and Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1807-1831. [PMID: 35786660 PMCID: PMC9535548 DOI: 10.3233/jpd-223215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Quality of life (QoL) of persons with Parkinson’s disease (PD) is diminished by (non-)motor symptoms, that require personalized care. Parkinson Nurses (PN) may be pivotal promoting tailored care offerings. This systematic review and meta-analysis investigates PD care models and aims at furnishing current concepts of PN to offer personalized care. Objective: The purpose of this study is to identify the various roles and functions that PN may hold for personalized PD care. Methods: We performed a systematic literature review, utilizing: PubMed, Web of Science, The Cochrane Library, and PsycINFO. The review qualitatively evaluated articles, which described personalized care models involving PNs and was guided by the personalized care management model. A meta-analysis compared patient-reported QoL (quantified using the 39-item Parkinson’s Disease Questionnaire) between personalized care interventions involving PN versus standard care with. Results: Twenty-seven publications were identified, including six randomized, controlled trials ascertaining with health related QoL (n = 1830 PwPs). The qualitative evaluation revealed that PN contribute to all aspects of personalized care. The meta-analysis showed no improved QoL in personalized care models compared to standard care, thought a great heterogeneity among study design and interventions was outlined (Standardized Mean Difference = –0.8935; 95% Confidence Interval, –2.1177 to 0.3307; z = –1.43, p = 0.1526). Conclusion: PN fulfil important functions in personalized PD care. For the future, a clear role definition will be necessary to adjust training for PN across healthcare systems and care settings but especially to realize their full potential for PD care.
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Affiliation(s)
- Marlena van Munster
- Department of Neurology Philipps University Marburg, University Hospital Marburg, Marburg, Germany
- Department of International Health, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Johanne Stümpel
- Cologne Centre for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne, Cologne, Germany
- Center for Life Ethics, University of Bonn, Bonn, Germany
| | - Franziska Thieken
- Department of Neurology Philipps University Marburg, University Hospital Marburg, Marburg, Germany
| | - Florin Ratajczak
- Helmholtz Zentrum München: German Research Center for Environmental Health, Institute of Network Biology, Neuherberg, Germany
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN) and the French NS-Park/F-CRIN network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
| | - Margherita Fabbri
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN) and the French NS-Park/F-CRIN network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
| | - Timo Clemens
- Department of International Health, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Katarzyna Czabanowska
- Department of International Health, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
- Jagiellonian University, Department of Health Policy Management, Institute of Public Health, Faculty of Health Sciences, Krakow, Poland
| | - Tiago A. Mestre
- Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - David J. Pedrosa
- Department of Neurology Philipps University Marburg, University Hospital Marburg, Marburg, Germany
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Tsukita K, Sakamaki-Tsukita H, Takahashi R. Author Response: Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease. Neurology 2022; 99:402. [PMID: 36038287 DOI: 10.1212/wnl.0000000000201128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/15/2022] Open
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122
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Janssen Daalen JM, Schootemeijer S, Richard E, Darweesh SKL, Bloem BR. Lifestyle Interventions for the Prevention of Parkinson Disease: A Recipe for Action. Neurology 2022; 99:42-51. [PMID: 35970584 DOI: 10.1212/wnl.0000000000200787] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
The prevalence of Parkinson disease (PD) is growing fast, amplifying the quest for disease-modifying therapies in early disease phases where pathology is still limited. Lifestyle interventions offer a promising avenue for preventing progression from prodromal to manifest PD. We illustrate this primarily for 1 specific lifestyle intervention, namely aerobic exercise because the case for the other main lifestyle factor (dietary interventions) to modify the course of prodromal PD is currently less persuasive. Various observations have hinted at the disease-modifying potential of exercise. First, studies in rodents with experimental parkinsonism showed that exercise elicits adaptive neuroplasticity in basal ganglia circuitries. Second, exercise is associated with a reduced risk of developing PD, suggesting a disease-modifying potential. Third, 2 large trials in persons with manifest PD indicate that exercise can help to stabilize motor parkinsonism, although this could also reflect a symptomatic effect. In addition, exercise seems to be a feasible intervention, given its minimal risk of side effects. Theoretical risks include an increase in fall incidents and cardiovascular complications, but these concerns seem to be acceptably low. Innovative approaches using gamification elements indicate that adequate long-term compliance with regular exercise programs can be achieved, although more work remains necessary to demonstrate enduring adherence for multiple years. Advances in digital technology can be used to deliver the exercise intervention in the participant's own living environment and also to measure the outcomes remotely, which will help to further boost long-term compliance. When delivering exercise to prodromal participants, outcome measures should focus not just on phenoconversion to manifest PD (which may well take many years to occur) but also on measurable intermediate outcomes, such as physical fitness or prodromal nonmotor symptoms. Taken together, there seems to be sufficient evidence to advocate the first judicious attempt of investigating exercise as a disease-modifying treatment in prodromal PD.
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Affiliation(s)
- Jules M Janssen Daalen
- From the Department of Neurology (J.M.J.D., S.S., E.R., S.K.L.D., B.R.B.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior; Center of Expertise for Parkinson & Movement Disorders (J.M.J.D., S.S., S.K.L.D., B.R.B.); and Radboud University Medical Center Alzheimer Center (E.R.), the Netherlands
| | - Sabine Schootemeijer
- From the Department of Neurology (J.M.J.D., S.S., E.R., S.K.L.D., B.R.B.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior; Center of Expertise for Parkinson & Movement Disorders (J.M.J.D., S.S., S.K.L.D., B.R.B.); and Radboud University Medical Center Alzheimer Center (E.R.), the Netherlands
| | - Edo Richard
- From the Department of Neurology (J.M.J.D., S.S., E.R., S.K.L.D., B.R.B.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior; Center of Expertise for Parkinson & Movement Disorders (J.M.J.D., S.S., S.K.L.D., B.R.B.); and Radboud University Medical Center Alzheimer Center (E.R.), the Netherlands
| | - Sirwan K L Darweesh
- From the Department of Neurology (J.M.J.D., S.S., E.R., S.K.L.D., B.R.B.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior; Center of Expertise for Parkinson & Movement Disorders (J.M.J.D., S.S., S.K.L.D., B.R.B.); and Radboud University Medical Center Alzheimer Center (E.R.), the Netherlands
| | - Bastiaan R Bloem
- From the Department of Neurology (J.M.J.D., S.S., E.R., S.K.L.D., B.R.B.), Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior; Center of Expertise for Parkinson & Movement Disorders (J.M.J.D., S.S., S.K.L.D., B.R.B.); and Radboud University Medical Center Alzheimer Center (E.R.), the Netherlands.
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Benarroch E. What Muscle Signals Mediate the Beneficial Effects of Exercise on Cognition? Neurology 2022; 99:298-304. [PMID: 35970575 DOI: 10.1212/wnl.0000000000201049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/15/2022] Open
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Cai J, Liu A, Wang Y, Tan SN, Chomiak T, Burt J, Camicioli R, Hu B, McKeown MJ, Ba F. Walking exercise alters pedunculopontine nucleus connectivity in Parkinson’s disease in a dose-dependent manner. Front Neurosci 2022; 16:930810. [PMID: 36017180 PMCID: PMC9397130 DOI: 10.3389/fnins.2022.930810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Gait disturbances are critical motor symptoms in Parkinson’s disease (PD). The mechanisms of gait impairment in PD are not entirely understood but likely involve changes in the Pedunculopontine Nucleus (PPN), a critical locomotion center, and its associated connections. Exercise is universally accepted as helpful in PD, but the extent and intensity of exercise required for plastic changes are unclear. Methods Twenty-seven PD subjects participated in a 3-month gait training intervention. Clinical assessments and resting-state functional magnetic resonance imaging were performed at baseline and 3 months after exercise. Functional connectivity of PPN was assessed by combining the methods of partial least squares, conditional dependence and partial correlation. In addition, paired t-tests were used to examine the effect of exercise on PPN functional connectivity and clinical measures, and Pearson’s correlation was used to assess the association between altered PPN functional connectivity and clinical measures. Results Exercise significantly improved Unified Parkinson’s Disease Rating Scale-III (UPDRS-III). A significant increase in right PPN functional connectivity was observed after exercise, which did not correlate with motor improvement. However, the decrease in left PPN functional connectivity significantly correlated with the improvement in UPDRS-III and was linearly related to both number of walks and the duration of walks. In addition, exercise induced a significant increase in the laterality of PPN connectivity strength, which correlated with motor improvement. Conclusion PPN functional connectivity is modifiable by walking exercise in both a dose-independent (right PPN and laterality of PPN connectivity strength) and dose-dependent (left PPN) manner. The PPN may contribute to pathological and compensatory processes in PD gait control. The observed gait improvement by walking exercise is most likely due to the reversal of the maladaptive compensatory mechanism. Altered PPN functional connectivity can be a marker for exercise-induced motor improvement in PD.
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Affiliation(s)
- Jiayue Cai
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Aiping Liu
- Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China
| | - Yuheng Wang
- School of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Yuheng Wang,
| | - Sun Nee Tan
- Graduate Program in Neuroscience, The University of British Columbia, Vancouver, BC, Canada
| | - Taylor Chomiak
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Jacqueline Burt
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Richard Camicioli
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Bin Hu
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Martin J. McKeown
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Fang Ba
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Sabe M, Chen C, Sentissi O, Deenik J, Vancampfort D, Firth J, Smith L, Stubbs B, Rosenbaum S, Schuch FB, Solmi M. Thirty years of research on physical activity, mental health, and wellbeing: A scientometric analysis of hotspots and trends. Front Public Health 2022; 10:943435. [PMID: 36016904 PMCID: PMC9396383 DOI: 10.3389/fpubh.2022.943435] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/15/2022] [Indexed: 01/21/2023] Open
Abstract
The sheer volume of research publications on physical activity, mental health, and wellbeing is overwhelming. The aim of this study was to perform a broad-ranging scientometric analysis to evaluate key themes and trends over the past decades, informing future lines of research. We searched the Web of Science Core Collection from inception until December 7, 2021, using the appropriate search terms such as "physical activity" or "mental health," with no limitation of language or time. Eligible studies were articles, reviews, editorial material, and proceeding papers. We retrieved 55,353 documents published between 1905 and 2021. The annual scientific production is exponential with a mean annual growth rate of 6.8% since 1989. The 1988-2021 co-cited reference network identified 50 distinct clusters that presented significant modularity and silhouette scores indicating highly credible clusters (Q = 0.848, S = 0.939). This network identified 6 major research trends on physical activity, namely cardiovascular diseases, somatic disorders, cognitive decline/dementia, mental illness, athletes' performance, related health issues, and eating disorders, and the COVID-19 pandemic. A focus on the latest research trends found that greenness/urbanicity (2014), concussion/chronic traumatic encephalopathy (2015), and COVID-19 (2019) were the most active clusters of research. The USA research network was the most central, and the Chinese research network, although important in size, was relatively isolated. Our results strengthen and expand the central role of physical activity in public health, calling for the systematic involvement of physical activity professionals as stakeholders in public health decision-making process.
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Affiliation(s)
- Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Thonex, Switzerland
| | - Chaomei Chen
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Thonex, Switzerland
| | - Jeroen Deenik
- Scientific Research Department, GGz Centraal, Amersfoort, Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Davy Vancampfort
- Katholieke Universiteit Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Center Katholieke Universiteit Leuven, Leuven, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, Medicine and Health, University of New South Wales, Kensington, NSW, Australia
- School of Health Sciences, Medicine and Health, University of New South Wales, Kensington, NSW, Australia
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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Rosenfeldt AB, Koop MM, Penko AL, Zimmerman E, Miller DM, Alberts JL. Components of a successful community-based exercise program for individuals with Parkinson’s disease: Results from a participant survey. Complement Ther Med 2022; 70:102867. [DOI: 10.1016/j.ctim.2022.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/03/2022] Open
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Physical Therapy for at Least 6 Months Improves Motor Symptoms in Parkinson’s Patients: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3393191. [PMID: 35959355 PMCID: PMC9357765 DOI: 10.1155/2022/3393191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
Objective Long-term physical therapy helps to improve the motor symptoms of patients with Parkinson's disease, but the effectiveness is not clear. The purpose of this study was to evaluate the effect of long-term physical therapy on improving motor symptoms or daily activities in Parkinson's patients with drug use or discontinuation, as well as its impact on drug treatment dose. A subgroup analysis was conducted on different treatment methods to determine the most effective treatment method. Methods The researchers independently searched databases, including PubMed, Medline, Embase, Ovid, Cochrane Library, and ISI Web of science. The search deadline was June 2022. A randomized controlled trial was conducted on Parkinson's disease patients with HY stages 1-3 who received continuous physical therapy for 6 months or more. Systematic evaluation and meta-analysis were carried out by using common clinical evaluation indicators, namely, MDS-UPDRS exercise score, daily activity (ADL) score, or LED dose. The quality of the literature was assessed using the modified Jadad scale of Cochrane's bias risk tool. Results A total of 523 Parkinson's disease patients with HY stages of 1-3 were included in the study. The results showed that long-term physical therapy could improve patients' motor symptoms with combined antiparkinsonian drugs (Z = 2.61 and P = 0.009) and had a significant positive effect on the motor symptoms of patients with discontinued antiparkinsonian drugs (Z = 2.73 and P = 0.006). Meanwhile, it could reduce the LED dose of patients with Parkinson's disease. The difference was statistically significant (Z = 2.58 and P = 0.010). Conclusion The results of this study indicated that physical therapy for at least 6 months or longer for patients with mild to moderate Parkinson's HY could effectively improve the motor symptoms of Parkinson's patients, whether or not combined with antiparkinson drugs. Meanwhile, long-term physical therapy reduced the LED dose of patients treated with drugs compared with patients in the control group who received short-term physical therapy, other types of intervention group, or no treatment.
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128
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Ye X, Li L, He R, Jia Y, Poon W. Rhythmic auditory stimulation promotes gait recovery in Parkinson's patients: A systematic review and meta-analysis. Front Neurol 2022; 13:940419. [PMID: 35968291 PMCID: PMC9366143 DOI: 10.3389/fneur.2022.940419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveUsing rhythmic auditory stimulation (RAS) to improve gait disturbance in Parkinson's disease (PD) is an available treatment option, yet a consensus on its effectiveness remains controversial. We summarized the effects of RAS on gait, functional activity and quality of life in PD patients through a systematic review and meta-analysis.MethodsPubMed, Embase, Web of Science, Medline, and Cochrane Library databases were initially searched to identify relevant literature up to August 2021. Next, the methodological quality of eligible comparative studies was assessed by the Physiotherapy Evidence Database Scale. The treatment effects to clinical outcome in relation to gait, motor activities, and quality of life were analyzed.ResultsA total of 18 studies consisted of 774 subjects were included in this meta-analysis. Comparing with the control group, RAS had significantly increased stride length (p < 0.001), accelerated gait speed (p < 0.001), reduced the occurrence of freezing events during walking (P = 0.009), achieved an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) II (P = 0.030), UPDRS-III (P < 0.001) and Parkinson's Disease Quality of Life Questionnaire (PDQL) (p = 0.009) scores over an interval of 1–26 months.ConclusionIn this meta-analysis of 18 randomized controlled trials, we have demonstrated that RAS improves the general motor functions (UPDRS-III), particularly in gait, mobility and quality of life, in patients with Parkinson's disease.
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Affiliation(s)
- Xiaofan Ye
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Ling Li
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Rong He
- Physiotherapy Department, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yizhen Jia
- Core Laboratory, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Waisang Poon
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
- *Correspondence: Waisang Poon
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Darweesh SKL, De Vries N, Bloem BR. Reader Response: Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease. Neurology 2022; 99:131-132. [PMID: 35851553 DOI: 10.1212/wnl.0000000000200922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/15/2022] Open
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Tsukita K, Sakamaki-Tsukita H, Takahashi R. Author Response: Long-term Effect of Regular Physical Activity and Exercise Habits in Patients With Early Parkinson Disease. Neurology 2022; 99:132. [PMID: 35851557 DOI: 10.1212/wnl.0000000000200923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/15/2022] Open
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131
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Garcia Ruiz PJ, Luquin Piudo R, Martinez Castrillo JC. On Disease Modifying and Neuroprotective Treatments for Parkinson's Disease: Physical Exercise. Front Neurol 2022; 13:938686. [PMID: 35911891 PMCID: PMC9331172 DOI: 10.3389/fneur.2022.938686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/07/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Pedro J. Garcia Ruiz
- Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain
- *Correspondence: Pedro J. Garcia Ruiz
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132
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Thrue C, Hvid LG, Gamborg M, Dawes H, Dalgas U, Langeskov-Christensen M. Aerobic capacity in persons with Parkinson’s disease: a systematic review. Disabil Rehabil 2022:1-13. [DOI: 10.1080/09638288.2022.2094480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Cecilie Thrue
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Lars G. Hvid
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Mads Gamborg
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
| | - Helen Dawes
- Faculty of Health and Life Sciences, Centre for Movement and Occupational Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Ulrik Dalgas
- Department of Public Health, Exercise Biology, Aarhus University, Aarhus, Denmark
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Kehagia AA, North TK, Grose J, Jeffery AN, Cocking L, Chapman R, Carroll C. Enhancing Trial Delivery in Parkinson’s Disease: Qualitative Insights from PD STAT. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1591-1604. [PMID: 35466952 PMCID: PMC9398073 DOI: 10.3233/jpd-212987] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Recruitment and retention of participants in clinical trials for Parkinson’s disease (PD) is challenging. A qualitative study embedded in the PD STAT multi-centre randomised controlled trial of simvastatin for neuroprotection in PD explored the motivators, barriers and challenges of participants, care partners and research staff. Objective: To outline a set of considerations informing a patient-centred approach to trial recruitment, retention, and delivery. Method: We performed semi-structured interviews and focus groups with a subset of trial participants and their care partners. Quantitative and qualitative data were obtained through surveys circulated among the 235 participants across 23 UK sites at the beginning, middle and end of the 2-year trial. We also interviewed and surveyed research staff at trial closure. Results: Twenty-seven people with PD, 6 care partners and 9 researchers participated in interviews and focus groups. A total of 463 trial participant survey datasets were obtained across three timepoints, and 53 staff survey datasets at trial closure. Trial participants discussed the physical and psychological challenges they faced, especially in the context of OFF state assessments, relationships, and communication with research staff. Care partners shared their insights into OFF state challenges, and the value of being heard by research teams. Research staff echoed many concerns with suggestions on flexible, person-centred approaches to maximising convenience, comfort, and privacy. Conclusion: These considerations, in favour of person-centred research protocols informed by the variable needs of participants, care partners and staff, could be developed into a set of recommendations for future trials.
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Affiliation(s)
- Angie A. Kehagia
- University College Hospital, University London Hospitals NHS Trust, London, UK
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
| | - Tracie K. North
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
| | - Jane Grose
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
| | | | - Laura Cocking
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
| | - Rebecca Chapman
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
| | - Camille Carroll
- University of Plymouth, Faculty of Health, Plymouth, Devon, UK
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Darweesh SK, De Vries NM, Helmich RC, Verbeek MM, Schwarzschild MA, Bloem BR. Inhibition of Neuroinflammation May Mediate the Disease-Modifying Effects of Exercise: Implications for Parkinson’s Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1419-1422. [PMID: 35466957 PMCID: PMC9398068 DOI: 10.3233/jpd-223216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Sirwan K.L. Darweesh
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nienke M. De Vries
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rick C. Helmich
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel M. Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Bastiaan R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Park Y, Kim SR, So HY, Jo S, Lee SH, Hwang YS, Kim MS, Chung SJ. Effect of mobile health intervention for self-management on self-efficacy, motor and non-motor symptoms, self-management, and quality of life in people with Parkinson's disease: Randomized controlled trial. Geriatr Nurs 2022; 46:90-97. [DOI: 10.1016/j.gerinurse.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/04/2022]
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Domingos J, Dean J, Fernandes JB, Massano J, Godinho C. Community Exercise: A New Tool for Personalized Parkinson’s Care or Just an Addition to Formal Care? Front Syst Neurosci 2022; 16:916237. [PMID: 35844246 PMCID: PMC9280427 DOI: 10.3389/fnsys.2022.916237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Physiotherapy and exercise are associated with motor and non-motor benefits in Parkinson’s disease (PD). Community exercise programs may increase ongoing exercise participation and help people with Parkinson’s disease actively participate in their health management. But there is still limited knowledge about these programs regarding their benefits, safety, implications over the long-term, and effective implementation. These questions could hold relevant clinical implications. In this perspective article, we identify the current challenges and reflect upon potential solutions to help community exercise to be implemented as an additional anchor to personalize management models for Parkinson’s disease.
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Affiliation(s)
- Josefa Domingos
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
- Triad Health AI, Aurora, CO, United States
- Young Parkies, Porto, Portugal
- *Correspondence: Josefa Domingos
| | - John Dean
- Triad Health AI, Aurora, CO, United States
| | - Júlio Belo Fernandes
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | - João Massano
- Young Parkies, Porto, Portugal
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
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137
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Feenstra W, Nonnekes J, Rahimi T, Reinders-Messelink HA, Dijkstra PU, Bloem BR. Dance classes improve self-esteem and quality of life in persons with Parkinson's disease. J Neurol 2022; 269:5843-5847. [PMID: 35763112 DOI: 10.1007/s00415-022-11206-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/29/2022] [Accepted: 05/29/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Dance can reduce motor symptoms in persons with Parkinson's disease (PD). However, the effect on psychosocial wellbeing, including self-esteem and quality of life is less clear. METHODS Forty-nine persons with PD (Hoehn and Yahr stage 1-4) participated in weekly dance classes for a consecutive period of 22 weeks, 36 participants completed the classes. Two baseline measurements (T1a and T1b) were performed during a 2-week control period prior to the dance classes. Post-measurements (T2) were performed immediately after 22 weeks of dance classes. Primary outcome was self-esteem as measured with the Rosenberg Self-Esteem Score. RESULTS Self-esteem scores were stable across the two baseline measurements and improved significantly after the dance classes (1.5 points improvement between T1b and T2, 95% CI 0.3, 2.7; p = 0.012). Additionally, quality of life as measured with the Parkinson's Disease Questionnaire 39 improved significantly (3.4 points reduction between T1b and T2, 95%CI - 5.7, - 1.2; p = 0.003) as did motor symptoms as measured with the Movement Disorders Society-Unified Parkinson's Disease Rating Scale-part III (6.2 points reduction between T1b and T2, 95%CI - 10.1, - 2.4; p = 0.002). Balance confidence as measured with the Activities-Specific Balance Confidence Scale did not change. DISCUSSION AND CONCLUSIONS Dance classes seem to improve self-esteem, quality of life and motor symptoms in persons with PD. These effects should be investigated further in a randomized clinical trial. CLINICAL MESSAGE Dance classes may be a valuable complementary treatment option in people with PD to improve not only motor symptoms, but also self-esteem and quality of life.
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Affiliation(s)
- Wya Feenstra
- Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.
| | - Jorik Nonnekes
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Rehabilitation, Sint Maartenskliniek, Ubbergen, The Netherlands
| | - Tahmina Rahimi
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.,Utrecht University, Utrecht, The Netherlands
| | - Heleen A Reinders-Messelink
- Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands.,Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bas R Bloem
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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138
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Tong W, Zhang K, Yao H, Li L, Hu Y, Zhang J, Song Y, Guan Q, Li S, Sun YE, Jin L. Transcriptional Profiling Reveals Brain Region-Specific Gene Networks Regulated in Exercise in a Mouse Model of Parkinson’s Disease. Front Aging Neurosci 2022; 14:891644. [PMID: 35813950 PMCID: PMC9260255 DOI: 10.3389/fnagi.2022.891644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundExercise plays an essential role in improving motor symptoms in Parkinson’s disease (PD), but the underlying mechanism in the central nervous system remains unclear.MethodsMotor ability was observed after 12-week treadmill exercise on a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of PD. RNA-sequencing on four brain regions (cerebellum, cortex, substantia nigra (SN), and striatum) from control animals, MPTP-induced PD, and MPTP-induced PD model treated with exercise for 12 weeks were performed. Transcriptional networks on the four regions were further identified by an integrative network biology approach.ResultsThe 12-week treadmill exercise significantly improved the motor ability of an MPTP-induced mouse model of PD. RNA-seq analysis showed SN and striatum were remarkably different among individual region’s response to exercise in the PD model. Especially, synaptic regulation pathways about axon guidance, synapse assembly, neurogenesis, synaptogenesis, transmitter transport-related pathway, and synaptic regulation genes, including Neurod2, Rtn4rl2, and Cd5, were upregulated in SN and striatum. Lastly, immunofluorescence staining revealed that exercise rescued the loss of TH+ synapses in the striatal region in PD mice, which validates the key role of synaptic regulation pathways in exercise-induced protective effects in vivo.ConclusionSN and striatum are important brain regions in which critical transcriptional changes, such as in synaptic regulation pathways, occur after the exercise intervention on the PD model.
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Affiliation(s)
- Weifang Tong
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
- Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kunshan Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
| | - Hongkai Yao
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
| | - Lixi Li
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
| | - Yong Hu
- The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, Department of Neurology, NYU Langone Health, NYU School of Medicine, New York, NY, United States
| | - Jingxing Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
| | - Yunping Song
- Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiang Guan
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
| | - Siguang Li
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
- *Correspondence: Siguang Li,
| | - Yi E. Sun
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
- Yi E. Sun,
| | - Lingjing Jin
- Department of Neurology, Tongji Hospital, School of Medicine, Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Tongji University, Shanghai, China
- Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
- Lingjing Jin,
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Milne-Ives M, Carroll C, Meinert E. Self-management interventions for people with Parkinson’s Disease: A scoping review (Preprint). J Med Internet Res 2022; 24:e40181. [PMID: 35930315 PMCID: PMC9391969 DOI: 10.2196/40181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Madison Milne-Ives
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Camille Carroll
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
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Rhon DI, Fritz JM, Kerns RD, McGeary DD, Coleman BC, Farrokhi S, Burgess DJ, Goertz CM, Taylor SL, Hoffmann T. TIDieR-telehealth: precision in reporting of telehealth interventions used in clinical trials - unique considerations for the Template for the Intervention Description and Replication (TIDieR) checklist. BMC Med Res Methodol 2022; 22:161. [PMID: 35655144 PMCID: PMC9161193 DOI: 10.1186/s12874-022-01640-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/20/2022] [Indexed: 12/28/2022] Open
Abstract
Abstract
Background
Recent international health events have led to an increased proliferation of remotely delivered health interventions. Even with the pandemic seemingly coming under control, the experiences of the past year have fueled a growth in ideas and technology for increasing the scope of remote care delivery. Unfortunately, clinicians and health systems will have difficulty with the adoption and implementation of these interventions if ongoing and future clinical trials fail to report necessary details about execution, platforms, and infrastructure related to these interventions. The purpose was to develop guidance for reporting of telehealth interventions.
Methods
A working group from the US Pain Management Collaboratory developed guidance for complete reporting of telehealth interventions. The process went through 5-step process from conception to final checklist development with input for many stakeholders, to include all 11 primary investigators with trials in the Collaboratory.
Results
An extension focused on unique considerations relevant to telehealth interventions was developed for the Template for the Intervention Description and Replication (TIDieR) checklist.
Conclusion
The Telehealth Intervention guideline encourages use of the Template for the Intervention Description and Replication (TIDieR) checklist as a valuable tool (TIDieR-Telehealth) to improve the quality of research through a reporting guide of relevant interventions that will help maximize reproducibility and implementation.
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Effects of Ten Different Exercise Interventions on Motor Function in Parkinson’s Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials. Brain Sci 2022; 12:brainsci12060698. [PMID: 35741584 PMCID: PMC9221238 DOI: 10.3390/brainsci12060698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this study was to evaluate ten exercise interventions (YOGA: yoga training, RT: resistance training, AQU: aquatic training, TAI: Taiji Qigong training, TRD: treadmill training, VR: virtual reality training, DANCE: musical dance training, WKT: walking training, CYC: cycling training, BDJ: Baduanjin Qigong training) on motor function in Parkinson’s disease (PD) patients. Design: Through searching PubMed, Embase, Cochrane Library, Web of Science, and CNKI, only randomized controlled trials (RCTs) were collected to study the effects of the ten exercise interventions on motor function in patients with Parkinson’s disease. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool. Results: The RCTs were collected between the earliest available date and April 2022. Sixty RCTs were included and the total sample size used in the study was 2859. The results of the network meta-analysis showed that DANCE can significantly improve patients’ Berg Balance Scale (BBS) (SUCRA = 78.4%); DANCE can significantly decline patients’ Unified Parkinson’s Disease Rating Scale score (UPDRS) (SUCRA = 72.3%) and YOGA can significantly decline patients’ Timed-Up-and-Go score (TUGT) (SUCRA = 78.0%). Conclusion: Based on the network meta-analysis and SUCRA ranking, we can state that dance, yoga, virtual reality training and resistance training offers better advantages than other exercise interventions for patients’ motor function.
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Song J, Mun JK, Ahn JH, Youn J, Choi I, Cho JW. Daily Exercise Patterns and Their Differences between Parkinson's Disease Patients with and without Postural Instability. PARKINSON'S DISEASE 2022; 2022:3191598. [PMID: 35634542 PMCID: PMC9135569 DOI: 10.1155/2022/3191598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Due to the clinical impact of exercise in patients with Parkinson's disease (PD), management should include personalized and effective exercises according to patient's PD stage. We investigated the detailed exercise behaviors of patients with mild to advanced PD and compared their patterns between PD with and without postural instability (PI). METHODS We enrolled PD patients from September to December 2019. Clinical data on parkinsonism, exercise behaviors, and Physical Activity Scale of the Elderly (PASE) scores were collected and compared between mild PD without PI (Hoehn-Yahr (HY) stages 1 and 2) and advanced PD with PI (HY stages 3 and 4). RESULTS In total, 263 PD patients were recruited. The mean exercise frequency was 4.7 ± 2.1 times/week, and the average duration was 7.8 ± 6.7 hours/week. The most common exercise was an aerobic exercise (71.9%) of mild-to-moderate intensity, with active walking being the most common (49.0%). The mild PD patients demonstrated a higher duration and intensity of exercise and more physical activity than the advanced PD patients. However, the frequency of exercise was not significantly different between the two groups. The PASE score was significantly higher in mild PD patients than in advanced PD patients (p < 0.001). CONCLUSION PD patients focused mostly on aerobic exercises, especially active walking. With the disease progression, the amount and intensity of exercise decreased while frequency remained. Higher intensity of exercise is needed in the mild PD group, while the advanced PD group requires the increment of duration for each exercise session.
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Affiliation(s)
- Joomee Song
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jun Kyu Mun
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jong Hyeon Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Inyoung Choi
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
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143
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Wagner L, Hauptmann B, Hoffmann AK, Jochems N, Schmeier B, Schrader A, Kohlmann T, Deck R. Evaluation of an individualized, tablet-based physiotherapy training programme for patients with Parkinson's disease: the ParkProTrain study, a quasi-randomised controlled trial. BMC Neurol 2022; 22:176. [PMID: 35568805 PMCID: PMC9106978 DOI: 10.1186/s12883-022-02647-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity is of great relevance in Parkinson's disease (PD). It is part of the inpatient multimodal Parkinson's complex treatment (MKP) in Germany. However, there is often a lack of human resources in outpatient settings to continue an interprofessional approach. A large proportion of PD patients live a predominantly sedentary lifestyle and do not get enough exercise. METHODS The intervention group (IG) used a tablet-based physiotherapy training programme at home for a period of nine months. We conducted a quasi-randomised longitudinal study with three measurement times (at the beginning (t0) and end of MKP (t1) and at 9 months after MKP (t2)). The primary outcome measured was PD-specific quality of life using the PDQ-8. The secondary outcome focused on participation restrictions, falling anxiety, sleep disorder, anxiety and depression as well as comorbidity, pain, performance capability and physical activity. RESULTS For n = 93 IG and n = 137 control group (CG) patients, evaluable cases were available for all measurement times. Both groups achieved significant improvements in all parameters at the end of MKP. These parameters deteriorated again at nine months after MKP for most parameters and were even below the baseline levels. However, this deterioration was less pronounced in the IG than in the CG. For general health and social participation, a significant slightly positive effect was observed in the IG nine months after MKP when compared with the baseline level. Paying attention to physical activity slightly increased in the IG for the catamnesis survey compared to baseline. Nearly all IG patients were satisfied with the intervention, especially with the consultations with the physiotherapist. CONCLUSIONS Although the expected extent of effects could not be determined for the IG, stabilisation effects could be demonstrated. These stabilisation effects shown for the IG might be attributed to the intervention. The effects might have been greater without the COVID-19 pandemic. TRIAL REGISTRATION German Register of Clinical Trials, drks.de. Identifier: DRKS00014952. Registered 20/06/2018. Date and version identifier 25/04/2019; version 1.
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Affiliation(s)
- Lynn Wagner
- Department Rehabilitation Sciences, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Björn Hauptmann
- Neurological Centre, Segeberger Kliniken GmbH, Bad Segeberg, Germany
- Department Performance Neuroscience, Therapy and Health, Medical School Hamburg, Hamburg, Germany
| | | | - Nicole Jochems
- Institute for Multimedia and Interactive Systems, University of Lübeck, Lübeck, Germany
| | - Bastian Schmeier
- Institute for Multimedia and Interactive Systems, University of Lübeck, Lübeck, Germany
| | | | - Thomas Kohlmann
- Methoden der Community Medicine, Universität, Greifswald, Germany
| | - Ruth Deck
- Department Rehabilitation Sciences, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
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144
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Gamborg M, Hvid LG, Dalgas U, Langeskov‐Christensen M. Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. Acta Neurol Scand 2022; 145:504-528. [PMID: 34997759 DOI: 10.1111/ane.13579] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
In 2015, Uhrbrand et al. published the first review on Parkinson´s disease (PD) and exercise entirely based on randomized controlled trials (RCT) applying strict exercise definitions. The present review aimed to update the PD literature by assessing the effects of different intensive exercise modalities: resistance training (RT), endurance training (ET), and other intensive exercise modalities (OITM). An updated systematic literature search identified 33 new RCTs. Qualitative and quantitative analyses were performed. A total of 18 RT, 14 ET, and 1 OITM studies were identified (adding to the 8 RT, 6 ET, and 4 OITM studies identified by Uhrbrand et al. in 2015). RT, ET, and OITM were feasible, safe, and did not worsen PD symptoms. Furthermore, RT, ET, and OITM may positively affect functional outcomes (e.g., balance) and depressive symptoms in PD but inconsistencies across these findings warrant cautious conclusions. Meta-analyses showed that RT had a positive impact on muscle strength (standardized mean difference (SMD) = 0.83 [95% CI;0.54, 1.12]), functional capacity (Timed Up and Go Test (TUG): SMD = -0.62 [-1.01, -0.24]), and quality of life (SMD = -0.41 [-0.72, -0.09]), while ET had a positive impact on cardiorespiratory fitness (SMD = 0.27 [0.07, 0.47]) and functional capacity (TUG: SMD = -0.21 [-0.46, 0.04], 6-Min Walk Test: SMD = 0.89 [0.17, 1.62]), and a potentially positive impact on "on-medication" UPDRS-III (SMD = -0.15 [-0.38, 0.09]) and "off-medication" UPDRS-III (SMD = -0.19 [-0.41, 0.04]). In conclusion, RT, ET, and OITM all represent safe, feasible, and beneficial adjunct rehabilitation strategies in PD, with particularly RT and ET showing solid effects.
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Affiliation(s)
- Mads Gamborg
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
| | - Lars G. Hvid
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
- The Danish MS Hospitals, Ry and Haslev Denmark
| | - Ulrik Dalgas
- Exercise Biology Department of Public Health Aarhus University Aarhus Denmark
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145
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Burtscher J, Romani M, Bernardo G, Popa T, Ziviani E, Hummel FC, Sorrentino V, Millet GP. Boosting mitochondrial health to counteract neurodegeneration. Prog Neurobiol 2022; 215:102289. [DOI: 10.1016/j.pneurobio.2022.102289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/23/2022] [Accepted: 05/25/2022] [Indexed: 12/22/2022]
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146
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Kannarkat GT, Rafferty MR, Luo S, Liu H, Mills KA. Effect of Exercise and Rehabilitation Therapy on Risk of Hospitalization in Parkinson's Disease. Mov Disord Clin Pract 2022; 9:494-500. [PMID: 35586527 PMCID: PMC9092731 DOI: 10.1002/mdc3.13456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/23/2022] [Accepted: 03/26/2022] [Indexed: 11/05/2022] Open
Abstract
Background Exercise and physical therapy (PT) can improve motor function and quality of life in individuals with Parkinson's disease (PD), but their role in hospitalization avoidance is not well-studied. Objectives To determine the longitudinal and temporal association of exercise and PT use with hospital encounter. Methods Longitudinal regression and χ2 analyses were performed on Parkinson's Foundation Parkinson's Outcome Project exercise and PT use data from 4674 and 9259 persons with PD, respectively. Results Greater exercise duration and intensity were associated with reduced odds of hospital encounter, whereas both PT and occupational therapy use were associated with increased odds. In the 2 years before a hospital encounter, there was an increased frequency of PT use, but not reductions in exercise. Conclusions Consistent exercise may reduce hospitalization risk whereas PT referral may identify at-risk individuals without preventing this outcome. Further work to incentivize consistent exercise in PD may reduce healthcare use.
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Affiliation(s)
| | - Miriam R. Rafferty
- Shirley Ryan AbilityLabChicagoIllinoisUSA
- Department of Physical Medicine and RehabilitationNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Sheng Luo
- Department of Biostatistics and BioinformaticsDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Hongliang Liu
- Department of Population Health SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Kelly A. Mills
- Department of NeurologyThe Johns Hopkins HospitalBaltimoreMarylandUSA
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147
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Morowitz JM, Pogson KB, Roque DA, Church FC. Role of SARS-CoV-2 in Modifying Neurodegenerative Processes in Parkinson's Disease: A Narrative Review. Brain Sci 2022; 12:536. [PMID: 35624923 PMCID: PMC9139310 DOI: 10.3390/brainsci12050536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, continues to impact global health regarding both morbidity and mortality. Although SARS-CoV-2 primarily causes acute respiratory distress syndrome (ARDS), the virus interacts with and influences other organs and tissues, including blood vessel endothelium, heart, gastrointestinal tract, and brain. We are learning much about the pathophysiology of SARS-CoV-2 infection; however, we are just beginning to study and understand the long-term and chronic health consequences. Since the pandemic's beginning in late 2019, older adults, those with pre-existing illnesses, or both, have an increased risk of contracting COVID-19 and developing severe COVID-19. Furthermore, older adults are also more likely to develop the neurodegenerative disorder Parkinson's disease (PD), with advanced age as the most significant risk factor. Thus, does SARS-CoV-2 potentially influence, promote, or accelerate the development of PD in older adults? Our initial focus was aimed at understanding SARS-CoV-2 pathophysiology and the connection to neurodegenerative disorders. We then completed a literature review to assess the relationship between PD and COVID-19. We described potential molecular and cellular pathways that indicate dopaminergic neurons are susceptible, both directly and indirectly, to SARS-CoV-2 infection. We concluded that under certain pathological circumstances, in vulnerable persons-with-Parkinson's disease (PwP), SARS-CoV-2 acts as a neurodegenerative enhancer to potentially support the development or progression of PD and its related motor and non-motor symptoms.
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Affiliation(s)
- Jeremy M. Morowitz
- Developmental and Stem Cell Biology Program, Duke University, Durham, NC 27708, USA;
| | - Kaylyn B. Pogson
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Daniel A. Roque
- Department of Neurology, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA;
| | - Frank C. Church
- Department of Pathology and Laboratory Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
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Moya-Galé G, Spielman J, Ramig LA, Campanelli L, Maryn Y. The Acoustic Voice Quality Index (AVQI) in People with Parkinson's Disease Before and After Intensive Voice and Articulation Therapies: Secondary Outcome of a Randomized Controlled Trial. J Voice 2022:S0892-1997(22)00080-7. [PMID: 35450735 PMCID: PMC9576821 DOI: 10.1016/j.jvoice.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The majority of individuals with Parkinson's disease (PD) experience voice and speech problems during the course of the disease. Despite the importance of voice quality in communication and the documented disordered voice quality in PD, few studies have explored the effects of speech treatment on this variable. STUDY DESIGN/METHODS A parallel arm, unblinded randomized controlled trial (RCT) was conducted with two active comparators, LSVT LOUD (n = 23) and LSVT ARTIC (n = 20), and an inactive comparator group of untreated individuals with PD (n = 22). A group of 20 healthy adults was also included for pre-treatment analysis. Voice recordings were obtained pre-treatment, immediately post-treatment and at 6-month follow-up. The acoustic voice quality index (AVQI) is reported here as a secondary outcome measure of the RCT. Linear mixed-effects regression analysis was performed with AVQI and sound pressure level (SPL) as dependent variables. Pearson correlation coefficient analysis was also conducted to explore the relationship between voice quality and SPL. RESULTS Statistically significant improvements in AVQI and SPL from pre-treatment to post-treatment and follow-up were only observed in the LSVT LOUD group. Voice quality significantly improved only from pre-treatment to follow-up in the LSVT ARTIC group, whilst significant improvements in SPL were observed during maximum phonation only immediately post-treatment. No significant changes were observed in the untreated group. DISCUSSION This study investigated the effects of intensive speech treatment targeting voice or targeting articulation on voice quality, as measured by the AVQI, in individuals with PD. Findings indicate that voice-focused treatment leads to greater improvements in voice quality in this population.
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Affiliation(s)
- Gemma Moya-Galé
- Department of Communication Sciences and Disorders, Long Island University, Brooklyn, New York.
| | | | - Lorraine A Ramig
- National Center for Voice and Speech-Denver, University of Colorado, Boulder, Colorado; Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York; LSVT Global, Inc, Tucson, Arizona
| | - Luca Campanelli
- Department of Communicative Disorders, The University of Alabama, Tuscaloosa, Alabama
| | - Youri Maryn
- Department of Otorhinolaryngology and Head and Neck Surgery, European Institute for ORL-HNS, Wilrijk, Belgium; Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium; Department of Speech-Language Therapy and Audiology, University College Ghent, Ghent, Belgium; School of Logopedics, Faculty of Psychology and Educational Sciences, Université Catolique de Louvain, Louvain-La-Neuve, Belgium; Phonanium, Lokeren, Belgium
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149
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Saba RA, Maia DP, Cardoso FEC, Borges V, F. Andrade LA, Ferraz HB, Barbosa ER, Rieder CRDM, da Silva DJ, Chien HF, Capato T, Rosso AL, Souza Lima CF, Bezerra JMF, Nicaretta D, Povoas Barsottini OG, Godeiro-Júnior C, Broseghini Barcelos L, Gisbert Cury R, Spitz M, Azevedo Silva SMC, Della Colletta MV. Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:316-329. [DOI: 10.1590/0004-282x-anp-2021-0219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/02/2021] [Indexed: 11/21/2022]
Abstract
ABSTRACT The treatment of Parkinson's disease (PD) is challenging, especially since it is considered highly individualized. The Brazilian Academy of Neurology has recognized the need to disseminate knowledge about the management of PD treatment, adapting the best evidence to the Brazilian reality. Thus, the main published treatment guidelines were reviewed based on the recommendations of group from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology.
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Affiliation(s)
- Roberta Arb Saba
- Universidade Federal de São Paulo, Brazil; Hospital do Servidor Público Estadual, Brazil
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150
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Castro SL, Tapias V, Gathagan R, Emes A, Brandon TE, Smith AD. Blueberry Juice Augments Exercise-Induced Neuroprotection in a Parkinson’s Disease Model Through Modulation of GDNF Levels. IBRO Neurosci Rep 2022; 12:217-227. [PMID: 35321527 PMCID: PMC8935512 DOI: 10.1016/j.ibneur.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/21/2022] Open
Abstract
Exercise and consumption of plant-based foods rich in polyphenols are attractive therapeutic approaches for the prevention and treatment of Parkinson’s disease (PD). Few studies, however, have examined the neuroprotective efficacy of combining these treatment modalities against PD. Therefore we investigated whether combining voluntary running and consumption of blueberry juice (BBJ) was more efficacious against 6-hydroxydopamine (6-OHDA) toxicity than either treatment alone. Four weeks of running before and after intrastriatal 6-OHDA reduced amphetamine-induced rotational behavior and loss of substantia nigra dopamine (DA) neurons. BBJ consumption alone had no ameliorative effects, but when combined with exercise, behavioral deficits and nigrostriatal DA neurodegeneration were reduced to a greater extent than exercise alone. The neuroprotection observed with exercise alone was associated with an increase in striatal glial cell-lined derived neurotrophic factor (GDNF), whereas combining exercise and BBJ was associated with an increase in nigral GDNF. These results suggest that polyphenols may potentiate the protective effects of exercise and that differential regulation of GDNF expression underlies protection observed with exercise alone versus combined treatment with consumption of BBJ.
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Affiliation(s)
- Sandra L. Castro
- Pittsburgh Institute of Neurodegenerative Disease, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neurology, University of Pittsburgh, PA 15213, USA
| | - Victor Tapias
- Pittsburgh Institute of Neurodegenerative Disease, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neurology, University of Pittsburgh, PA 15213, USA
- Unidad de Excelencia Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid – Consejo Superior de Investigaciones Científicas, Valladolid 47003, Spain
| | - Ronald Gathagan
- Pittsburgh Institute of Neurodegenerative Disease, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neurology, University of Pittsburgh, PA 15213, USA
| | - Alexandra Emes
- Pittsburgh Institute of Neurodegenerative Disease, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neurology, University of Pittsburgh, PA 15213, USA
| | | | - Amanda D. Smith
- Pittsburgh Institute of Neurodegenerative Disease, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Neurology, University of Pittsburgh, PA 15213, USA
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA
- Correspondence to: Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15240.
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