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Kim Y, Smith BE, Shigo LM, Shaikh AG, Loparo KA, Ridgel AL. Utilizing Entropy of Cadence to Optimize Cycling Rehabilitation in Individuals With Parkinson's Disease. Neurorehabil Neural Repair 2024; 38:693-704. [PMID: 39104198 DOI: 10.1177/15459683241268556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Previous studies have established that increased Sample Entropy (SampEn) of cadence, a measure of non-linear variability, during dynamic cycling leads to greater improvements in motor function for individuals with Parkinson's disease (PD). However, there is significant variability in responses among individuals with PD due to symptoms and disease progression. OBJECTIVES The aim of this study was to develop and test a paradigm for adapting a cycling exercise intervention using SampEn of cadence and rider effort to improve motor function. METHODS Twenty-two participants were randomized into either patient-specific adaptive dynamic cycling (PSADC) or non-adaptive (NA) group. SampEn of cadence was calculated after each of the 12 sessions, and motor function was evaluated using the Kinesia test. Pearson's correlation coefficient was used to analyze the relationship between SampEn of cadence and motor function improvement. Multiple linear regression (MLR) was used to identify the strongest predictors of motor function improvement. RESULTS Pearson's correlation coefficient revealed a significant correlation between SampEn of cadence and motor function improvements (R2 = -.545, P = .009), suggesting that higher SampEn of cadence led to greater motor function improvement. MLR demonstrated that SampEn of cadence was the strongest predictor of motor function improvement (β = -8.923, t = -2.632, P = .018) over the BMI, Levodopa equivalent daily dose, and effort. CONCLUSIONS The findings show that PSADC paradigm promoted a greater improvement in motor function than NA dynamic cycling. These data will be used to develop a predictive model to optimize motor function improvement after cycling in individuals with PD.
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Affiliation(s)
- Younguk Kim
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, OH, USA
- Department of Physical Medicine and Rehabilitation, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittany E Smith
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, OH, USA
| | - Lara M Shigo
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, OH, USA
| | - Aasef G Shaikh
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
- Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
| | - Kenneth A Loparo
- Institute for Smart, Secure and Connected Systems, Case Western Reserve University, Cleveland, OH, USA
| | - Angela L Ridgel
- Exercise Science and Exercise Physiology Program, Kent State University, Kent, OH, USA
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de Abreu FMC, de Oliveira DA, de Araujo Romero Ferrari SS, E Silva KHCV, Titze-de-Almeida R, Titze-de-Almeida SS. Exploring circular RNAs as biomarkers for Parkinson's disease and their expression changes after aerobic exercise rehabilitation. Funct Integr Genomics 2024; 24:130. [PMID: 39069524 DOI: 10.1007/s10142-024-01409-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/13/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
Circular RNAs (circRNAs) are circularized single-stranded ribonucleic acids that interacts with DNA, RNA, and proteins to play critical roles in cell biology. CircRNAs regulate microRNA content, gene expression, and may code for specific peptides. Indeed, circRNAs are differentially expressed in neurodegenerative disorders like Parkinson's disease (PD), playing a potential role in the mechanisms of brain pathology. The RNA molecules with aberrant expression in the brain can cross the blood-brain barrier and reach the bloodstream, which enable their use as non-invasive PD disease biomarker. Promising targets with valuable discriminatory ability in combined circRNA signatures include MAPK9_circ_0001566, SLAIN1_circ_0000497, SLAIN2_circ_0126525, PSEN1_circ_0003848, circ_0004381, and circ_0017204. On the other hand, regular exercises are effective therapy for mitigating PD symptoms, promoting neuroprotective effects with epigenetic modulation. Aerobic exercises slow symptom progression in PD by improving motor control, ameliorating higher functions, and enhancing brain activity and neuropathology. These improvements are accompanied by changes circRNA expression, including hsa_circ_0001535 (circFAM13B) and hsa_circ_0000437 (circCORO1C). The sensitivity of current methods for detecting circulating circRNAs is considered a limitation. While amplification kits already exist for low-abundant microRNAs, similar kits are needed for circRNAs. Alternatively, the use of digital PCR can help overcome this constraint. The current review examines the potential use of circRNAs as non-invasive biomarkers of PD and to assess the effects of rehabilitation. Although circRNAs hold promise as targets for PD diagnosis and therapeutics, further validation is needed before their clinical implementation.
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Affiliation(s)
- Flávia Maria Campos de Abreu
- Graduate Program in Gerontology, Campus Taguatinga, Universidade Católica de Brasília, Brasília DF, Brazil
- University of Brasília - Central Institute of Sciences, Technology for Gene Therapy Laboratory / FAV, Brasília, Brazil
| | - Deborah Almeida de Oliveira
- University of Brasília - Central Institute of Sciences, Technology for Gene Therapy Laboratory / FAV, Brasília, Brazil
- University of Brasília - Central Institute of Sciences, Research Center for Major Themes - Neurodegenerative Disorders Group, Brasília, Brazil
| | - Sabrina Simplício de Araujo Romero Ferrari
- University of Brasília - Central Institute of Sciences, Technology for Gene Therapy Laboratory / FAV, Brasília, Brazil
- University of Brasília - Central Institute of Sciences, Research Center for Major Themes - Neurodegenerative Disorders Group, Brasília, Brazil
| | | | - Ricardo Titze-de-Almeida
- University of Brasília - Central Institute of Sciences, Technology for Gene Therapy Laboratory / FAV, Brasília, Brazil
- University of Brasília - Central Institute of Sciences, Research Center for Major Themes - Neurodegenerative Disorders Group, Brasília, Brazil
| | - Simoneide Souza Titze-de-Almeida
- University of Brasília - Central Institute of Sciences, Technology for Gene Therapy Laboratory / FAV, Brasília, Brazil.
- University of Brasília - Central Institute of Sciences, Research Center for Major Themes - Neurodegenerative Disorders Group, Brasília, Brazil.
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Burtscher J, Moraud EM, Malatesta D, Millet GP, Bally JF, Patoz A. Exercise and gait/movement analyses in treatment and diagnosis of Parkinson's Disease. Ageing Res Rev 2024; 93:102147. [PMID: 38036102 DOI: 10.1016/j.arr.2023.102147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
Cardinal motor symptoms in Parkinson's disease (PD) include bradykinesia, rest tremor and/or rigidity. This symptomatology can additionally encompass abnormal gait, balance and postural patterns at advanced stages of the disease. Besides pharmacological and surgical therapies, physical exercise represents an important strategy for the management of these advanced impairments. Traditionally, diagnosis and classification of such abnormalities have relied on partially subjective evaluations performed by neurologists during short and temporally scattered hospital appointments. Emerging sports medical methods, including wearable sensor-based movement assessment and computational-statistical analysis, are paving the way for more objective and systematic diagnoses in everyday life conditions. These approaches hold promise to facilitate customizing clinical trials to specific PD groups, as well as personalizing neuromodulation therapies and exercise prescriptions for each individual, remotely and regularly, according to disease progression or specific motor symptoms. We aim to summarize exercise benefits for PD with a specific emphasis on gait and balance deficits, and to provide an overview of recent advances in movement analysis approaches, notably from the sports science community, with value for diagnosis and prognosis. Although such techniques are becoming increasingly available, their standardization and optimization for clinical purposes is critically missing, especially in their translation to complex neurodegenerative disorders such as PD. We highlight the importance of integrating state-of-the-art gait and movement analysis approaches, in combination with other motor, electrophysiological or neural biomarkers, to improve the understanding of the diversity of PD phenotypes, their response to therapies and the dynamics of their disease progression.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Eduardo Martin Moraud
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland; Defitech Centre for Interventional Neurotherapies (NeuroRestore), UNIL-CHUV and Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Davide Malatesta
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Julien F Bally
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Aurélien Patoz
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland
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Mobile health technology, exercise adherence and optimal nutrition post rehabilitation among people with Parkinson's Disease (mHEXANUT) - a randomized controlled trial protocol. BMC Neurol 2023; 23:93. [PMID: 36864377 PMCID: PMC9979434 DOI: 10.1186/s12883-023-03134-5] [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: 11/11/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson's Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme. METHODS A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1-3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out. DISCUSSION The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. TRIAL REGISTRATION ClinicalTrials.gov (NCT04945876). First registration 01.03.2021.
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Yu WY, Yang QH, Wang XQ. The mechanism of exercise for pain management in Parkinson's disease. Front Mol Neurosci 2022; 15:1039302. [PMID: 36438185 PMCID: PMC9684336 DOI: 10.3389/fnmol.2022.1039302] [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: 09/08/2022] [Accepted: 10/07/2022] [Indexed: 08/03/2023] Open
Abstract
The research and clinical applications of exercise therapy to the treatment of Parkinson's disease (PD) are increasing. Pain is among the important symptoms affecting the daily motor function and quality of life of PD patients. This paper reviewed the progress of research on different exercise therapies for the management of pain caused by PD and described the role and mechanism of exercise therapy for pain relief. Aerobic exercise, strength exercise, and mind-body exercise play an effective role in pain management in PD patients. The pain suffered by PD patients is divided into central neuropathic, peripheral neuropathic, and nociceptive pain. Different types of pain may coexist with different mechanistic backgrounds and treatments. The analgesic mechanisms of exercise intervention in PD-induced pain include altered cortical excitability and synaptic plasticity, the attenuation of neuronal apoptosis, and dopaminergic and non-dopaminergic analgesic pathways, as well as the inhibition of oxidative stress. Current studies related to exercise interventions for PD-induced pain suffer from small sample sizes and inadequate research of analgesic mechanisms. The neurophysiological effects of exercise, such as neuroplasticity, attenuation of neuronal apoptosis, and dopaminergic analgesic pathway provide a sound biological mechanism for using exercise in pain management. However, large, well-designed randomized controlled trials with improved methods and reporting are needed to evaluate the long-term efficacy and cost-effectiveness of exercise therapy for PD pain.
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Affiliation(s)
- Wen-Ye Yu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Qi-Hao Yang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangtishang Orthopaedic Hospital, Shanghai, China
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KIZIL N, ÖĞÜT H, OKUYUCU E, GÜLER H, ÖZER C, TURHANOĞLU AD. Parkinson hastalarına yönelik bir rehabilitasyon programının reaksiyon ve hareket zamanı üzerine etkileri: bir elektromiyografik çalışma. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1017006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: The aim of the study was to investigate the effects of a rehabilitation program consisting of specific exercises for Parkinson's Disease (PD) patients on reaction time (RT), movement time (MT), quality of life and disease activity.
Materials and Methods: A total of 26 idiopathic PD patients were included in the study. The exercises specific to Parkinson’s were applied to the patients for 16 weeks. The evaluation of the patients were done before and after the treatment. The disease severity was measured with Unified Parkinson’s Disease Rating Scale (UPDRS), quality of life was measured with Short Form-36 (SF-36). RT and MT measurements were done electromyographically.
Results: There was no statistically significant difference in UPDRS total and sub-section values and SF-36 quality of life evaluation before and after the exercise program. While a significant decrease was observed in the RT values of the patients after the 16 week exercise program compared to prior to the program (Deltoid RT 370.46 ± 25 to 219.58 ± 17, biceps RT 370.42 ± 27 to 216.49 ± 14 and triceps RT 445.21 ± 31 to 247.53 ± 23, respectively).
Conclusion: In PD, the rehabilitation program specific to the disease leads to a significant decrease in RT. Although the exercise has no statistically significant effect on disease activity, quality of life and MT values, it was seen that it still led to improvement.
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Affiliation(s)
- Nurhan KIZIL
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | | | - Esra OKUYUCU
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | - Hayal GÜLER
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
| | - Cahit ÖZER
- MUSTAFA KEMAL ÜNİVERSİTESİ, TAYFUR ATA SÖKMEN TIP FAKÜLTESİ
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Meng D, Jin Z, Chen K, Yu X, Wang Y, Du W, Wei J, Xi J, Fang B. Quality of life predicts rehabilitation prognosis in Parkinson's disease patients: Factors influence rehabilitation prognosis: Factors influence rehabilitation prognosis. Brain Behav 2022; 12:e2579. [PMID: 35429406 PMCID: PMC9120870 DOI: 10.1002/brb3.2579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/14/2022] [Accepted: 03/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Rehabilitation has been reported to improve the quality of life (QoL) of patients with Parkinson's disease (PD). Nevertheless, not all patients are satisfied with rehabilitation outcomes and could achieve a significant improvement in QoL. OBJECTIVE To detect possible predictors of QoL improvement in patients with PD after rehabilitation. METHODS A total of 86 PD patients were included and followed up for 3 months with a 39-item Parkinson's Disease Questionnaire summary index (PDQ-39 SI) as the primary endpoint. All patients received 2 weeks of multidisciplinary intensive rehabilitation treatment (MIRT). Changes in patients' QoL were assessed using the PDQ-39 at baseline and at the 3-month follow-up. The reliable change index (RCI) was adapted to determine the individual QoL outcome. The predictors of QoL outcome were detected using logistic regression analysis. RESULTS After a 3-month follow-up, PDQ-39 SI decreased significantly from 22.95 ± 9.75 to 18.73 ± 10.32 (P < 0.001). Scores for QoL improved (RCI>10.9) after rehabilitation for 18.6% of the patients, and 74.4% of patients reported an unchanged QoL (-10.9≤RCI≤10.9), while 7.0% of patients reported a worsening of QoL (RCI<-10.9). Among the baseline parameters, the PDQ-39 SI was a baseline predictor for changes in QoL in the logistic regression model (OR: 1.15, CI: 1.07-1.24, P < 0.001). CONCLUSIONS MIRT could improve QoL for some patients with PD, and PDQ-39 score at baseline is the most important predictor for QoL improvements after rehabilitation for this patients.
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Affiliation(s)
- Detao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Keke Chen
- Beijing Rehabilitation Medical College, Capital Medical University, Beijing, China
| | - Xin Yu
- Beijing Rehabilitation Medical College, Capital Medical University, Beijing, China
| | - Yixuan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Wenjun Du
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jingran Wei
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jianing Xi
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Boyan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
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Gassner L, Dabnichki P, Pokan R, Schmoeger M, Willinger U, Maetzler W, Moser H, Zach H. Therapeutic climbing in Parkinson’s disease: Differences in self-reported health and well-being, feasibility and clinical changes. Physiother Theory Pract 2022; 39:1163-1177. [DOI: 10.1080/09593985.2022.2036279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lucia Gassner
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- School of Engineering, RMIT University, VIC Australia
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
| | | | - Rochus Pokan
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
| | | | - Ulrike Willinger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Kiel University, Kiel, Germany
| | - Hermann Moser
- Therapy Center Gmundnerberg, Altmünster Am Traunsee, Austria
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Heidemarie Zach
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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New Recovery Strategies in Motor and Cognitive Functions, before, during and after Home-Confinement COVID-19, for Healthy Adults and Patients with Neurodegenerative Diseases: Review. J Clin Med 2022; 11:jcm11030597. [PMID: 35160048 PMCID: PMC8836374 DOI: 10.3390/jcm11030597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/17/2022] Open
Abstract
Distancing and confinement at home during the Coronavirus Disease 2019 (COVID-19) outbreak has led to worsening of motor and cognitive functions, both for healthy adults and for patients with neurodegenerative diseases. The decrease in physical activity, the cessation of the intervention of the recovery and the social distance imposed by the lockdown, has had a negative impact on the physical and mental health, quality of life, daily activities, as well as on the behavioral attitudes of the diet. The purpose of this paper was to evaluate the impact of decreasing physical activity and the affected emotional status in healthy adults and patients with neurodegenerative diseases in conditions imposed by the stay at home mandate of COVID-19, along with new interventions, such as telemedicine and telerehabilitation. These interventions include online surveys carried out in multi-languages, semi-structured interviews, intervention smartphones and interventions through online platforms, for instance: Google, WhatsApp, Twitter, ResearchGate, Facebook and LinkedIn. For this study, we selected original papers that were intensively processed using characteristics co-related with physical activity, mental wellbeing, sleep quality, good eating behavior and healthy lifestyle. By searching the last two years of literature, our review presents and demonstrates the benefit of online technological interventions in lockdown, which promote physical exercise patterns and rehabilitation techniques, for healthy adults and patients with neurodegenerative diseases, and the need to develop new strategic directions and governmental measures, designed procedures and health services, which are expected to improve the quality of life, the progress of physical and cognitive functions, mental health and wellbeing for all.
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Wang K, Li K, Zhang P, Ge S, Wen X, Wu Z, Yao X, Jiao B, Sun P, Lv P, Lu L. Mind–Body Exercises for Non-motor Symptoms of Patients With Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2021; 13:770920. [PMID: 36226304 PMCID: PMC9549381 DOI: 10.3389/fnagi.2021.770920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to systematically evaluate the effects of mind–body exercise on global cognitive function, depression, sleep disorders, fatigue level, and quality of life (QOL) in a Parkinson’s disease (PD) population. Methods: Total six English and Chinese databases were searched for articles published up to May 2021. Randomized controlled trials (RCTs) evaluating mind–body excises on non-motor symptoms of PD were included. The Cochrane risk of bias tool was used to assess the methodological quality, and we defined high-quality studies as having a low risk of bias in four or more domains. Global cognitive function was considered the primary outcome and was assessed using the Montreal Cognitive Assessment (MoCA). The secondary outcomes included QOL, fatigue, depression, and sleep quality, which were measured using the Parkinson’s Disease Questionnaire (PDQ-39), 16-item Parkinson’s Disease Fatigue Scale (PFS-16), Beck Depression Inventory (BDI), and revised Parkinson’s Disease Sleep Scale (PDSS-2), respectively. Subgroup analyses were conducted for global cognitive function and QOL to assess the optimal treatment measure across the various mind–body exercises. Results: Fourteen RCTs with 404 patients were finally included in the meta-analysis. Eight (57.14%) studies were of high quality. The pooled results showed that mind–body exercises generally had a significant advantage over the control intervention in improving global cognitive function (MD = 1.68; P = 0.0008). The dose subgroup analysis revealed that the low dose (60–120 min per week) and moderate dose (120–200 min per week) significantly increased MoCA scores compared with the control group (MD = 2.11, P = 0.01; MD = 1.27, P = 0.02, respectively). The duration subgroup analysis indicated a significant difference in the effect of the duration (6–10 and >15 weeks) on increasing MoCA scores compared with the control group (MD = 3.74, P < 0.00001; MD = 1.45, P = 0.01, respectively). Conclusion: Mind–body exercise may improve global cognitive function, sleep quality, and QOL in the PD population. In addition, low to moderate doses and appropriate durations significantly improved global cognitive function. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [CRD42021275522].
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Affiliation(s)
- Kai Wang
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Kunbin Li
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
- *Correspondence: Kunbin Li,
| | - Peiming Zhang
- Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuqi Ge
- Department of Rehabilitation, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Xiaopeng Wen
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Zhiyuan Wu
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Xianli Yao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Bing Jiao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Pingge Sun
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Peipei Lv
- Department of Medical Imaging, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Liming Lu
- Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Liming Lu,
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Larson D, Yeh C, Rafferty M, Bega D. High satisfaction and improved quality of life with Rock Steady Boxing in Parkinson's disease: results of a large-scale survey. Disabil Rehabil 2021; 44:6034-6041. [PMID: 34498995 DOI: 10.1080/09638288.2021.1963854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare demographics, self-reported symptom burden, Health-Related Quality of Life (HRQL), and Self-Efficacy for Exercise (SEE) between participants and non-participants of Rock Steady Boxing (RSB), a non-contact boxing program for individuals with Parkinson's disease (PD) that focuses on agility, balance, and speed training. MATERIALS AND METHODS Adults with PD who had heard of RSB completed a 20 min, 61-question electronic survey including the Parkinson's Disease Questionnaire-39 (PDQ-39) and the Self-Efficacy for Exercise (SEE) scale. Differences between participants and never-participants were analyzed using chi-squared test, fisher's exact test and Wilcoxon test. RESULTS Of 2054 individuals enrolled in the survey, 1709 were eligible for analysis. 1333 were current participants, 166 previous-participants, and 210 never-participants. RSB participants were median age 69, 59% male, and 97% Caucasian. The majority of current participants reported that RSB improved their social life (70%), fatigue (63%), fear of falling (62%), depression (60%), and anxiety (59%). Compared to previous and never-participants, current participants had better median PDQ-39 scores (36 and 32 vs 25, p < 0.01) and SEE scores (43 and 48 vs 54, p < 0.01). CONCLUSIONS This is the largest survey of RSB use in PD. RSB participants report improvement in non-motor impairments and have significantly better HRQL and ESE compared to never-participants.IMPLICATIONS FOR REHABILITATIONParkinson's disease (PD) is a slowly progressive neurodegenerative condition that affects motor function and subsequently, quality of life.Exercise is increasingly recognized as an important treatment for motor and non-motor symptoms of PD.Rock Steady Boxing (RSB) is a specific non-contact boxing program for PD that is growing and increasing in popularity, though there is limited data on its effect on PD symptoms and quality of life.
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Affiliation(s)
- Danielle Larson
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Chen Yeh
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Miriam Rafferty
- Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation and Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Danny Bega
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Qureshi AR, Jamal MK, Rahman E, Paul DA, Oghli YS, Mulaffer MT, Qureshi D, Danish MA, Rana AQ. Non-pharmacological therapies for pain management in Parkinson's disease: A systematic review. Acta Neurol Scand 2021; 144:115-131. [PMID: 33982803 DOI: 10.1111/ane.13435] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 12/29/2022]
Abstract
Among the various non-motor symptoms of Parkinson's disease (PD), pain is often cited as the most common and debilitating feature. Currently, the literature contains gaps in knowledge with respect to the various forms of treatment available, particularly non-pharmacological therapies. Thus, the purpose of this systematic review is to provide an examination of the literature on non-pharmacological therapies for pain in PD. We compared the findings of research articles indexed within various literature databases related to non-pharmacological treatments of pain in PD patients. Our review identified five major non-pharmacological methods of pain therapy in PD: acupuncture, hydrotherapy, massage therapy, neuromodulation, and exercise. Treatments such as exercise therapy found a reduction in pain perception due to various factors, including the analgesic effects of neurotransmitter release during exercise and increased activity leading to a decrease in musculoskeletal rigidity and stiffness. By the same token, hydrotherapy has been shown to reduce pain perception within PD patients, with authors often citing a combined treatment of exercise and hydrotherapy as an effective treatment for pain management. Multiple methods of neurostimulation were also observed, including deep brain stimulation and spinal cord stimulation. Deep brain stimulation showed efficacy in alleviating certain pain types (dystonic and central), while not others (musculoskeletal). Hence, patients may consider deep brain stimulation as an additive procedure for their current treatment protocol. On the other hand, spinal cord stimulation showed significant improvement in reducing VAS scores for pain. Finally, although the literature on massage therapy and acupuncture effectiveness on pain management is limited, both have demonstrated a reduction in pain perception, with common reasons such as tactile stimulation and release of anti-nociceptive molecules in the body. Although literature pertaining to non-pharmacological treatments of pain in PD is sparse, there is copious support for these treatments as beneficial to pain management. Further exploration in the form of clinical trials is warranted to assess the efficacy of such therapies.
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Affiliation(s)
- Abdul Rehman Qureshi
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada
| | - Muhammad Khizar Jamal
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Eraad Rahman
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Dion A. Paul
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Yazan Shamli Oghli
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Mohamed Thariq Mulaffer
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Danial Qureshi
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa ON Canada
- Bruyère Research Institute Ottawa ON Canada
| | - Muhammad Affan Danish
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
| | - Abdul Qayyum Rana
- Neurology Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Toronto ON Canada
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Analysis of the Effects of Coordination Program Viva 2 Parkinson (CoVi2) on Dynamic Balance, Muscle Parameters, and Symptomatology in Older Adults Diagnosed With Advanced Stages of Parkinson's Disease. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Slater LV, Gebska A, McCartney K, Rafferty MR. Designing a screening battery for exercisers with Parkinson's disease. Disabil Rehabil 2021; 44:4111-4117. [PMID: 33645370 DOI: 10.1080/09638288.2021.1883748] [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: 10/22/2022]
Abstract
PURPOSE Develop a screening battery for persons with Parkinson's Disease (PD) that is easily administered in a short amount of time by community exercise professionals and measures changes in function. METHODS An integrated, stakeholder-engaged, mixed methods approach included interviews and meetings with community exercise professionals on the development of a screening battery. Persons with PD (n = 57, age = 72.1 ± 8.1 years) who were already enrolled in fitness classes or individualized training at three locations participated in the screening battery twice over 8-16 weeks and provided feedback. Trends from interviews and meeting notes were identified using summative content analysis. Quantitative changes in performance were compared with paired t-tests. Cohen's d effect sizes were calculated for all significant differences. RESULTS Current barriers for functional screenings included time and space. Using this feedback, we developed a screening battery that took under 20 min, required little equipment, had been previously validated, could be performed in individual and group settings, and provided objective feedback that was motivating for persons with PD to continue exercising. Persons with PD demonstrated improved functional performance on sit-to-stand (d = -0.71), two-minute walk test (d = -3.83), and arm curls (d = -0.78). CONCLUSION Test results can be a motivator for persons with PD and lead to increased exercise adherence. Easily administered tests can show improvements in this population. Community exercise professionals are able to safely screen persons with PD to detect functional deficits and assist with programming.Implications for RehabilitationRegular exercise can slow declines in physical function and quality of life in people with Parkinson's disease.Use of physical assessments in community exercise programs can improve motivation to exercise for this population.Physical assessments such as sit-to-stand and arm curls can be used to demonstrate improvements in people with Parkinson's disease.
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Affiliation(s)
- Lindsay V Slater
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Miriam R Rafferty
- Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Physical Rehabilitation and Medicine, Northwestern University, Chicago, IL, USA
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15
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Lin I, Edison B, Mantri S, Albert S, Daeschler M, Kopil C, Marras C, Chahine LM. Triggers and alleviating factors for fatigue in Parkinson's disease. PLoS One 2021; 16:e0245285. [PMID: 33540422 PMCID: PMC7861907 DOI: 10.1371/journal.pone.0245285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/24/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Fatigue is common in Parkinson's Disease, but few effective treatments are available for it. Exploring triggers and alleviating factors, including effects of exercise, could inform development of management strategies for Parkinson's Disease fatigue. OBJECTIVES To examine triggers and alleviating factors for fatigue reported by individuals with Parkinson's Disease, including perceived effect of exercise. METHODS A sample of individuals with self-reported Parkinson's Disease participating in the study Fox Insight were administered an online survey. The survey included the Parkinson's Fatigue Scale, the Physical Activity Scale for the Elderly, and multiple-choice questions about triggers and alleviating factors for fatigue. RESULTS Among the sample of 1,029 individuals with Parkinson's disease, mean (standard deviation (SD)) age was 67.4 (9.3) years, 44.0% were female. Parkinson's Fatigue Scale score ranged from 16-80, mean (SD) 48.8 (16.2). Poor sleep (62.1%) and physical exertion (45.1%) were frequently reported triggers for fatigue. Coping strategies including sitting quietly (58.1%), laying down with or without napping, and exercise (20%). Physical Activity Scale for the Elderly scores were higher in those who reported that exercise alleviated their fatigue (49.7%) compared to those who reported it worsened their fatigue (18.9%) (mean (SD) score 158.5 (88.8) vs 119.8 (66.6) respectively; p<0.001). CONCLUSIONS Several behavioral and environmental triggers and alleviating strategies for fatigue are reported by individuals with Parkinson's disease. Many feel that exercise alleviates fatigue, though the relationship between exercise and fatigue in Parkinson's Disease appears complex. This exploratory study may inform future development of treatments or coping strategies for Parkinson's disease fatigue.
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Affiliation(s)
- Iris Lin
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Briana Edison
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Sneha Mantri
- Department of Neurology, Duke University, Durham, NC, United States of America
| | - Steven Albert
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Margaret Daeschler
- Columbia University School of Social Work, New York, NY, United States of America
| | - Catherine Kopil
- The Michael J. Fox Foundation for Parkinson’s Research, New York, NY, United States of America
| | - Connie Marras
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Lana M. Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States of America
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16
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The impact of COVID-19 and social distancing on people with Parkinson's disease: a survey study. NPJ PARKINSONS DISEASE 2021; 7:10. [PMID: 33479241 PMCID: PMC7820020 DOI: 10.1038/s41531-020-00153-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/08/2020] [Indexed: 12/14/2022]
Abstract
As the COVID-19 pandemic continues to affect the international community, very little is known about its impact on the health and day-to-day activities of people with Parkinson’s disease (PwPD). To better understand the emotional and behavioral consequences of the public health policies implemented to mitigate the spread of SARS-CoV-2 in PwPD, and to explore the factors contributing to accessing alternative health care mechanisms, such as telehealth, we administered an anonymous knowledge, attitude, and practice survey to PwPD and care partners, via the mailing lists of the Parkinson’s Foundation and Columbia University Parkinson’s Disease Center of Excellence with an average response rate of 19.3%. Sufficient information was provided by 1,342 PwPD to be included in the final analysis. Approximately half of respondents reported a negative change in PD symptoms, with 45–66% reporting mood disturbances. Telehealth use increased from 9.7% prior to the pandemic to 63.5% during the pandemic. Higher income and higher education were associated with telehealth use. Services were more often used for doctor’s appointment than physical, occupational, speech, or mental health therapies. Almost half (46%) of PwPD preferred to continue using telehealth always or sometimes after the coronavirus outbreak had ended. Having received support/instruction for telehealth and having a care partner, friend, or family member to help them with the telehealth visit increased the likelihood of continuous use of telehealth after the pandemic ended. Taken together, PD symptoms and management practices were markedly affected by COVID-19. Given the observed demographic limitations of telehealth, expanding its implementation to include additional physical, occupational, psychological, and speech therapies, increasing support for telehealth, as well as reaching underserved (low income) populations is urgently required.
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17
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Myers PS, Harrison EC, Rawson KS, Horin AP, Sutter EN, McNeely ME, Earhart GM. Yoga Improves Balance and Low-Back Pain, but Not Anxiety, in People with Parkinson's Disease. Int J Yoga Therap 2020; 30:41-48. [PMID: 31584838 DOI: 10.17761/2020-d-18-00028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Individuals with Parkinson's disease (PD) experience postural instability, low-back pain (LBP), and anxiety. These symptoms increase the risk of falls and decrease quality of life. Research shows yoga improves balance and decreases LBP and anxiety in healthy adults, but its effects in PD are poorly understood. All participants were part of a larger intervention study. Participants received pretest and posttest evaluations, including the Balance Evaluation Systems Test (BESTest), Beck Anxiety Inventory (BAI), and Revised Oswestry Disability Index (ROSW). Total scores for each measure, as well as individual balance system section scores from the BESTest (biomechanical constraints, stability limits/verticality, transitions/anticipatory, reactive, sensory orientation, and stability in gait) were compared within groups pre- to posttest. Participants in the yoga group (n = 13) completed a twice-weekly 12-week yoga interve n t i o n , whereas controls (n = 13) continued their usual routines for 12 weeks. Both the yoga (Z = -3.20, p = 0.001) and control (Z = -2.10, p = 0.040) groups improved on the BESTest total score. The control group showed no changes in individual balance systems, whereas the yoga group improved in stability limits/verticality (Z = -2.3, p = 0.020), transitions/ anticipatory (Z = -2.50, p = 0.010), reactive (Z = -2.70, p = 0.008), and sensory orientation (Z = -2.30, p = 0.020). ROSW decreased in the yoga group only (Z = -2.10, p = 0.030). BAI did not change in either group. Yoga is a nonpharmacological intervention that can improve balance and LBP in people with PD. This study demonstrated that yoga is feasible for people with PD, and participants reported high levels of enjoyment and intent to practice yoga after the study.
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Affiliation(s)
- Peter S Myers
- Department of Neurology, Washington University School of Medicine; formerly, Program in Physical Therapy, Washington University School of Medicine, St. Louis
| | - Elinor C Harrison
- Department of Neurology, Washington University School of Medicine; formerly, Program in Physical Therapy, Washington University School of Medicine, St. Louis
| | - Kerri S Rawson
- Program in Physical Therapy, Washington University School of Medicine, St. Louis
| | - Adam P Horin
- Program in Physical Therapy, Washington University School of Medicine, St. Louis
| | - Ellen N Sutter
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis; formerly, Program in Physical Therapy, Washington University School of Medicine, St. Louis
| | - Marie E McNeely
- Unfold Productions, LLC, St. Louis; formerly, Program in Physical Therapy, Washington University School of Medicine, and Department of Neurology, Washington University School of Medicine, St. Louis
| | - Gammon M Earhart
- Program in Physical Therapy; Department of Neurology; and Department of Neuroscience, Washington University School of Medicine, St. Louis
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18
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Edinoff A, Sathivadivel N, McBride T, Parker A, Okeagu C, Kaye AD, Kaye AM, Kaye JS, Kaye RJ, M. Sheth M, Viswanath O, Urits I. Chronic Pain Treatment Strategies in Parkinson's Disease. Neurol Int 2020; 12:61-76. [PMID: 33218135 PMCID: PMC7768530 DOI: 10.3390/neurolint12030014] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/11/2022] Open
Abstract
Neurological disorders, including Parkinson's disease (PD), have increased in prevalence and are expected to further increase in the coming decades. In this regard, PD affects around 3% of the population by age 65 and up to 5% of people over the age of 85. PD is a widely described, physically and mentally disabling neurodegenerative disorder. One symptom often poorly recognized and under-treated by health care providers despite being reported as the most common non-motor symptom is the finding of chronic pain. Compared to the general population of similar age, PD patients suffer from a significantly higher level and prevalence of pain. The most common form of pain reported by Parkinson's patients is of musculoskeletal origin. One of the most used combination drugs for PD is Levodopa-Carbidopa, a dopamine precursor that is converted to dopamine by the action of a naturally occurring enzyme called DOPA decarboxylase. Pramipexole, a D2 dopamine agonist, and apomorphine, a dopamine agonist, and Rotigotine, a dopamine receptor agonist, have showed efficacy on PD-associated pain. Other treatments that have shown efficacy in treating pain of diverse etiologies are acetaminophen, Nonsteroidal anti-inflammatory drugs (NSAIDs), and cyclooxygenase-2 (COX-2) inhibitors. Opioids and opioid-like medications such as oxycodone, morphine, tramadol, and codeine are also commonly employed in treatment of chronic pain in PD. Other opioid related medications such as Tapentadol, a central-acting oral analgesic with combined opioid and noradrenergic properties, and Targinact, a combination of the opioid agonist oxycodone and the opioid antagonist naloxone have shown improvement in pain. Anticonvulsants such as gabapentin, pregabalin, lamotrigine, carbamazepine and tricyclic antidepressants (TCAs) can be trialed when attempting to manage chronic pain in PD. The selective serotonin and noradrenaline reuptake inhibitors (SNRIs) also possess pain relieving and antidepressant properties, but carry less of the risk of anticholinergic side effects seen in TCAs. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been shown in multiple studies to be effective against various types of PD associated pain symptoms. Massage therapy (MT) is one of the most common forms of complementary and alternative medicine. Studies have shown that pressure applied during MT may stimulate vagal activity, promoting reduced anxiety and pain, as well as increasing levels of serotonin. In a survey study of PD patients, rehabilitative therapy and physical therapy were rated as the most effective for pain reduction, though with only temporary relief but these studies were uncontrolled. Yoga has been studied for patients with a wide array of neurological disorders. In summary, PD pathology is thought to have a modulating effect on pain sensation, which could amplify pain. This could help explain a portion of the higher incidence of chronic pain felt by PD patients. A treatment plan can be devised that may include dopaminergic agents, acetaminophen, NSAIDs, opioids, antidepressants, physical therapies, DBS and other options discussed in this review. A thorough assessment of patient history and physical examination should be made in patients with PD so chronic pain may be managed effectively.
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Affiliation(s)
- Amber Edinoff
- Department of Psychiatry and Behavioral Medicine, Health Science Center, Louisiana State University Shreveport, Shreveport, LA 71103, USA;
| | - Niro Sathivadivel
- Department of Psychiatry and Behavioral Medicine, Health Science Center, Louisiana State University Shreveport, Shreveport, LA 71103, USA;
| | - Timothy McBride
- School of Medicine, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (T.M.); (A.P.)
| | - Allyson Parker
- School of Medicine, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (T.M.); (A.P.)
| | - Chikezie Okeagu
- Department of Anesthesiology, Louisiana State University New Orleans, New Orleans, LA 70112, USA; (C.O.); (A.D.K.)
| | - Alan D. Kaye
- Department of Anesthesiology, Louisiana State University New Orleans, New Orleans, LA 70112, USA; (C.O.); (A.D.K.)
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (M.M.S.); (O.V.); (I.U.)
| | - Adam M. Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.M.K.); (J.S.K.)
| | - Jessica S. Kaye
- Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.M.K.); (J.S.K.)
| | - Rachel J. Kaye
- School of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Meeta M. Sheth
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (M.M.S.); (O.V.); (I.U.)
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (M.M.S.); (O.V.); (I.U.)
- School of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA;
- College of Medicine-Phoenix, University of Arizona, Phoenix, AZ 85004, USA
- Department of Anesthesiology, School of Medicine, Creighton University, Omaha, NE 68124, USA
- Valley Anesthesiology and Pain Consultants–Envision Physician Services, Phoenix, AZ 85004, USA
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA 71103, USA; (M.M.S.); (O.V.); (I.U.)
- Southcoast Health, Southcoast Physicians Group Pain Medicine, Wareham, MA 02571, USA
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Bacanoiu MV, Mititelu RR, Danoiu M, Olaru G, Buga AM. Functional Recovery in Parkinson's Disease: Current State and Future Perspective. J Clin Med 2020; 9:jcm9113413. [PMID: 33114424 PMCID: PMC7692963 DOI: 10.3390/jcm9113413] [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: 09/21/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/05/2022] Open
Abstract
Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders, affecting not only the motor function but also limiting the autonomy of affected people. In the last decade, the physical exercises of different intensities carried out by kinetic therapeutic activities, by robotic technologies or with the participation of sensory cues, have become increasingly appreciated in the management of Parkinson’s disease impairments. The aim of this paper was to evaluate the impact of physical exercises with and without physical devices on the motor and cognitive variables of PD patients. In order to achieve our objectives, we performed a systematic review of available original articles based on the impact of kinetic therapeutic activity. Through the search strategy, we selected original papers that were laboriously processed using characteristics related to physical therapy, or the tools used in physiological and psychological rehabilitation strategies for PD patients. In this study, we presented the most current intervention techniques in the rehabilitation programs of patients with Parkinson’s disease, namely the use of assisted devices, virtual imagery or the performing of physical therapies that have the capacity to improve walking deficits, tremor and bradykinesia, to reduce freezing episodes of gait and postural instability, or to improve motor and cognitive functions.
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Affiliation(s)
- Manuela Violeta Bacanoiu
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
- Department of Laboratory Medicine, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
- Correspondence: (M.V.B.); (A.M.B.); Tel.: +40-0351-443-500 (A.M.B.)
| | - Radu Razvan Mititelu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; or
| | - Mircea Danoiu
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
| | - Gabriela Olaru
- Department of Physical Therapy and Sports Medicine, University of Craiova, 200207 Craiova, Romania; (M.D.); (G.O.)
| | - Ana Maria Buga
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; or
- Correspondence: (M.V.B.); (A.M.B.); Tel.: +40-0351-443-500 (A.M.B.)
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20
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Spencer CM, Haub M, Rockers M. Living with Parkinson's disease: The benefits of community programming. Complement Ther Clin Pract 2020; 41:101241. [PMID: 32987326 DOI: 10.1016/j.ctcp.2020.101241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/16/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND and purpose. Parkinson's Disease (PD) is a common neurodegenerative disorder that has significant physical, mental and financial costs for individuals and families. It is necessary to examine ways to improve the lives of individuals living with PD. MATERIALS AND METHODS Through the use of a thematic analysis, this study examined the benefits that participants in a community PD program experienced, and the barriers that prohibited individuals from participating. RESULTS Participants of the community PD program reported that participating in the program gave them a sense of community/belonging, increased knowledge about PD, a sense of hope/improved outlook on life, and physical improvements. Two main barriers preventing individuals from participating in the program was a lack of transportation and a fear of seeing PD symptom progression in others. CONCLUSION Results highlight that community PD programs can aid in improvements in quality of life related to exercise, an improved outlook, and support.
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Cristini J, Weiss M, De Las Heras B, Medina-Rincón A, Dagher A, Postuma RB, Huber R, Doyon J, Rosa-Neto P, Carrier J, Amara AW, Roig M. The effects of exercise on sleep quality in persons with Parkinson's disease: A systematic review with meta-analysis. Sleep Med Rev 2020; 55:101384. [PMID: 32987321 DOI: 10.1016/j.smrv.2020.101384] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 12/20/2022]
Abstract
We conducted a systematic review with meta-analysis to determine the evidence in support of exercise to improve sleep quality assessed subjectively and objectively in Parkinson's Disease (PD). Standardized mean differences (SMD) comparing the effects of exercise and control interventions on sleep quality with 95% confidence intervals (CI) were calculated. Data from 10 randomized and 2 non-randomized controlled trials, including a total of 690 persons with PD were included. Exercise had a significant positive effect on sleep quality assessed subjectively (SMD = 0.53; 95% CI = 0.16-0.90; p = 0.005). However, the methodological quality of the studies showing positive effects on sleep quality was significantly poorer than the studies showing no effects. Only one study assessed the impact of exercise on objective sleep quality, showing improvements in sleep efficiency assessed with polysomnography (SMD = 0.94; 95% CI = 0.38-1.50; p = 0.001). Exercise performed at moderate to maximal intensities (SMD = 0.46; 95% CI = 0.05-0.87; p = 0.03) had significant effects on subjective sleep quality. In contrast, exercise performed at mild to moderate intensities showed non-significant effects (SMD = 0.76; 95% CI = -0.24-1.76; p = 0.14). These results support the use of exercise to improve sleep quality in persons with PD and reinforce the importance of achieving vigorous exercise intensities. Biases, limitations, practice points and directions for future research are discussed.
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Affiliation(s)
- Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maxana Weiss
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Bernat De Las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Almudena Medina-Rincón
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada; Universitat Internacional de Catalunya, Barcelona, Catalonia, Spain
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Ronald B Postuma
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Reto Huber
- Child Development Center, University Children's Hospital and Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland
| | - Julien Doyon
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Canada
| | - Julie Carrier
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Amy W Amara
- University of Alabama at Birmingham, Alabama, USA
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. https://memorylab.ca/
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Krishnamurthi N, Fleury J, Belyea M, Shill HA, Abbas JJ. ReadySteady intervention to promote physical activity in older adults with Parkinson's disease: Study design and methods. Contemp Clin Trials Commun 2020; 17:100513. [PMID: 32211555 PMCID: PMC7083754 DOI: 10.1016/j.conctc.2019.100513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/16/2019] [Accepted: 12/30/2019] [Indexed: 02/02/2023] Open
Abstract
The main motor impairments of gait and balance experienced by people with Parkinson's disease (PD) contribute to a sedentary lifestyle, resulting in poor physical conditioning, loss of functional independence, and reduced quality of life. Despite the known benefits of physical activity in PD, the majority of older adults with PD are insufficiently active. Few studies incorporate behavioral change approaches to promoting physical activity in PD. The main goal of this research is to foster community mobility in older adults with PD by promoting physical activity and improving gait patterns using a theory-based behavioral change intervention. The ReadySteady intervention combines wellness motivation theory with polestriding physical activity, which has been shown to be beneficial for people with PD. The intervention will be tested using a randomized controlled design, including inactive older adults diagnosed with PD. Participants will be randomly assigned the 12-week ReadySteady intervention, 12-week polestriding, and education intervention, or 12-week education intervention. Thirty-six older adults with PD will participate in each of the interventions. Level of physical activity, clinical scores, quantitative measures of gait and balance control, and motivational variables for each intervention will be measured at three time points: pre-intervention, post-intervention (12 weeks), and follow-up (24 weeks). If the intervention is beneficial, it may serve as a sustainable addition to current practice in health promotion efforts serving the PD population.
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Affiliation(s)
- Narayanan Krishnamurthi
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Julie Fleury
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Michael Belyea
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, 85004, USA
| | - Holly A. Shill
- Muhammad Ali Parkinson Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA
| | - James J. Abbas
- Center for Adaptive Neural Systems, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287, USA
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Stevens A, Stanton R, Rebar AL. Helping People With Parkinson Disease Build Exercise Self-Efficacy. Phys Ther 2020; 100:205-208. [PMID: 31665447 DOI: 10.1093/ptj/pzz160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/14/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Amy Stevens
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Robert Stanton
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Amanda L Rebar
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
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Sacheli MA, Neva JL, Lakhani B, Murray DK, Vafai N, Shahinfard E, English C, McCormick S, Dinelle K, Neilson N, McKenzie J, Schulzer M, McKenzie DC, Appel‐Cresswell S, McKeown MJ, Boyd LA, Sossi V, Stoessl AJ. Exercise increases caudate dopamine release and ventral striatal activation in Parkinson's disease. Mov Disord 2019; 34:1891-1900. [DOI: 10.1002/mds.27865] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Matthew A. Sacheli
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
| | - Jason L. Neva
- Department of Physical Therapy, Brain Behaviour Laboratory, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Bimal Lakhani
- Department of Physical Therapy, Brain Behaviour Laboratory, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Danielle K. Murray
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
- Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Nasim Vafai
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - Elham Shahinfard
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - Carolyn English
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - Siobhan McCormick
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - Katie Dinelle
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - Nicole Neilson
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
| | - Jessamyn McKenzie
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
| | - Michael Schulzer
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
| | - Don C. McKenzie
- School of Kinesiology University of British Columbia Vancouver British Columbia Canada
| | - Silke Appel‐Cresswell
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
- Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Martin J. McKeown
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
- Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Lara A. Boyd
- Department of Physical Therapy, Brain Behaviour Laboratory, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Vesna Sossi
- Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada
| | - A. Jon Stoessl
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health University of British Columbia & Vancouver Coastal Health Vancouver British Columbia Canada
- Faculty of Medicine University of British Columbia Vancouver British Columbia Canada
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The effect of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease: a systematic review and meta-analysis of systematic reviews. Int J Rehabil Res 2019; 42:196-204. [PMID: 31116118 DOI: 10.1097/mrr.0000000000000358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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26
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Daneshvar P, Ghasemi G, Zolaktaf V, Karimi MT. Comparison of the Effect of 8-Week Rebound Therapy-Based Exercise Program and Weight-Supported Exercises on the Range of Motion, Proprioception, and the Quality of Life in Patients with Parkinson's Disease. Int J Prev Med 2019; 10:131. [PMID: 31516672 PMCID: PMC6710923 DOI: 10.4103/ijpvm.ijpvm_527_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/13/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Parkinson's disease (PD) is a chronic, progressive disorder that mainly affects the central nervous system and, consequently, the patient's functional status. This study aimed to compare the effect of 8-week rebound therapy-based exercise program and weight-supported exercises on the range of motion, proprioception, and the quality of life in patients with PD. Methods Twenty patients were randomly divided into two equal groups of weight-bearing exercises and rebound exercise with no significant differences in age, weight, and height. The variables of the range of motion, proprioception, and the quality of life were assessed in pre- and posttest. Data were analyzed using repeated measure ANOVA and t-test at a significant level of P < 0.05. Results All of the variables in the two groups were significantly improved after 8 weeks of exercise, whereas the improvement rate in the rebound therapy group was more than the weight-bearing exercises group in range of motion (134.60 ± 13.22 vs. 118.38 ± 12.48), proprioception (7.60 ± 3.22 vs. 10.38 ± 2.48), and the quality of life (147.60 ± 13.22 vs. 118.38 ± 12.48) of the patients (P < 0.001 for all variables). Conclusions Given that both rebound and weight-supported exercises are effective on improving the range of motion, proprioception, and the quality of life of people with PD, it is recommended that the benefits of these exercises to be used in physical rehabilitation programs. However, rebound therapy exercises have had a greater effect on people with PD, and it seems better to use these exercises more than others.
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Affiliation(s)
- Pooya Daneshvar
- Department of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Gholamali Ghasemi
- Department of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Vahid Zolaktaf
- Department of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Mohammad Taghi Karimi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
Parkinson's disease is the second most common neurodegenerative disease with a prevalence rate of 1-2 per 1000 of the population worldwide. Pharmacological management is the mainstay of treatment. Despite optimal medication, motor impairment particularly balance and gait impairment persist leading to various degree of disability and reduced quality-of-life. The present review describes motor impairment including postural impairment, gait dysfunction, reduced muscle strength and aerobic capacity and falls. Physical therapy and complementary exercises have been proven to improve motor performance and functional mobility. Evidence on the efficacy of physical therapy and complementary exercises is presented in this review. These exercises include gait training with cues, gait training with treadmill, Nordic walking, brisk walking, balance training, virtual reality interventions, Tai Chi and dance. All these treatment interventions produce short-term beneficial effects and some interventions demonstrate long-term benefit. Gait training with treadmill enhance walking performance and the effects sustain for 3-6 months. Balance training improves balance, function and reduces fall rate, and these effects carry over to at least 12 months after training ended. Sustained Tai Chi for 6 months, dance therapy for 12 months, progressive resistive training for 24 months alleviates the PD motor symptoms, suggesting that they could slow down PD progression. Based on this evidence, individuals with PD are encouraged to sustain their training in order to improve/maintain their physical ability and to combat the progression of PD.
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Affiliation(s)
- Margaret K Y Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Irene S K Wong-Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Crowley EK, Nolan YM, Sullivan AM. Exercise as a therapeutic intervention for motor and non-motor symptoms in Parkinson's disease: Evidence from rodent models. Prog Neurobiol 2018; 172:2-22. [PMID: 30481560 DOI: 10.1016/j.pneurobio.2018.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 10/25/2018] [Accepted: 11/23/2018] [Indexed: 12/11/2022]
Abstract
Parkinson's disease (PD) is characterised by degeneration of dopaminergic neurons of the nigrostriatal pathway, which leads to the cardinal motor symptoms of the disease - tremor, rigidity and postural instability. A number of non-motor symptoms are also associated with PD, including cognitive impairment, mood disturbances and dysfunction of gastrointestinal and autonomic systems. Current therapies provide symptomatic relief but do not halt the disease process, so there is an urgent need for preventative strategies. Lifestyle interventions such as aerobic exercise have shown potential to lower the risk of developing PD and to alleviate both motor and non-motor symptoms. However, there is a lack of large-scale randomised clinical trials that have employed exercise in PD patients. This review will focus on the evidence from studies on rodent models of PD, for employing exercise as an intervention for both motor and non-motor symptoms.
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Affiliation(s)
- E K Crowley
- Department of Anatomy and Neuroscience, University College Cork, Ireland
| | - Y M Nolan
- Department of Anatomy and Neuroscience, University College Cork, Ireland; APC Microbiome Institute, University College Cork, Ireland
| | - A M Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Ireland; APC Microbiome Institute, University College Cork, Ireland.
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Abstract
BACKGROUND The delayed diagnosis, altered body image, and clinical complications associated with acromegaly impair quality of life. PURPOSE To assess the efficacy of the cognitive-behavioral therapy (CBT) technique "Think Healthy" to increase the quality of life of patients with acromegaly. METHODS This non-randomized clinical trial examined ten patients with acromegaly (nine women and one man; mean age, 55.5 ± 8.4 years) from a convenience sample who received CBT. The intervention included nine weekly group therapy sessions. The quality of life questionnaire the 36-Item Short Form Survey (SF-36) and the Beck Depression Inventory (BDI) were administered during the pre- and post-intervention phases. The Wilcoxon signed-rank test was performed to assess the occurrence of significant differences. RESULTS According to the SF-36, the general health domain significantly improved (d' = - 0.264; p = 0.031). The mental health domain improved considerably (d' = - 1.123; p = 0.012). Physical functioning showed a non-significant trend toward improvement (d' = - 0.802; p = 0.078), although four of the five patients who showed floor effects improved and remained at this level. Regarding emotional well-being, five patients showed floor effects and four improved, and the condition did not change among any of the four patients who showed ceiling effects. No significant changes were found with regard to the other domains. No significant differences in the BDI were found before or after the intervention. CONCLUSION The technique presented herein effectively improved the quality of life of patients with acromegaly with different levels of disease activity, type, and treatment time.
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Affiliation(s)
- Lia Silvia Kunzler
- SRTVS 701, Edifício Centro Empresarial Brasília, Bloco "C", sala 204, Asa Sul, Brasília, DF, CEP: 70.340-907, Brazil.
| | - Luciana Ansaneli Naves
- SRTVS 701, Edifício Centro Empresarial Brasília, Bloco "C", sala 204, Asa Sul, Brasília, DF, CEP: 70.340-907, Brazil
| | - Luiz Augusto Casulari
- SRTVS 701, Edifício Centro Empresarial Brasília, Bloco "C", sala 204, Asa Sul, Brasília, DF, CEP: 70.340-907, Brazil
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31
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Mollinedo-Cardalda I, Cancela-Carral JM, Vila-Suárez MH. Effect of a Mat Pilates Program with TheraBand on Dynamic Balance in Patients with Parkinson's Disease: Feasibility Study and Randomized Controlled Trial. Rejuvenation Res 2018; 21:423-430. [PMID: 29207899 DOI: 10.1089/rej.2017.2007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to assess the effect of a physical exercise program based on Mat Pilates (MP) with TheraBand® on the dynamic balance of a sample population diagnosed with Parkinson's disease (PD). After random selection, 26 participants were allocated to a MP group or a control group where they performed calisthenics exercises. Both interventions lasted 12 weeks and involved 2 weekly sessions of 60 minutes. Assessments took place at baseline, 12 weeks after the intervention started and 4 weeks after the intervention was completed using the body mass index (BMI), the Timed Up and Go (TUG) test with Wiva® sensors, the 30 Second Chair Stand test, and the Five Times Sit to Stand test. The group that completed the MP program presented significant improvements in BMI (F1,21 = 3.986; p = 0.038), the 30 Second Chair Stand test (F1,21 = 6.716; p = 0.014), the Five Times Sit to Stand test (F1,21 = 5.213; p = 0.032), and the time required to complete the TUG dynamic balance test (F1,21 = 5.035; p = 0.035). The MP program performed by a sample population with PD led to improvements in dynamic balance, and participants in the MP group showed increased strength in the lower limbs, but such improvements were not permanent after the activity ceased.
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Amara AW, Memon AA. Effects of Exercise on Non-motor Symptoms in Parkinson's Disease. Clin Ther 2018; 40:8-15. [PMID: 29198450 PMCID: PMC5875718 DOI: 10.1016/j.clinthera.2017.11.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/09/2017] [Accepted: 11/10/2017] [Indexed: 02/07/2023]
Abstract
Patients with Parkinson's disease experience disabling non-motor symptoms, including autonomic dysfunction, cognitive decline, and sleep disorders. Pharmacologic treatments for these symptoms are often ineffective or have intolerable side effects. Therefore, non-pharmacologic interventions are an attractive alternative. Exercise in particular has the potential to alleviate the progressive impairment related to these non-motor symptoms. In this commentary, we explore available research that addresses the impact of exercise and physical activity on autonomic dysfunction, cognitive impairment, and sleep disorders in Parkinson's disease and suggest areas in need of further study. Many gaps remain in our understanding of the most effective exercise intervention for these symptoms, the mechanisms underlying exercise-induced changes, and the best way to monitor response to therapy. However, available research suggests that exercise is a promising approach to improve non-motor symptoms in patients with Parkinson's disease.
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Affiliation(s)
- Amy W Amara
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Adeel A Memon
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
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Johnson BP, Westlake KP. Link Between Parkinson Disease and Rapid Eye Movement Sleep Behavior Disorder With Dream Enactment: Possible Implications for Early Rehabilitation. Arch Phys Med Rehabil 2017; 99:411-415. [PMID: 28890381 DOI: 10.1016/j.apmr.2017.08.468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 12/11/2022]
Abstract
The purpose of this article is 2-fold: first, to inform readers of the link between the loss of motor inhibition during rapid eye movement (REM) sleep dreaming, diagnosed as REM sleep behavior disorder, and the future onset of neurodegenerative disorders, such as Parkinson disease and dementia with Lewy bodies; it has been reported that motor disinhibition during REM sleep often precedes the onset of these disorders by years or even decades; second, to consider that the identification of REM sleep behavior disorder and the early involvement of rehabilitation and/or development of home exercise plans may aid in prolonging and even increasing function, independence, and quality of life, should such neurodegenerative disorders develop later in life.
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Affiliation(s)
- Brian P Johnson
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD
| | - Kelly P Westlake
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD.
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Complementary and Alternative Medicine and Exercise in Nonmotor Symptoms of Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:1163-1188. [PMID: 28805568 DOI: 10.1016/bs.irn.2017.05.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The use of complementary and alternative medicine (CAM) therapy in nonmotor symptoms (NMS) for Parkinson disease (PD) is growing worldwide. Well-performed, systematic evidence-based research is largely lacking in this area and many studies include various forms of CAM with small patient numbers and a lack of standardization of the approaches studied. Taichi, Qigong, dance, yoga, mindfulness, acupuncture, and other CAM therapies are reviewed and there is some evidence for the following: Taichi in sleep and PDQ39; dance in cognition, apathy, and a mild trend to improved fatigue; yoga in PDQ39; and acupuncture in depression, PDQ39, and sleep. Exercise including occupational therapy (OT) and physical therapy (PT) has been studied in motor symptoms of PD and balance but only with small studies with a mounting evidence base for use of exercise in NMS of PD including PDQ39, sleep, fatigue, depression, and some subsets of cognition. Studies of OT and PT largely show some benefit to depression, apathy, and anxiety. Sustainability of an improvement has not been shown given short duration of follow up. Finding optimal control groups and blind for these interventions is also an issue. This is a very important area of study since patients want to be self-empowered and they want guidance on which form of exercise is the best. Additionally, evidence for PT and OT in NMS would give added weight to get these interventions covered through medical insurance.
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Gandolfi M, Geroin C, Antonini A, Smania N, Tinazzi M. Understanding and Treating Pain Syndromes in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:827-858. [PMID: 28805585 DOI: 10.1016/bs.irn.2017.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pain affects many people with Parkinson's disease (PD) and diminishes their quality of life. Different types of pain have been described, but their related pathophysiological mechanisms remain unclear. The aim of this chapter is to provide movement disorders specialists an update about the pathophysiology of pain and a practical guide for the management of pain syndromes in clinical practice. This chapter reviews current knowledge on the pathophysiological mechanisms of sensory changes and pain in PD, as well as assessment and treatment procedures to manage these symptoms. In summary, changes in peripheral and central pain processing have been demonstrated in PD patients. A decrease in pain threshold and tolerance to several stimuli, a reduced nociceptive withdrawal reflex, a reduced pain threshold, and abnormal pain-induced activation in cortical pain-related areas have been reported. There is no direct association between improvement of motor symptoms and sensory/pain changes, suggesting that motor and nonmotor symptoms do not inevitably share the same mechanisms. Special care in pain assessment in PD is warranted by the specific pathophysiological aspects and the complexity of motor and nonmotor symptoms associated with pain symptoms. Rehabilitation may represent a valid option to manage pain syndromes in PD. However, further research in this field is needed. An integrated approach to pain involving a multidisciplinary team of medical specialists and rehabilitation experts should allow a comprehensive approach to pain in PD.
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Affiliation(s)
- Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy; Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Christian Geroin
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy
| | - Angelo Antonini
- University of Padua and Hospital San Camillo IRCCS, Venice, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy; Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, University of Verona, Verona, Italy.
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Amara AW, Chahine LM, Videnovic A. Treatment of Sleep Dysfunction in Parkinson's Disease. Curr Treat Options Neurol 2017; 19:26. [PMID: 28567500 DOI: 10.1007/s11940-017-0461-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OPINION STATEMENT Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption. Despite its high prevalence in the PD population, there is a paucity of clinical studies that have investigated treatment of sleep dysfunction associated with PD. Therefore, we aim to review available evidence and outline treatment strategies for improvement of disorders of sleep and wakefulness in PD patients. Evidence supporting the efficacy of pharmacological and non-pharmacological treatment strategies in PD is limited. There is thus a great need but also opportunity for development of well-designed clinical trials for impaired sleep and alertness in PD. Providing education about sleep hygiene and strategies for its implementation represents the initial step in management. Prompt diagnosis and treatment of co-existent primary sleep and psychiatric disorders are critical, as this may significantly improve sleep and alertness. While the optimal treatment for insomnia in PD has not been established, available strategies include cognitive-behavioral therapy, medications with soporific properties, and light therapy. Safety measures, clonazepam, and melatonin are the mainstay of treatment for RBD. Continuous positive airway pressure is an effective treatment for SDB in PD. The treatment algorithm for RLS associated with PD mirrors that used for idiopathic RLS. Circadian disruption has emerged as an important etiology of impaired sleep-wake cycles in PD, and circadian-based interventions hold promise for novel treatment approaches.
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Affiliation(s)
- Amy W Amara
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, SC 360A, 1720 2nd Ave S, Birmingham, AL, 35294-0017, USA.
| | - Lana M Chahine
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aleksandar Videnovic
- Neurobiological Clinical Research Institute, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Aburub A, Khalil H, Al-Sharman A, Alomari M, Khabour O. The association between physical activity and sleep characteristics in people with multiple sclerosis. Mult Scler Relat Disord 2017; 12:29-33. [DOI: 10.1016/j.msard.2016.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/04/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
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Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson's Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:5935782. [PMID: 27891159 PMCID: PMC5116525 DOI: 10.1155/2016/5935782] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 09/19/2016] [Accepted: 10/04/2016] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson's disease (PD). Fifty-four moderate PD patients (N = 54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P < 0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson's disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD.
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39
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Swank C, Shearin S, Cleveland S, Driver S. Auditing the Physical Activity and Parkinson Disease Literature Using the Behavioral Epidemiologic Framework. PM R 2016; 9:612-621. [PMID: 27777097 DOI: 10.1016/j.pmrj.2016.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/04/2016] [Accepted: 10/07/2016] [Indexed: 11/26/2022]
Abstract
Motor and nonmotor symptoms associated with Parkinson disease place individuals at greater risk of sedentary behaviors and comorbidities. Physical activity is one modifiable means of improving health and reducing the risk of morbidity. We applied a behavioral framework to classify existing research on physical activity and Parkinson disease to describe the current evolution and inform knowledge gaps in this area. Research placed in phase 1 establishes links between physical activity and health-related outcomes; phase 2 develops approaches to quantify physical activity behavior; phase 3 identifies factors associated with implementation of physical activity behaviors; phase 4 assesses the effectiveness of interventions to promote activity; and phase 5 disseminates evidence-based recommendations. Peer-reviewed literature was identified by searching PubMed, Google Scholar, and EBSCO-host. We initially identified 287 potential articles. After further review, we excluded 109 articles, leaving 178 included articles. Of these, 75.84% were categorized into phase 1 (n = 135), 10.11% in phase 2 (n = 18), 9.55% into phase 3 (n = 17), 3.37% into phase 4 (n = 6), and 1.12% into phase 5 (n = 2). By applying the behavioral framework to the physical activity literature for people with Parkinson disease, we suggest this area of research is nascent with more than 75% of the literature in phase 1. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Chad Swank
- School of Physical Therapy, Texas Woman's University, 5500 Southwestern Medical Ave, Dallas, TX 75235-7299(∗).
| | - Staci Shearin
- Department of Physical Therapy, University of Texas Southwestern School of Health Professions, Dallas, TX(†)
| | | | - Simon Driver
- Baylor Institute for Rehabilitation, Dallas, TX(§)
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Lauzé M, Daneault JF, Duval C. The Effects of Physical Activity in Parkinson's Disease: A Review. JOURNAL OF PARKINSON'S DISEASE 2016; 6:685-698. [PMID: 27567884 PMCID: PMC5088404 DOI: 10.3233/jpd-160790] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/10/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity (PA) is increasingly advocated as an adjunct intervention for individuals with Parkinson's disease (PD). However, the specific benefits of PA on the wide variety of impairments observed in patients with PD has yet to be clearly identified. OBJECTIVE Highlight health parameters that are most likely to improve as a result of PA interventions in patients with PD. METHODS We compiled results obtained from studies examining a PA intervention in patients with PD and who provided statistical analyses of their results. 868 outcome measures were extracted from 106 papers published from 1981 to 2015. The results were classified as having a statistically significant positive effect or no effect. Then, outcome measures were grouped into four main categories and further divided into sub-categories. RESULTS Our review shows that PA seems most effective in improving Physical capacities and Physical and cognitive functional capacities. On the other hand, PA seems less efficient at improving Clinical symptoms of PD and Psychosocial aspects of life, with only 50% or less of results reporting positive effects. The impact of PA on Cognitive functions and Depression also appears weaker, but few studies have examined these outcomes. DISCUSSION Our results indicate that PA interventions have a positive impact on physical capacities and functional capacities. However, the effect of PA on symptoms of the disease and psychosocial aspects of life are moderate and show more variability. This review also highlights the need for more research on the effects of PA on cognitive functions, depression as well as specific symptoms of PD.
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Affiliation(s)
- Martine Lauzé
- Département des sciences de l’activité physique, Université du Québec à Montréal, QC, Canada
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Jean-Francois Daneault
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Christian Duval
- Département des sciences de l’activité physique, Université du Québec à Montréal, QC, Canada
- Centre de Recherche Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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Allen NE, Moloney N, van Vliet V, Canning CG. The Rationale for Exercise in the Management of Pain in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2016; 5:229-39. [PMID: 25649828 PMCID: PMC4923748 DOI: 10.3233/jpd-140508] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Pain is a distressing non-motor symptom experienced by up to 85% of people with Parkinson’s disease (PD), yet it is often untreated. This pain is likely to be influenced by many factors, including the disease process, PD impairments as well as co-existing musculoskeletal and/or neuropathic pain conditions. Expert opinion recommends that exercise is included as one component of pain management programs; however, the effect of exercise on pain in this population is unclear. This review presents evidence describing the potential influence of exercise on the pain-related pathophysiological processes present in PD. Emerging evidence from both animal and human studies suggests that exercise might contribute to neuroplasticity and neuro-restoration by increasing brain neurotrophic factors, synaptic strength and angiogenesis, as well as stimulating neurogenesis and improving metabolism and the immune response. These changes may be beneficial in improving the central processing of pain. There is also evidence that exercise can activate both the dopaminergic and non-dopaminergic pain inhibitory pathways, suggesting that exercise may help to modulate the experience of pain in PD. Whilst clinical data on the effects of exercise for pain relief in people with PD are scarce, and are urgently needed, preliminary guidelines are presented for exercise prescription for the management of central neuropathic, peripheral neuropathic and musculoskeletal pain in PD.
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Affiliation(s)
- Natalie E Allen
- Clinical and Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Bognar S, DeFaria AM, O'Dwyer C, Pankiw E, Simic Bogler J, Teixeira S, Nyhof-Young J, Evans C. More than just dancing: experiences of people with Parkinson's disease in a therapeutic dance program. Disabil Rehabil 2016; 39:1073-1078. [PMID: 27216230 DOI: 10.1080/09638288.2016.1175037] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To understand why individuals with Parkinson's disease (PD) participate in a community-based therapeutic dance program and to explore its influence on perceived physical, social and emotional well-being of participants. METHODS A qualitative descriptive design was employed using one-on-one semi-structured interviews. Individuals with PD who participated in the Dancing with Parkinson's program were recruited from two locations. Interviews were audio-recorded, transcribed, de-identified and then placed into NVivo 10 software for analysis. A content analysis approach was used with an inductive analysis method to generate a coding scheme. Group discussion facilitated development of overarching themes. RESULTS Ten participants' responses revealed that the dance program allows for self-improvement and regaining identity through disease self-management. Positive influences of socialization arose through the class, decreasing isolation and improving quality of life. Participants communicate through music and dance to enhance connection with others. CONCLUSIONS Dancing with Parkinson's classes allow for re-development of the social self, which can increase sense of enjoyment in life. Dance programs provide opportunities for social interaction, non-verbal communication and self-improvement, reestablishing self-identity and a sense of usefulness. This study provides unique insight into the experience of participating in a dance program from the perspective of individuals with PD. Implications for rehabilitation Dance is emerging as a strategy to address the physical and psychosocial effects of Parkinson's disease (PD), but little is known regarding participants' perceptions of community-based therapeutic dance programs for PD. This study found that Dancing with Parkinson's (DWP) facilitated an improvement in social participation, resulting in decreased isolation and improved quality of life. Participation in the DWP program can facilitate a positive change in perspective and attitude toward a PD diagnosis, thereby increasing feelings of self-efficacy and improving self-management of the disease. Participants of this study emphasized the multifaceted benefits of DWP, suggesting that it has great potential for addressing not only the physical challenges, but also the cognitive and emotional challenges associated with PD.
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Affiliation(s)
- Stephanie Bognar
- a Department of Physical Therapy , University of Toronto , Toronto , Canada
| | - Anne Marie DeFaria
- a Department of Physical Therapy , University of Toronto , Toronto , Canada
| | - Casey O'Dwyer
- a Department of Physical Therapy , University of Toronto , Toronto , Canada
| | - Elana Pankiw
- a Department of Physical Therapy , University of Toronto , Toronto , Canada
| | | | | | - Joyce Nyhof-Young
- c Department of Undergraduate Medical Education , University of Toronto , Toronto , Canada
| | - Cathy Evans
- a Department of Physical Therapy , University of Toronto , Toronto , Canada
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Reynolds GO, Otto MW, Ellis TD, Cronin-Golomb A. The Therapeutic Potential of Exercise to Improve Mood, Cognition, and Sleep in Parkinson's Disease. Mov Disord 2016; 31:23-38. [PMID: 26715466 PMCID: PMC4724300 DOI: 10.1002/mds.26484] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 10/11/2015] [Accepted: 10/15/2015] [Indexed: 01/15/2023] Open
Abstract
In addition to the classic motor symptoms, Parkinson's disease (PD) is associated with a variety of nonmotor symptoms that significantly reduce quality of life, even in the early stages of the disease. There is an urgent need to develop evidence-based treatments for these symptoms, which include mood disturbances, cognitive dysfunction, and sleep disruption. We focus here on exercise interventions, which have been used to improve mood, cognition, and sleep in healthy older adults and clinical populations, but to date have primarily targeted motor symptoms in PD. We synthesize the existing literature on the benefits of aerobic exercise and strength training on mood, sleep, and cognition as demonstrated in healthy older adults and adults with PD, and suggest that these types of exercise offer a feasible and promising adjunct treatment for mood, cognition, and sleep difficulties in PD. Across stages of the disease, exercise interventions represent a treatment strategy with the unique ability to improve a range of nonmotor symptoms while also alleviating the classic motor symptoms of the disease. Future research in PD should include nonmotor outcomes in exercise trials with the goal of developing evidence-based exercise interventions as a safe, broad-spectrum treatment approach to improve mood, cognition, and sleep for individuals with PD.
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Affiliation(s)
| | - Michael W. Otto
- Boston University, Department of Psychological and Brain Sciences
| | - Terry D. Ellis
- Boston University College of Health and Rehabilitation Sciences: Sargent College, Department of Physical Therapy & Athletic Training and Center for Neurorehabilitation
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Sung YH. Effects of treadmill exercise on hippocampal neurogenesis in an MPTP /probenecid-induced Parkinson's disease mouse model. J Phys Ther Sci 2015; 27:3203-6. [PMID: 26644675 PMCID: PMC4668166 DOI: 10.1589/jpts.27.3203] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/16/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to investigate the effect of treadmill exercise on non-motor
function, specifically long-term memory, in a
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid-induced Parkinson’s disease mouse
model. [Methods] A mouse model of Parkinson’s disease was developed by injecting 20 mg/kg
of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 250 mg/kg of probenecid (P). We
divided in into four groups: probenecid group, probenecid-exercise group,
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid group, and
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid-exercise group. Mice in the
exercise groups ran on treadmill for 30 min/day, five times per week for 4 weeks.
[Results] Latency in the passive avoidance test increased in the
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid-exercise group compared with
1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid group. In addition, the number of
5-bromo-2-deoxyuridine/NeuN-positive cells and
5-bromo-2-deoxyuridine/doublecortin-positive cells in the hippocampal dentate gyrus was
higher in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid-exercise group than
that in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/probenecid group. These changes
were associated with the expression of brain-derived neurotrophic factor in the
hippocampus. [Conclusion] Our results suggest that treadmill exercise may improve
long-term memory in Parkinson’s disease mice by facilitating neurogenesis via increased
expression of neurotrophic factors.
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Affiliation(s)
- Yun-Hee Sung
- Department of Physical Therapy, College of Natural Sciences, Kyungnam University, Republic of Korea
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Fernandes Â, Rocha N, Santos R, Tavares JMRS. Effects of dual-task training on balance and executive functions in Parkinson's disease: A pilot study. Somatosens Mot Res 2015; 32:122-7. [PMID: 25874637 DOI: 10.3109/08990220.2014.1002605] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to analyze the efficacy of cognitive-motor dual-task training compared with single-task training on balance and executive functions in individuals with Parkinson's disease. Fifteen subjects, aged between 39 and 75 years old, were randomly assigned to the dual-task training group (n = 8) and single-task training group (n = 7). The training was run twice a week for 6 weeks. The single-task group received balance training and the dual-task group performed cognitive tasks simultaneously with the balance training. There were no significant differences between the two groups at baseline. After the intervention, the results for mediolateral sway with eyes closed were significantly better for the dual-task group and anteroposterior sway with eyes closed was significantly better for the single-task group. The results suggest superior outcomes for the dual-task training compared to the single-task training for static postural control, except in anteroposterior sway with eyes closed.
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Affiliation(s)
- Ângela Fernandes
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Terapia Ocupacional, Centro de Estudos de Movimento e Actividade Humana , Vila Nova de Gaia , Portugal
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Frazzitta G, Maestri R, Ferrazzoli D, Riboldazzi G, Bera R, Fontanesi C, Rossi RP, Pezzoli G, Ghilardi MF. Multidisciplinary intensive rehabilitation treatment improves sleep quality in Parkinson's disease. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2015; 2:11. [PMID: 26788347 PMCID: PMC4711016 DOI: 10.1186/s40734-015-0020-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/04/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sleep disturbances are among the most common non-motor symptoms of Parkinson's disease (PD), greatly interfering with daily activities and diminishing life quality. Pharmacological treatments have not been satisfactory because of side effects and interactions with anti-parkinsonian drugs. While studies have shown that regular exercise improves sleep quality in normal aging, there is no definitive evidence in PD. METHODS In a retrospective study, we determined whether an intense physical and multidisciplinary exercise program improves sleep quality in a large group of patients with PD. We analyzed the scores of PD Sleep Scale (PDSS), which was administered twice, 28 days apart, to two groups of patients with PD of comparable age, gender, disease duration and pharmacological treatment. The control group (49 patients) did not receive rehabilitation, The treated group (89 patients) underwent a 28-day multidisciplinary intensive rehabilitation program (three one-hour daily sessions comprising cardiovascular warm-up, relaxation, muscle-stretching, balance and gait training, occupational therapy to improve daily living activities). RESULTS At enrolment, control and treated groups had similar UPDRS and PDSS scores. At re-test, 28 days later, UPDRS and total PDSS scores improved in the treated (p < 0.0001) but not in the control group. In particular, the treated group showed significant improvement in PDSS scores for sleep quality, motor symptoms and daytime somnolence. The control group did not show improvement for any item. CONCLUSIONS These results suggest that multidisciplinary intensive rehabilitation treatment may have a positive impact on many aspects of sleep in PD.
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Affiliation(s)
- Giuseppe Frazzitta
- Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy ; Department of Parkinson Rehabilitation, Ospedale Moriggia Pelascini, Via Pelascini 3, Gravedona ed Uniti, Como, 22015 Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy
| | - Davide Ferrazzoli
- Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy
| | - Giulio Riboldazzi
- Center for Parkinson's Disease, Macchi Foundation, Varese and Department of Rehabilitation, "Le Terrazze" Hospital, Cunardo, Italy
| | - Rossana Bera
- Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy
| | - Cecilia Fontanesi
- Department of Physiol. Pharmacol. & Neuroscience, CUNY Medical School, Harris Hall 08, CCNY, 160 Convent Ave, New York, NY 10031 USA ; The Graduate Center, Biology - Neuroscience PhD Program, CUNY, New York, NY USA
| | - Roger P Rossi
- Department of Physical Medicine & Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ USA ; NYU Movement Disorder Center, New York University, New York, NY USA
| | - Gianni Pezzoli
- Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy
| | - Maria F Ghilardi
- Department of Physiol. Pharmacol. & Neuroscience, CUNY Medical School, Harris Hall 08, CCNY, 160 Convent Ave, New York, NY 10031 USA ; Department of Physical Medicine & Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ USA
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Sharma NK, Robbins K, Wagner K, Colgrove YM. A randomized controlled pilot study of the therapeutic effects of yoga in people with Parkinson's disease. Int J Yoga 2015; 8:74-9. [PMID: 25558138 PMCID: PMC4278140 DOI: 10.4103/0973-6131.146070] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Exercise can be beneficial for cardiopulmonary, musculoskeletal or neurological systems, and other factors including mood, and may be beneficial in reducing fall risks, dementia and variables associated with quality of life (QOL). Parkinson's disease (PD) produces progressive motor and cognitive deterioration that may leave those inflicted unable to participate in standard exercise programs. Alternative forms of exercise such as yoga may be successful in improving physical function, QOL and physiological variables for overall well-being. Aim: This randomized controlled pilot study investigated the effectiveness of yoga intervention on physiological and health-related QOL measures in people with PD. Methods and Materials: Thirteen people with stage 1-2 PD were randomized to either a yoga (n = 8) or a control group (n = 5). The yoga group participated in twice-weekly yoga sessions for 12 weeks. Participants were tested at baseline, and at 6 and 12 weeks using the Unified Parkinson's Disease Rating Scale (UPDRS), clinical measures of health-related QOL and physiological measures. Results: Significant improvement in UPDRS scores (P = .006), diastolic blood pressure (P = 0.036) and average forced vital capacity (P = 0.03) was noted in the yoga group over time. Changes between groups were also noted in two SF-36 subscales. Positive trends of improvement were noted in depression scores (P = 0.056), body weight (P = 0.056) and forced expiratory volume (P = 0.059). Yoga participants reported more positive symptom changes including immediate tremor reduction. Conclusions: The results suggest that yoga may improve aspects of QOL and physiological functions in stages 1-2 PD. Future larger studies are needed to confirm and extend our findings of the effects of yoga in PD.
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Affiliation(s)
- Neena K Sharma
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kristin Robbins
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kathleen Wagner
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Yvonne M Colgrove
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
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Ory Magne F, Fabre N, Gu C, Pastorelli C, Tardez S, Marchat JC, Marque P, Brefel Courbon C. An individual rehabilitation program: Evaluation by Parkinsonian patients and their physiotherapists. Rev Neurol (Paris) 2014; 170:680-4. [DOI: 10.1016/j.neurol.2014.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/19/2014] [Accepted: 05/28/2014] [Indexed: 11/15/2022]
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Park YJ. Effects of communal exercise with visual and auditory feedback provided by a smart application on gait ability and fear of falling in Parkinson's disease patients. J Exerc Rehabil 2014; 10:286-90. [PMID: 25426465 PMCID: PMC4237843 DOI: 10.12965/jer.140148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 10/15/2014] [Indexed: 11/22/2022] Open
Abstract
Parkinson's disease is a chronically developing neurodegenerative disease showing typical motor symptoms of the following triad: resting tremor, freezing of gait, and bradykinesia-hypokinesia. In the present study, we investigated the effects of a communal exercise program, using the visual and auditory feedback provided by a smart application, to assess gait ability, fear of falling, and fall efficacy in Parkinson's disease patients. Subjects consisted of 29 Parkinson's disease patients who were non-demented individuals. The subjects were randomly divided into three groups: the control group (n= 9, CG), the communal exercise group using the smart application (n= 10, CCEG), and the individual exercise group using the smart application (n= 10, ICEG). The communal exercise program consisted of a warm up (10 min) followed by communal exercise using the smart application (40 min), and a cool down (10 min) for 3 days per week over 10 weeks. The results presented here show that velocity and cadence were significantly increased among groups. Step and stride length were significantly increased among times. Fear of falling and fall efficacy were significantly different among groups and times. In particular, fear of falling was lower and fall efficacy was higher in the CCEG than in the ICEG and CG. These findings indicate that 10 weeks of the communal exercise program using the smart application can be effective in improving gait ability, fear of falling, and fall efficacy in Parkinson's disease patients.
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Affiliation(s)
- Yun-Jin Park
- College of Sports and Leisure, Korea University, Sejong,
Korea
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