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Huang X, Dong K, Gan C, Xu Z, Lei D, Dong X, Liu H, Chen X. Effect of Rhythmically Cued Exercise Interventions on Functions in Patients With Parkinson Disease: A Meta-Analysis. Phys Ther 2024; 104:pzad158. [PMID: 37962936 DOI: 10.1093/ptj/pzad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease. METHODS PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203). RESULTS A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups. CONCLUSION Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation. IMPACT This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
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Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu Gan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xinghua Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Hartmann-Nardin D, Stock S, Kalbe E, Folkerts AK. Cost-Effectiveness Analyses of Non-Pharmacological and Non-Surgical Interventions in Idiopathic Parkinson's Disease: A Systematic Review. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S241-S252. [PMID: 38339939 PMCID: PMC11380296 DOI: 10.3233/jpd-230213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Background Interest in non-pharmacological/non-surgical interventions to treat Parkinson's disease (PD) has substantially increased. Although a few health-economic studies have been conducted, summary information on the cost-effectiveness is still scarce. Objective To give an overview of cost-effectiveness analyses (CEA) focusing on non-pharmacological/non-surgical interventions in PD patients. Methods A systematic literature search was conducted in five databases. Studies were included that provided cost-effectiveness analysis (CEA) or cost-utility analysis (CUA) of non-pharmacological/non-surgical interventions in PD patients. Study quality was assessed with the Drummond and CHEERS 2022 checklists, respectively for economic evaluation. Results N = 9 studies published between 2012-2023 were identified. Most studies undertook a CUA (n = 5); n = 3 reported a combination of CEA and CUA, and n = 1 a pure CEA. Most studies (n = 6) examined physical exercise. The CEA studies identified additional costs of 170€ -660€ for the improvement of one single unit of a clinical outcome and savings of 18.40€ -22.80€ per score gained as measured with established instruments. The four studies that found significant quality of life benefits show large variations in the incremental cost effectiveness ratio (ICER) of 3,220€ -214,226€ per quality-adjusted life year (QALY); notably interventions were heterogenous regarding content and intensity. Conclusions Despite increasing numbers of non-pharmacological/non-surgical intervention trials in PD patients, health-economic evaluations are rare. The examined intervention types and health-economic results vary greatly. Together with the heterogeneity of the health-economic studies these factors limit the conclusions that can be drawn. Further research and a standardization of methods is needed to allow decision makers to make meaningful interpretations, and to allocate scarce resources.
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Affiliation(s)
- Daniel Hartmann-Nardin
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Current Treatments and New, Tentative Therapies for Parkinson’s Disease. Pharmaceutics 2023; 15:pharmaceutics15030770. [PMID: 36986631 PMCID: PMC10051786 DOI: 10.3390/pharmaceutics15030770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative pathology, the origin of which is associated with the death of neuronal cells involved in the production of dopamine. The prevalence of PD has increased exponentially. The aim of this review was to describe the novel treatments for PD that are currently under investigation and study and the possible therapeutic targets. The pathophysiology of this disease is based on the formation of alpha-synuclein folds that generate Lewy bodies, which are cytotoxic and reduce dopamine levels. Most pharmacological treatments for PD target alpha-synuclein to reduce the symptoms. These include treatments aimed at reducing the accumulation of alpha-synuclein (epigallocatechin), reducing its clearance via immunotherapy, inhibiting LRRK2, and upregulating cerebrosidase (ambroxol). Parkinson’s disease continues to be a pathology of unknown origin that generates a significant social cost for the patients who suffer from it. Although there is still no definitive cure for this disease at present, there are numerous treatments available aimed at reducing the symptomatology of PD in addition to other therapeutic alternatives that are still under investigation. However, the therapeutic approach to this pathology should include a combination of pharmacological and non-pharmacological strategies to maximise outcomes and improve symptomatological control in these patients. It is therefore necessary to delve deeper into the pathophysiology of the disease in order to improve these treatments and therefore the quality of life of the patients.
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Unver F, Buke M. The Effect of Music on Balance Parameters. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-2015-3446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Abstract
Objectives This study aimed to determine the effect of music on balance
parameters in healthy individuals.
Methods Forty-two participants were included in the study, mean
age=23.3 (SD=5.31). Prokin Tecnobody balance device was used for
balance measurements. Static and dynamic balance measurements on the dominant
foot and bipedal stance were recorded while listening to high-intensity music
and without music.
Results In the study, there was a statistically significant difference in
the dominant foot static mediolateral balance in measurements taken with music
(p=0.013). But, there was no difference in other parameters
(p>0.05). When examined by gender, it was found that the mediolateral
balance scores of females on static and dynamic dominant feet were significantly
higher in high-intensity music than males (p<0.05).
Conclusion In healthy participants, music improves the mediolateral
balance on the dominant foot. Therefore, high-intensity music can be a safe and
motivating method to be used in addition to clinical applications.
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Affiliation(s)
- Fatma Unver
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University,
Denizli, Turkey
| | - Meryem Buke
- Faculty of Health Sciences, Department of Physiotherapy and
Rehabilitation, Van Yuzuncu Yil University, Van, Turkey
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Lee H, Ko B. Effects of Music-Based Interventions on Motor and Non-Motor Symptoms in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1046. [PMID: 36673802 PMCID: PMC9859027 DOI: 10.3390/ijerph20021046] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
This systematic review and meta-analysis examined previous studies on music-based interventions for individuals with Parkinson’s disease (PD). The effectiveness of the interventions on various motor and non-motor outcomes was evaluated. This review was conducted by searching PubMed, CINAHL, PsycINFO, and Cochrane Library CENTRAL prior to June 2022 for randomized controlled trial (RCT) and controlled clinical trial (CCT) studies published in English. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was used for heterogeneity. The initial search identified 745 studies, and 13 studies involving 417 participants with PD which met the inclusion criteria included in this review. The results of the meta-analysis revealed that music-based interventions can significantly improve walking velocity (MD = 0.12, 95% CI = 0.07~0.16, p < 0.00001), stride length (MD = 0.04, 95% CI = 0.02~0.07, p = 0.002), and mobility (MD = −1.05, 95% CI = −1.53~−0.57, p < 0.0001). However, the results did not support significant effects for music-based interventions on cadence (MD = 3.21, 95% CI = −4.15~10.57, p = 0.39), cognitive flexibility (MD = 20.91, 95% CI = −10.62~52.44, p = 0.19), inhibition (SMD = 0.07, 95% CI = −0.40~0.55, p = 0.76), and quality of life (SMD = −0.68, 95% CI= −1.68~0.32, p = 0.18). The findings suggest that music-based interventions are effective for the improvement of some motor symptoms, but evidence for non-motor symptoms is limited. Further high-quality studies with a larger sample size are required to obtain the robust effects of music-based interventions on various outcomes among patients with PD.
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Affiliation(s)
- Hyunjung Lee
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Bumsuk Ko
- Department of Music, Graduate School, Hansei University, Gunpo 15852, Republic of Korea
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Jola C, Sundström M, McLeod J. Benefits of dance for Parkinson's: The music, the moves, and the company. PLoS One 2022; 17:e0265921. [PMID: 36409733 PMCID: PMC9678293 DOI: 10.1371/journal.pone.0265921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
Dance classes designed for people with Parkinson's are very popular and associated not only with increasing individuals' motor control abilities but also their mood; not least by providing a social network and the enjoyment of the music. However, quantitative evidence of the benefits is inconsistent and often lacks in power. For a better understanding of the contradictory findings between participants' felt experiences and existing quantitative findings in response to dance classes, we employed a mixed method approach that focussed on the effects of music. Participant experience of the dance class was explored by means of semi-structured interviews and gait changes were measured in a within-subjects design through the Timed Up and Go (TUG) test before and after class, with and without music. We chose the TUG test for its ecological validity, as it is a simple test that resembles movements done in class. We hypothesised that the music and the dance class would have a facilitating effect on the TUG performance. In line with existing research, we found that before class, the gait of 26 participants was significantly improved when accompanied by a soundtrack. However, after class, music did not have a significantly facilitating effect, yet gait without music significantly improved after class compared to before. We suggest that whilst the music acts as an external stimulator for movement before the dance class, after the dance class, participants have an internalised music or rhythm that supports their motor control. Thus, externally played music is of less relevance. The importance of music was further emphasised in the qualitative data alongside social themes. A better understanding of how music and dance affects Parkinson's symptoms and what aspects make individuals 'feel better' will help in the design of future interventions.
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Affiliation(s)
- Corinne Jola
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Moa Sundström
- Division of Psychology and Forensic Science, School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- Division of Nursing and Mental Health, School of Applied Sciences, Abertay University, Dundee, United Kingdom
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Park KS. Decomposing the Effects of Familiarity with Music Cues on Stride Length and Variability in Persons with Parkinson's Disease: On the Role of Covariates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10793. [PMID: 36078509 PMCID: PMC9518111 DOI: 10.3390/ijerph191710793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to determine the role of cognitive and affective responses to music cues in modulating the effects of familiarity with music on stride length and stride-to-stride variability in people with Parkinson's disease (PD). Using multilevel modeling, people with PD's spatiotemporal gait parameters and self-reported ratings of familiarity, enjoyment, cognitive and physical demand, beats salience of music cues after each walking trial, as well as music reward, were analyzed. Our findings indicate that (1) condition-varying perceived enjoyment and beat salience are positively associated with increased stride length; (2) participants with a greater music reward for mood regulation and emotion evocation show greater stride length changes compared with those with less music reward; (3) condition-varying perceived enjoyment is positively associated with decreases in stride-to-stride variability; and (4) participants with lower cognitive demand of walking with music cues and higher beat salience show lower stride-to-stride variability compared with those with higher cognitive demand and lower beat salience. These results provide behavioral evidence of independent and interactive influences of cognitive and affective responses to music cues on spatiotemporal gait parameters in people with PD.
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Affiliation(s)
- Kyoung Shin Park
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC 27412, USA
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Liu Y, Ding L, Xianyu Y, Nie S, Yang J. Research on depression in Parkinson disease: A bibliometric and visual analysis of studies published during 2012-2021. Medicine (Baltimore) 2022; 101:e29931. [PMID: 35945720 PMCID: PMC9351875 DOI: 10.1097/md.0000000000029931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The diagnosis and treatment rate of Parkinson disease (PD) with depression has a low diagnostic rate, and there is no consensus on the choice of treatment mode. This study evaluates the global research trends of scientific outputs related to depression in PD from multiple perspectives, using a bibliometric analysis and visualization tool to scientifically analyze the knowledge from the literature. METHODS Literature related to depression in PD published from 2012 to 2021 was included and selected from the Web of Science Core Collection database in October 2021. CiteSpace software was used to visualize and analyze co-occurrence analyses for countries, institutions, authors, and keywords. RESULTS A total of 4533 articles from the Web of Science database were included. The United States made the largest contribution with the majority of publications (1215; 29.40%). Toronto University was the most productive institution. PD, depression, quality of life, dementia, nonmotor symptom, prevalence, anxiety, Alzheimer disease, symptom, and disorder would be significantly correlated with depression in PD. The current hot spots in this field focus on the following: risk factors for depression in PD, assessment scale of depression in PD, and rehabilitation of depression in PD. CONCLUSIONS This analysis not only reveals the current research trends and hotspots but also provides some instructive suggestions on the development of depression in PD.
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Affiliation(s)
- Yan Liu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Yan Liu, Department of Nursing, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China (e-mail: )
| | - Linlin Ding
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yunyan Xianyu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuke Nie
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiying Yang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
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Wang L, Peng JL, Ou-Yang JB, Gan L, Zeng S, Wang HY, Zuo GC, Qiu L. Effects of Rhythmic Auditory Stimulation on Gait and Motor Function in Parkinson's Disease: A Systematic Review and Meta-Analysis of Clinical Randomized Controlled Studies. Front Neurol 2022; 13:818559. [PMID: 35493833 PMCID: PMC9053573 DOI: 10.3389/fneur.2022.818559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to summarize the effectiveness of rhythmic auditory stimulation (RAS) for the treatment of gait and motor function in Parkinson's disease (PD) through a systematic review and meta-analysis. Methods All studies were retrieved from eight databases. The effects of RAS on PD were determined using the following indicators: gait parameters including step length, stride width, step cadence, velocity, stride length; motor function including 6 min walk test (6MWT) and timed up-and-go test (TUGT); the Unified Parkinson's Disease Rating Scale (UPDRS); and the Berg Balance Scale (BBS). The risk map of bias of the quality of the studies and the meta-analysis results of the indicators was prepared with RevMan 5.2 software. Results Twenty-one studies were included in the systematic review, and 14 studies were included in the meta-analysis. In the meta-analysis, the results of gait parameters, namely, velocity, step length, and stride length, were statistically significant (P < 0.05), whereas the results of cadence and stride width were not statistically significant (P ≧ 0.05). The results of 6MWT and TUGT for motor function as well as UPDRS-II, UPDRS-III, and BBS were statistically significant (P < 0.05). Conclusions RAS could improve gait parameters, walking function, balance function, and daily living activities of individuals with PD. The application of RAS in conventional rehabilitation approaches can enhance motor performance in PD. Future studies should use a large sample size and a rigorous design to obtain strong conclusions about the advantages of RAS for the treatment of gait and motor function in PD.
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Affiliation(s)
- Lei Wang
- Department of Rehabilitation Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
- *Correspondence: Lei Wang
| | - Jin-lin Peng
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-bin Ou-Yang
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Li Gan
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuai Zeng
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
| | - Hong-Yan Wang
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guan-Chao Zuo
- Sichuan Rehabilitation Hospital Affiliated of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ling Qiu
- Department of Pain, Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, China
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Naro A, Pignolo L, Bruschetta D, Calabrò RS. What about the role of the cerebellum in music-associated functional recovery? A secondary EEG analysis of a randomized clinical trial in patients with Parkinson disease. Parkinsonism Relat Disord 2022; 96:57-64. [PMID: 35220062 DOI: 10.1016/j.parkreldis.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 10/19/2022]
Abstract
Rhythmic Auditory Stimulation (RAS) has been shown to be of help in an effective gait training of people with idiopathic Parkinson's disease (PD). The cerebellum may play an important role in RAS aftereffects by compensating the detrimental internal clock for automatic and rhythmic motricity. However, the neurophysiological mechanisms underlying RAS aftereffects are still poorly understood. In the present study, we tested the contribution of the cerebellum to RAS-based gait training aftereffects in people with PD by examining cerebellum-cerebral connectivity indices using standard EEG recording. We enrolled 50 patients with PD who were randomly assigned to two different modalities of treadmill gait training using GaitTrainer3 with and without RAS (non_RAS) during an 8-week training program. We measured clinical and kinematic gait indices and electrophysiological data (standard EEG recording during walking on GaitTrainer3) of both the gait trainings. We found that the greater improvement in gait performance following RAS than non_RAS training, as per clinical and kinematic assessment, was paralleled by a more evident reshape of cerebellum-brain functional connectivity with regard to specific brain areas (pre-motor, sensorimotor and temporal cortices) and gait-cycle phases (mainly 25-75% of the gait cycle duration). These findings suggest that the cerebellum mediates the reshape of sensorimotor rhythms and fronto-centroparietal connectivity in relation to specific gait-cycle phases. This may be consistent with a recovery of the internal timing mechanisms generating and controlling motor rhythmicity, eventually improving gait performance. The precise definition of the cerebellar role to gait functional recovery in people with PD may be crucial to create patient-tailored rehabilitative approaches.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
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Liang Z, Yip H, Sena Moore K, Ferreira T, Ji M, Signorile JF, Munro C. Self-Managed Music-Guided Exercise Intervention Improved Upper and Lower Extremity Muscle Strength for ICU Survivors-A Pilot Randomized Controlled Study. Biol Res Nurs 2021; 24:145-151. [PMID: 34738474 DOI: 10.1177/10998004211050297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ObjectiveThe objective of this study was to evaluate effects of a self-managed music-guided exercise intervention on muscle strength among intensive care unit (ICU) survivors. Methods We used a two-arm randomized-controlled trial. Following ICU discharge, eligible participants were assigned to one of two groups: music group (n = 13) or active control group (n = 13). The music group was taught to self-manage upper and lower extremity exercise movements by listening to an individualized music-guided playlist twice daily for 5 days. The active control group was provided an exercise brochure and advised to perform the same exercises at the same intervals. Dynamometers were used to measure muscle strength. T-tests and Weighted GEE models were used for testing the intervention effect between groups. Results Twenty-six subjects were enrolled. The mean age was 62.8 (SD = 13.8), 53.8% were male, 65.4% were Caucasian, and the mean APACHE severity of illness score was 59 (SD = 23.4). Reasons for ICU admission were mainly cardiac and medical. The music group showed significant improvements in handgrip, plantar flexion, leg extension, elbow flexion, and shoulder adduction strengths on left and right sides. Additionally, left and right leg extensor and left plantar flexor strengths showed significant post-differences, and small to moderately large effect sizes, between the music group and control group. Conclusion These findings suggest that a music-guided exercise intervention has the potential to improve muscle strength in ICU survivors and prevent further post-ICU deterioration in ICU survivors. Future trials should build upon these preliminary findings.
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Affiliation(s)
- Zhan Liang
- School of Nursing and Health Studies, 5452University of Miami, Coral Gables, FL, USA
| | - Hilary Yip
- Frost School of Music, 5452University of Miami, Coral Gables, FL, USA
| | - Kimberly Sena Moore
- Bower School of Music & the Arts, 3391Florida Gulf Coast University, Fort Myers, FL, USA
| | - Tanira Ferreira
- Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Miami Hospital & Clinics, Miami, FL, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Joseph F Signorile
- Department of Kinesiology and Sport Sciences, 25802University of Miami, Coral Gables, FL, USA
| | - Cindy Munro
- School of Nursing and Health Studies, 5452University of Miami, Coral Gables, FL, USA
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Machado Sotomayor MJ, Arufe-Giráldez V, Ruíz-Rico G, Navarro-Patón R. Music Therapy and Parkinson's Disease: A Systematic Review from 2015-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11618. [PMID: 34770129 PMCID: PMC8582661 DOI: 10.3390/ijerph182111618] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 12/05/2022]
Abstract
Parkinson's disease can be approached from various points of view, one of which is music therapy-a complementary therapy to a pharmacological one. This work aims to compile the scientific evidence published in the last five years (2015-2020) on the effects of music therapy in patients with Parkinson's disease. A systematic review has been performed using the Web of Science and Scopus databases with the descriptors "music therapy" and "Parkinson's disease". A total of 281 eligible articles were identified, which, after applying the inclusion and exclusion criteria, were reduced to 58 papers. The results display a great diversity of evidence, confirming positive effects on various spheres. All mentioned patients with Parkinson's disease had experienced different music therapy programs. Some studies focused on the motor component, which can be addressed through listening, body rhythm, and rhythmic auditory stimulation. Other studies confirm effects on communication, swallowing, breathing, and the emotional aspect through programs that focus on singing, either individually or in groups, in order to improve the quality of life of people with PD. It was concluded that music therapy programs can achieve improvements in various areas of patients with Parkinson's.
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Affiliation(s)
| | - Víctor Arufe-Giráldez
- Department of Specific Teaching Training and Research and Diagnosis Methods in Education, University of A Coruña, 15001 A Coruña, Spain
| | - Gerardo Ruíz-Rico
- Department of Education, Educational Sciences Faculty, University of Almería, 04120 Almería, Spain;
| | - Rubén Navarro-Patón
- Department of Applied Learning, Faculty of Teacher Training, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain;
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Vinolo-Gil MJ, Casado-Fernández E, Perez-Cabezas V, Gonzalez-Medina G, Martín-Vega FJ, Martín-Valero R. Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research. CHILDREN (BASEL, SWITZERLAND) 2021; 8:868. [PMID: 34682132 PMCID: PMC8534581 DOI: 10.3390/children8100868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. METHODS The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. RESULTS Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. CONCLUSIONS The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results.
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Affiliation(s)
- Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Esteban Casado-Fernández
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Veronica Perez-Cabezas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Francisco Javier Martín-Vega
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
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Nemade D, Subramanian T, Shivkumar V. An Update on Medical and Surgical Treatments of Parkinson's Disease. Aging Dis 2021; 12:1021-1035. [PMID: 34221546 PMCID: PMC8219497 DOI: 10.14336/ad.2020.1225] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/25/2020] [Indexed: 12/11/2022] Open
Abstract
Parkinson’s disease (PD) is characterized by degeneration of dopaminergic neurons in the substantia nigra pars compacta and other neuronal populations. The worldwide prevalence of PD is over 7 million and has been increasing more rapidly than many other neurodegenerative disorders. PD symptoms can be broadly divided into motor (slowness, stiffness, tremor) and non-motor symptoms (such as depression, dementia, psychosis, orthostatic hypotension). Patients can also have prodromal symptoms of rapid eye movement sleep behavior disorder, hyposmia, and constipation. The diagnosis of PD is mainly clinical, but dopamine transporter single-photon emission computed tomography can improve the accuracy of the diagnosis. Dopamine based therapies are used for the treatment of motor symptoms. Non-motor symptoms are treated with other medications such as selective serotonin reuptake inhibitors (depression/anxiety), acetylcholinesterase inhibitors (dementia), and atypical antipsychotics (psychosis). Patients with motor fluctuations or uncontrolled tremor, benefit from deep brain stimulation. Levodopa-carbidopa intestinal gel is an alternative to deep brain stimulation for uncontrolled motor fluctuations. Rehabilitative therapies such as physical, occupational, and speech therapy are important during all stages of the disease. Management of PD is complex but there have been significant advancements in the treatment of motor and non-motor symptoms over the past few years. This review discusses the updates in the medical and surgical management of PD.
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Affiliation(s)
- Dipali Nemade
- 1Department of Neurology, Marshall University School of Medicine, Huntington, WV 25701, USA
| | - Thyagarajan Subramanian
- 2Department of Neurology and Neural and Behavioral Sciences, Penn State University College of Medicine, Hershey, PA 17033, USA
| | - Vikram Shivkumar
- 1Department of Neurology, Marshall University School of Medicine, Huntington, WV 25701, USA
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Bai Y, Su X, Piao L, Jin Z, Jin R. Involvement of Astrocytes and microRNA Dysregulation in Neurodegenerative Diseases: From Pathogenesis to Therapeutic Potential. Front Mol Neurosci 2021; 14:556215. [PMID: 33815055 PMCID: PMC8010124 DOI: 10.3389/fnmol.2021.556215] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 02/23/2021] [Indexed: 12/11/2022] Open
Abstract
Astrocytes are the most widely distributed and abundant glial cells in the central nervous system (CNS). Neurodegenerative diseases (NDDs) are a class of diseases with a slow onset, progressive progression, and poor prognosis. Common clinical NDDs include Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and Huntington’s disease (HD). Although these diseases have different etiologies, they are all associated with neuronal loss and pathological dysfunction. Accumulating evidence indicates that neurotransmitters, neurotrophic factors, and toxic metabolites that are produced and released by activated astrocytes affect and regulate the function of neurons at the receptor, ion channel, antigen transfer, and gene transcription levels in the pathogenesis of NDDs. MicroRNAs (miRNAs) are a group of small non-coding RNAs that play a wide range of biological roles by regulating the transcription and post-transcriptional translation of target mRNAs to induce target gene expression and silencing. Recent studies have shown that miRNAs participate in the pathogenesis of NDDs by regulating astrocyte function through different mechanisms and may be potential targets for the treatment of NDDs. Here, we review studies of the role of astrocytes in the pathogenesis of NDDs and discuss possible mechanisms of miRNAs in the regulation of astrocyte function, suggesting that miRNAs may be targeted as a novel approach for the treatment of NDDs.
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Affiliation(s)
- Yang Bai
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Xing Su
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, China
| | - Lianhua Piao
- College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Zheng Jin
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
| | - Rihua Jin
- Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China
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Zhou Z, Zhou R, Wei W, Luan R, Li K. Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson's disease: A systematic review and meta-analysis. Clin Rehabil 2021; 35:937-951. [PMID: 33517767 DOI: 10.1177/0269215521990526] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson's disease. DATA SOURCES A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. REVIEW METHODS Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger's regression test. "Trim and fill" analysis was performed to adjust any potential publication bias. RESULTS Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson's Disease Rating Scale motor subscale, MD = -5.44, P = 0.002; Timed Up and Go Test, MD = -1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = -2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = -0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. CONCLUSION The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson's disease.
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Affiliation(s)
- Zonglei Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ruzhen Zhou
- Department of Anorectal Surgery, Changhai Hospital of Shanghai, Shanghai, China
| | - Wen Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rongsheng Luan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Kunpeng Li
- Department of Neurorehabilitation, Shanghai Second Rehabilitation Hospital, Shanghai, China
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Park KS, Hass CJ, Patel B, Janelle CM. Musical pleasure beneficially alters stride and arm swing amplitude during rhythmically-cued walking in people with Parkinson's disease. Hum Mov Sci 2020; 74:102718. [DOI: 10.1016/j.humov.2020.102718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022]
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18
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Berardi A, Regoli E, Tofani M, Valente D, Fabbrini G, Fabbrini A, Ruggieri M, Panuccio F, Galeoto G. Tools to assess the quality of life in patients with Parkinson's disease: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2020; 21:55-68. [PMID: 33090885 DOI: 10.1080/14737167.2021.1841638] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The clinical, social, and economic implications of Parkinson's disease (PD) are significant; disability occurs leading to a low quality of life (QoL). Information on the QoL of patients with PD and studies on the relationship between QoL and motor and cognitive function are necessary for both research and clinical use to make informed decisions in healthcare and rehabilitation. The aim of this study was to determine which scales are most used to assess QoL in patients with PD. AREA COVERED A literature search was conducted in MEDLINE, Scopus, CINAHL, PsycINFO, and Web of Science. Two authors independently identified eligible studies based on predefined inclusion criteria and extracted the data. Study quality and the risk of bias were assessed using the COSMIN checklist. EXPERT OPINION 116 suitable studies were included, and 42 different instruments were identified. The most frequently used scales were the 39-items and 8-items Parkinson's Disease Questionnaire (PDQ-39) (PDQ-8). These findings suggest further investigation of existing PD outcome measures would benefit patients, researchers, and clinicians. Validated, universal outcome measures are required to allow comparisons across practice; therefore, we recommend that future researchers use a common set of outcome assessments based on the results of this review.
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Affiliation(s)
- Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
| | | | - Marco Tofani
- Department of Neurorehabilitation and Robotics, Bambino Gesù Paediatric Hospital , Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | | | | | | | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
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Katlen da Silva L, Silva Brito TS, Pascucci Sande de Souza LA, Luvizutto GJ. Music-based physical therapy in Parkinson's disease: An approach based on international Classification of Functioning, Disability and Health. J Bodyw Mov Ther 2020; 26:524-529. [PMID: 33992292 DOI: 10.1016/j.jbmt.2020.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/31/2020] [Accepted: 08/30/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Several studies suggests that the provision of auditory cues with music could be beneficial for people with Parkinson's Disease (PD). The aim of the study was to evaluate the effects of music-based physical therapy on the international Classification of Functioning, Disability and Health (ICF) components: disability, cognition, muscle strength, balance, and functional mobility. METHODS This was a controlled, non-randomized clinical trial involving 13 individuals with PD assessed at three times: baseline, period 1 (treatment), and period 2 (no treatment). The variables analyzed were: disability by Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn & Yahr (H&Y), cognitive function by Trail Making Test, muscle strength by Medical Research Council (MRC) and sitting-rising (SR) test, balance and functional mobility by Berg Balance Scale (BBS) and Timed up and Go (TUG). ANOVA with post-hoc multiple comparison was used to determine statistical differences between the baseline, period 1 and 2. RESULTS there was statistically significant difference among the period 1 and 2 for the cognitive function; there was a statistically significant difference between the period 1 and 2 in SR test; in the balance evaluation by BBS, an increase was observed between the baseline and the period 1, followed by a decrease in period 2; in the TUG, there was an increase between the period 1 and 2. CONCLUSION the music-based physical therapy, according to the ICF construct, was able to improve balance and functional mobility in individuals with PD. The functional gains were not maintained when the therapy was discontinued.
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Affiliation(s)
- Luana Katlen da Silva
- Undergraduate of Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | | | | | - Gustavo José Luvizutto
- Professor of Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
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20
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Harvey AR. Links Between the Neurobiology of Oxytocin and Human Musicality. Front Hum Neurosci 2020; 14:350. [PMID: 33005139 PMCID: PMC7479205 DOI: 10.3389/fnhum.2020.00350] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022] Open
Abstract
The human species possesses two complementary, yet distinct, universal communication systems—language and music. Functional imaging studies have revealed that some core elements of these two systems are processed in closely related brain regions, but there are also clear differences in brain circuitry that likely underlie differences in functionality. Music affects many aspects of human behavior, especially in encouraging prosocial interactions and promoting trust and cooperation within groups of culturally compatible but not necessarily genetically related individuals. Music, presumably via its impact on the limbic system, is also rewarding and motivating, and music can facilitate aspects of learning and memory. In this review these special characteristics of music are considered in light of recent research on the neuroscience of the peptide oxytocin, a hormone that has both peripheral and central actions, that plays a role in many complex human behaviors, and whose expression has recently been reported to be affected by music-related activities. I will first briefly discuss what is currently known about the peptide’s physiological actions on neurons and its interactions with other neuromodulator systems, then summarize recent advances in our knowledge of the distribution of oxytocin and its receptor (OXTR) in the human brain. Next, the complex links between oxytocin and various social behaviors in humans are considered. First, how endogenous oxytocin levels relate to individual personality traits, and then how exogenous, intranasal application of oxytocin affects behaviors such as trust, empathy, reciprocity, group conformity, anxiety, and overall social decision making under different environmental conditions. It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.
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Affiliation(s)
- Alan R Harvey
- School of Human Sciences, The University of Western Australia, Perron Institute for Neurological and Translational Science, Perth, WA, Australia
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21
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Pohl P, Wressle E, Lundin F, Enthoven P, Dizdar N. Group-based music intervention in Parkinson's disease - findings from a mixed-methods study. Clin Rehabil 2020; 34:533-544. [PMID: 32070122 PMCID: PMC7132435 DOI: 10.1177/0269215520907669] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: To evaluate a group-based music intervention in patients with Parkinson’s
disease. Design: Parallel group randomized controlled trial with qualitative
triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinson’s disease were randomized into intervention
group (n = 26), which received training with the
music-based intervention, and control group (n = 20)
without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7’s (dual-task
ability). Secondary outcomes were cognition, balance, concerns about
falling, freezing of gait, and quality of life. All outcomes were evaluated
at baseline, post-intervention, and three months post-intervention. Focus
groups and individual interviews were conducted with the intervention group
and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability.
Between-group differences were observed for Falls Efficacy Scale (mean
difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0,
P = 0.001) and for Parkinson Disease Questionnaire-39
items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when
compared to the control group post-intervention, but these were not
maintained at three months post-intervention. Three themes were derived from
the interviews: Expectations versus Results, Perspectives on
Treatment Contents, and Key Factors for
Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music
intervention adds value to mood, alertness, and quality of life in patients
with Parkinson’s disease. The study does not support the efficacy in
producing immediate or lasting gains in dual-tasking, cognition, balance, or
freezing of gait.
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Affiliation(s)
- Petra Pohl
- Department of Activity and Health, and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ewa Wressle
- Department of Acute Internal Medicine and Geriatrics, Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
| | - Fredrik Lundin
- Department of Neurology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Paul Enthoven
- Pain and Rehabilitation Centre, and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Nil Dizdar
- Department of Neurology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Abstract
IMPORTANCE Parkinson disease is the most common form of parkinsonism, a group of neurological disorders with Parkinson disease-like movement problems such as rigidity, slowness, and tremor. More than 6 million individuals worldwide have Parkinson disease. OBSERVATIONS Diagnosis of Parkinson disease is based on history and examination. History can include prodromal features (eg, rapid eye movement sleep behavior disorder, hyposmia, constipation), characteristic movement difficulty (eg, tremor, stiffness, slowness), and psychological or cognitive problems (eg, cognitive decline, depression, anxiety). Examination typically demonstrates bradykinesia with tremor, rigidity, or both. Dopamine transporter single-photon emission computed tomography can improve the accuracy of diagnosis when the presence of parkinsonism is uncertain. Parkinson disease has multiple disease variants with different prognoses. Individuals with a diffuse malignant subtype (9%-16% of individuals with Parkinson disease) have prominent early motor and nonmotor symptoms, poor response to medication, and faster disease progression. Individuals with mild motor-predominant Parkinson disease (49%-53% of individuals with Parkinson disease) have mild symptoms, a good response to dopaminergic medications (eg, carbidopa-levodopa, dopamine agonists), and slower disease progression. Other individuals have an intermediate subtype. For all patients with Parkinson disease, treatment is symptomatic, focused on improvement in motor (eg, tremor, rigidity, bradykinesia) and nonmotor (eg, constipation, cognition, mood, sleep) signs and symptoms. No disease-modifying pharmacologic treatments are available. Dopamine-based therapies typically help initial motor symptoms. Nonmotor symptoms require nondopaminergic approaches (eg, selective serotonin reuptake inhibitors for psychiatric symptoms, cholinesterase inhibitors for cognition). Rehabilitative therapy and exercise complement pharmacologic treatments. Individuals experiencing complications, such as worsening symptoms and functional impairment when a medication dose wears off ("off periods"), medication-resistant tremor, and dyskinesias, benefit from advanced treatments such as therapy with levodopa-carbidopa enteral suspension or deep brain stimulation. Palliative care is part of Parkinson disease management. CONCLUSIONS AND RELEVANCE Parkinson disease is a heterogeneous disease with rapidly and slowly progressive forms. Treatment involves pharmacologic approaches (typically with levodopa preparations prescribed with or without other medications) and nonpharmacologic approaches (such as exercise and physical, occupational, and speech therapies). Approaches such as deep brain stimulation and treatment with levodopa-carbidopa enteral suspension can help individuals with medication-resistant tremor, worsening symptoms when the medication wears off, and dyskinesias.
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Affiliation(s)
- Melissa J Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville
- Fixel Institute for Neurologic Diseases, University of Florida, Gainesville
| | - Michael S Okun
- Department of Neurology, University of Florida College of Medicine, Gainesville
- Fixel Institute for Neurologic Diseases, University of Florida, Gainesville
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Chen X, Liu F, Yan Z, Cheng S, Liu X, Li H, Li Z. Therapeutic effects of sensory input training on motor function rehabilitation after stroke. Medicine (Baltimore) 2018; 97:e13387. [PMID: 30508935 PMCID: PMC6283184 DOI: 10.1097/md.0000000000013387] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Motor dysfunction is a common and severe complication of stroke that affects the quality of life of these patients. Currently, motor function rehabilitation predominantly focuses on active movement training; nevertheless, the role of sensory input is usually overlooked. Sensory input is very important to motor function. Voluntary functional movement necessitates preparation, execution, and monitoring functions of the central nervous system, while the monitoring needs the participation of the sensory system. Sensory signals affect motor functions by inputting external environment information and intrinsic physiological status as well as by guiding initiation of the motor system. Recent studies focusing on sensory input-based rehabilitation training for post-stroke dyskinesia have demonstrated that sensory function has significant effects on voluntary functional movements. In conclusion, sensory input plays a crucial role in motor function rehabilitation, and the combined sensorimotor training modality is more effective than conventional motor-oriented approaches.
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Pohl P. The Ronnie Gardiner Method: An Innovative Music-Based Intervention for Neurological Rehabilitation - Theoretical Background and Contemporary Research with Focus on Parkinson’s Disease. ACTA ACUST UNITED AC 2018. [DOI: 10.33805/2641-8991.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Ronnie Gardiner Method (RGM) is an innovative, practitioner-led, music-based intervention using sensorimotor and cognitive integration. RGM was originally developed by the Swedish musician Ronnie Gardiner. Since 2010, RGM has been successfully implemented within neurorehabilitation in many countries. The purpose of this article is to outline some of the theoretical assumptions underpinning the potential benefits from this intervention, using Parkinson’s disease as an example.
RGM is based on principles of neuroplasticity, motor learning, and postural control, and uses energizing, beat-based music to provide multisensory input (visual, audio, kinetic, and tactile) in order to stimulate experience-dependent neuroplastic processes. It aims at stimulating cognitive and motor function (e.g., memory, concentration, executive function, multitasking, coordination, mobility, balance, and motor skills). In addition, it may aid body awareness, self-esteem, and social skills. RGM has been scientifically evaluated as a means of multimodal sensory stimulation after stroke and as a means of improving mobility and cognitive function in Parkinson’s disease.
RGM is a complex multi-task intervention with the potential to be beneficial in different settings and in different neurological conditions. It can be performed either while standing up or sitting down and can be practiced with the advantages gained as a group activity or individually, which makes it very flexible. It is currently being used as rehabilitation activity for people with stroke, Parkinson’s disease, multiple sclerosis, dementia, and depression. Furthermore, RGM is used in programs targeting healthy aging, ADHD, autism, and dyslexia, and in ordinary school environments.
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Affiliation(s)
- Petra Pohl
- Department of Activity and Health, and Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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25
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The Hamburg Parkinson day-clinic: a new treatment concept at the border of in- and outpatient care. J Neural Transm (Vienna) 2018; 125:1461-1472. [DOI: 10.1007/s00702-018-1918-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
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Galeoto G, Colalelli F, Massai P, Berardi A, Tofani M, Pierantozzi M, Servadio A, Fabbrini A, Fabbrini G. Quality of life in Parkinson's disease: Italian validation of the Parkinson's Disease Questionnaire (PDQ-39-IT). Neurol Sci 2018; 39:1903-1909. [PMID: 30088166 DOI: 10.1007/s10072-018-3524-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/03/2018] [Indexed: 12/24/2022]
Abstract
Translation and cross-cultural adaptation of the 39-item Parkinson's Disease Questionnaire (PDQ-39) to the Italian culture was performed by Oxford University Innovation in 2008, but this version has never been validated. Therefore, we performed the process of validation of the Italian version of the PDQ-39 (PDQ-39-IT) following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. The translated PDQ-39-IT was tested with 104 patients diagnosed with Parkinson's disease (PD) who were recruited between June and October 2017. The mean age of the participants was 65.7 ± 10.2 years, and the mean duration of symptoms was 7.4 ± 5.3 years. The internal consistency of the PDQ-39-IT was assessed by Cronbach's alpha and ranged from 0.69 to 0.92. In an assessment of test-retest reliability in 35 of the 104 patients, the infraclass correlation coefficient (ICC) ranged from 0.85 to 0.96 for the various subitems of the PDQ-39-IT (all p < 0.01). Spearman's rank correlation coefficient for the validity of the PDQ-39-IT and the Italian version of the 36-Item Short Form (SF-36) was - 0.50 (p < 0.01). The results show that the PDQ-39-IT is a reliable and valid tool to assess the impact of PD on functioning and well-being. Thus, the PDQ-39-IT can be used in clinical and research practice to assess this construct and to evaluate the overall effect of different treatments in Italian PD patients.
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Affiliation(s)
- Giovanni Galeoto
- Department of Public Health, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Marco Tofani
- Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Annamaria Servadio
- Department of Health Professions, "Tor Vergata" University of Rome, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. .,IRCCS Neuromed, Pozzilli, IS, Italy.
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Strange J. Text Watch. BRITISH JOURNAL OF MUSIC THERAPY 2018. [DOI: 10.1177/1359457518763784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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