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Bae S, Hong I, Baek MS. Association between the length of stay in rehabilitation and mortality among the adults with Parkinson's disease: 2009-2019 Korean National Health Insurance Service Databases. Front Aging Neurosci 2024; 16:1428972. [PMID: 39161340 PMCID: PMC11330883 DOI: 10.3389/fnagi.2024.1428972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/15/2024] [Indexed: 08/21/2024] Open
Abstract
Background Rehabilitation is recognized as an effective means of alleviating the symptoms of Parkinson's disease (PD) and improving the physical and cognitive functions of patients with PD. However, research often focuses on short-term outcomes such as functioning and quality of life. This study investigated the association between the length of stay in rehabilitation and mortality among patients with PD. Methods Using the Korean National Health Insurance Service database, we identified 636 participants diagnosed with PD who received rehabilitation. The main outcome was all-cause mortality. We used a Cox proportional hazards regression model to examine the relationship between length of stay in rehabilitation and mortality among patients with PD. Results The final sample comprised 374 females (58.81%) and 262 males (41.19%). A survival analysis revealed a significant association between the length of stay in rehabilitation and mortality, with a decrease in mortality of 16.1% in patients with PD who received one year of rehabilitation (hazard ratio = 0.839, 95% confidence interval = 0.788-0.895). Conclusion Our findings underscore the potential benefits of timely implementation of rehabilitative interventions in patients with PD and the need for comprehensive and long-term rehabilitation strategies. It also highlights the necessity of such services for patients with PD and the importance of developing patient-centered rehabilitation guidelines.
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Affiliation(s)
- Suyeong Bae
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Min Seok Baek
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, Republic of Korea
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Sakai K, Kawasaki T, Kiminarita H, Kim K, Ogawa J. Validity, reliability, and measurement error of the Japanese version of the Freezing of Gait Questionnaire for patients with Parkinson's disease. Physiother Theory Pract 2024:1-7. [PMID: 38813872 DOI: 10.1080/09593985.2024.2361325] [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: 10/03/2023] [Accepted: 05/24/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND The Freezing of Gait Questionnaire has been translated into several languages. However, it has not been translated into Japanese and its measurement error remains unclear.Objectives: This study aimed to translate the Freezing of Gait Questionnaire into Japanese, investigate its validity and reliability, and calculate its measurement errors. METHODS Thirty-five patients with Parkinson's disease participated in the study. The Freezing of Gait Questionnaire was translated into Japanese using a forward - backward translation method. Convergent validity was assessed using the Freezing of Gait Questionnaire and Unified Parkinson's Disease Rating Scale Part II(item 14-freezing). The content validity index was calculated using the Freezing of Gait Questionnaire score using correlation coefficients. Internal consistency was measured using Cronbach's alpha. The test - retest reliability was evaluated using the intraclass correlation coefficient(1,1). The Bland - Altman analysis was performed to detect the limits of agreement. RESULTS The mean Freezing of Gait Questionnaire score was 9.1 (5.0) points. Convergent validity was 0.655 and content validity index was 0.958. Cronbach's alpha was 0.958, intraclass correlation coefficient(1,1) was 0.951, and the limits of agreement ranged from - 4.9 to3.2 points. CONCLUSIONS The Japanese version of the Freezing of Gait Questionnaire is a valid and useful tool to evaluate patients with Parkinson's disease.
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Affiliation(s)
- Katsuya Sakai
- Department of Physical Therapy, Faculty of Healthcare Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Tsubasa Kawasaki
- Department of Physical Therapy, School of Health Sciences, Tokyo International University, Kawagoe, Japan
| | - Hiroya Kiminarita
- Department of Rehabilitation, Kirameki Visiting Nursing Rehabilitation, Kawagoe, Japan
| | - Kichol Kim
- Department of Rehabilitation, Kawaguchi Neurosurgery Rehabilitation Clinic, Osaka, Japan
| | - Jyunya Ogawa
- Department of Rehabilitation, PDit Studio, Tokyo, Japan
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Goh L, Canning CG, Song J, Clemson L, Allen NE. The effect of rehabilitation interventions on freezing of gait in people with Parkinson's disease is unclear: a systematic review and meta-analyses. Disabil Rehabil 2023; 45:3199-3218. [PMID: 36106644 DOI: 10.1080/09638288.2022.2120099] [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: 12/19/2021] [Revised: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To summarize the effects of rehabilitation interventions to reduce freezing of gait (FOG) in people with Parkinson's disease. METHODS A systematic review with meta-analyses of randomized trials of rehabilitation interventions that reported a FOG outcome was conducted. Quality of included studies and certainty of FOG outcome were assessed using the PEDro scale and GRADE framework. RESULTS Sixty-five studies were eligible, with 62 trialing physical therapy/exercise, and five trialing cognitive and/or behavioral therapies. All meta-analyses produced very low-certainty evidence. Physical therapy/exercise had a small effect on reducing FOG post-intervention compared to control (Hedges' g= -0.26, 95% CI= -0.38 to -0.14, 95% prediction interval (PI)= -0.38 to -0.14). We are uncertain of the effects on FOG post-intervention when comparing: exercise with cueing to without cueing (Hedges' g= -0.58, 95% CI= -0.86 to -0.29, 95% PI= -1.23 to 0.08); action observation training plus movement strategy practice to practice alone (Hedges' g= -0.56, 95% CI= -1.16 to 0.05); and dance to multimodal exercises (Hedges' g= -0.64, 95% CI= -1.53 to 0.25). CONCLUSIONS We are uncertain if physical therapy/exercise, cognitive or behavioral therapies, are effective at reducing FOG.Implications for rehabilitationFOG leads to impaired mobility and falls, but the effect of rehabilitation interventions (including physical therapy/exercise and cognitive/behavioral therapies) on FOG is small and uncertain.Until more robust evidence is generated, clinicians should assess FOG using both self-report and physical measures, as well as other related impairments such as cognition, anxiety, and fear of falling.Interventions for FOG should be personalized based on the individual's triggers and form part of a broader exercise program addressing gait, balance, and falls prevention.Interventions should continue over the long term and be closely monitored and adjusted as individual circumstances change.
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Affiliation(s)
- Lina Goh
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Colleen G Canning
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jooeun Song
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Lindy Clemson
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Natalie E Allen
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Wang S, Li T, Zhou T, Pu L, Wang HY, Yin X, Hao X, Ren L, Liang Z. Survival in patients with Parkinson's disease: a ten-year follow-up study in northern China. BMC Neurol 2022; 22:367. [PMID: 36138355 PMCID: PMC9494910 DOI: 10.1186/s12883-022-02899-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A thorough understanding of the factors that influence patient survival in Parkinson's disease (PD) will aid in prognosis prediction and provide a new direction for disease modification treatment. Currently, there are no standardized mortality ratio (SMR) data for PD patients in the northern Chinese mainland. The main focus of this study was to determine which factors in the prospectively collected baseline characteristics can affect the survival of PD patients. In addition, for the first time, we investigated the SMR of PD patients in northern China. METHODS Between 2009 and 2012, 218 PD patients were continuously recruited from the movement disorder clinic of the First Affiliated Hospital of Dalian Medical University and followed up until death or May 31, 2021. The prespecified prognostic variables were demographics, clinical features, lifestyle factors, and drug dose prospectively collected at baseline. To determine the independent predictors of survival during follow-up, the Cox proportional hazards model was used. Kaplan-Meier analysis was applied to estimate the overall survival curve and to compare survival between layers based on statistically significant predictors. The SMR of this northern Chinese mainland PD cohort was calculated. RESULTS After a mean follow-up of 9.58 ± 2.27 years, 50 patients (22.90%) died. Factors that could individually predict shortened survival during follow-up included older age at onset (hazard ratio [HR] 1.10, 95% confidence interval [CI] 1.06-1.15), Hoehn and Yahr (H&Y) stage ≥ 3 (HR 9.36, 95% CI 2.82-31.03) and severe cognitive impairment (HR 6.18, 95% CI 2.75-13.88). Univariate Cox regression revealed that a certain amount of physical activity was associated with better survival (HR 0.41, 95% CI 0.22-0.74), while fatigue was associated with an increased risk of death (HR 2.54, 95% CI 1.37-4.70). The overall SMR was 1.32 (95% CI 0.98-1.74). CONCLUSIONS Older age at onset, higher baseline H&Y stage, and severe cognitive impairment have a negative impact on survival. The 10-year survival of PD patients is not significantly different from that of the general population in China.
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Affiliation(s)
- Song Wang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Tao Li
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Tingting Zhou
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Lanlan Pu
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Hai-Yang Wang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China.,Department of Neurology, Jining No. 1 People's Hospital, Jining, 272000, China
| | - Xiaoxue Yin
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Xinqing Hao
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Lu Ren
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China
| | - Zhanhua Liang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, No.222, Zhongshan Road, Dalian, 116011, Liaoning Province, China.
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Mitsui T, Arii Y, Taniguchi K, Tsutsumi S, Takahara M, Mabuchi M, Sumitomo N, Matsuura M, Kuroda Y. Efficacy of Repetitive Trans-spinal Magnetic Stimulation for Patients with Parkinson's Disease: a Randomised Controlled Trial. Neurotherapeutics 2022; 19:1273-1282. [PMID: 35759108 PMCID: PMC9587186 DOI: 10.1007/s13311-022-01213-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 12/18/2022] Open
Abstract
We evaluated the effect of repetitive trans-spinal magnetic stimulation (rTSMS) in patients with Parkinson's disease (PD) in a randomised, single-blind study. Participants were hospitalised and administered a single trial of rTSMS or sham treatment 2 days a week for 4 weeks. In addition, all participants underwent rehabilitation 5 days a week for 4 weeks. The primary outcome was the difference between the two groups in the mean change from baseline to post-training in the total score on the Unified Parkinson's Disease Rating Scale (UPDRS). Secondary endpoints included the differences between the two groups in the mean change on the UPDRS part III (motor) score and the Timed Up and Go (TUG) score. Eligible participants were randomly assigned to either the rTSMS group (n = 50) or sham group (n = 50). The between-group difference in mean change in the total UPDRS score was 10.28 (95% confidence interval (CI), 4.42 to 16.13; P = 0.014) immediately after intervention from baseline, 5.04 (95% CI, - 5.41 to 15.50; P = 0.024) 3 months after intervention from baseline and 2.38 (95% CI, 7.18 to 11.85; P = 0.045) 6 months after intervention from baseline. Significant differences between groups in UPDRS part III and TUG scores were maintained more strictly than those in the UPDRS total score. These results strongly indicate that rTSMS promotes the effect of rehabilitation on motor function in patients with PD.
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Affiliation(s)
- Takao Mitsui
- Department of Neurology, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan.
- Department of Clinical Research, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan.
| | - Yoshiharu Arii
- Department of Neurology, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Koichiro Taniguchi
- Department of Neurology, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Satoshi Tsutsumi
- Department of Neurology, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Mika Takahara
- Department of Neurology, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Masaru Mabuchi
- Department of Rehabilitation, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Nichika Sumitomo
- Department of Clinical Research, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Mieko Matsuura
- Department of Clinical Research, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
| | - Yukiko Kuroda
- Department of Clinical Research, Tokushima National Hospital National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima, 776-0031, Japan
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