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Ghilardi MF, Quartarone A, Di Rocco A, Calabrò RS, Luo S, Liu H, Norcini M, Canesi M, Cian V, Zarucchi M, Ortelli P, Volpe D, Bakdounes L, Castelli D, Di Fonzo A, Franco G, Frattini E, Avanzino L, Pelosin E, Ogliastro C, Ceravolo R, Palermo G, Tommasini L, Frosini D, Parnetti L, Tambasco N, Nigro P, Simoni S, Schmidt P. Supplementing Best Care with Specialized Rehabilitation Treatment in Parkinson's Disease: A Retrospective Study by Different Expert Centers. J Clin Med 2024; 13:2999. [PMID: 38792540 PMCID: PMC11122594 DOI: 10.3390/jcm13102999] [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: 04/01/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024] Open
Abstract
Background: This is a retrospective longitudinal study comparing 374 patients with Parkinson's disease (PD) who were treated in centers offering a specialized program of enhanced rehabilitation therapy in addition to expert outpatient care to 387 patients with PD, who only received expert outpatient care at movement disorders centers in Italy. Methods: The data are from subjects recruited in the Parkinson's Outcome Project (POP) at six Italian centers that are part of a multicenter collaboration for care quality improvement (the Fresco Network). The effects were measured with a baseline and a follow-up clinical evaluation of the Timed-Up-and-Go test (TUG), Parkinson's Disease Questionnaire (PDQ-39), and Multidimensional Caregiver Strain Index (MCSI), the number of falls and hospitalizations for any cause. We used a generalized linear mixed model with the dependent variables being the response variable, which included the covariates demographics, evaluation, and treatment variables. Results: We found that the subjects who underwent specialized enhanced rehabilitation had a better motor outcome over time than those who were managed by expert neurologists but had participated in community programs for exercise and other allied health interventions. The greatest effects were seen in patients in the early stages of the disease with a high amount of vigorous exercise per week in the last six months. Similar effects were seen for PDQ39, MCSI, the number of falls, and hospitalization. Conclusions: Long-term benefits to motor function and the quality of life in patients with PD and burden reduction in their caregivers can be achieved through a systematic program of specialized enhanced rehabilitation interventions.
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Affiliation(s)
- Maria Felice Ghilardi
- Cellular & Biomedical Sciences Department, CUNY School of Medicine, Molecular, New York, NY 10031, USA;
- The Graduate Center, City University of New York, New York, NY 10016, USA
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo” Messina, 98124 Messina, Italy;
| | | | | | - Sheng Luo
- Department of Population Health, Duke University, Durham, NC 27708, USA; (S.L.); (H.L.)
| | - Hongliang Liu
- Department of Population Health, Duke University, Durham, NC 27708, USA; (S.L.); (H.L.)
| | - Monica Norcini
- NYU Langone Health, Department of Neurology, New York, NY 10016, USA
| | - Margherita Canesi
- The Gravedona e Riuniti Ospedale, 22015 Gravedona, Italy; (M.C.); (V.C.); (M.Z.); (P.O.)
| | - Veronica Cian
- The Gravedona e Riuniti Ospedale, 22015 Gravedona, Italy; (M.C.); (V.C.); (M.Z.); (P.O.)
| | - Marianna Zarucchi
- The Gravedona e Riuniti Ospedale, 22015 Gravedona, Italy; (M.C.); (V.C.); (M.Z.); (P.O.)
| | - Paola Ortelli
- The Gravedona e Riuniti Ospedale, 22015 Gravedona, Italy; (M.C.); (V.C.); (M.Z.); (P.O.)
| | - Daniele Volpe
- Villa Margherita—S. Stefano Riabilitazione, 36057 Vicenza, Italy; (D.V.); (L.B.); (D.C.)
| | - Leila Bakdounes
- Villa Margherita—S. Stefano Riabilitazione, 36057 Vicenza, Italy; (D.V.); (L.B.); (D.C.)
| | - Davide Castelli
- Villa Margherita—S. Stefano Riabilitazione, 36057 Vicenza, Italy; (D.V.); (L.B.); (D.C.)
| | - Alessio Di Fonzo
- Department of Neurology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milano, Italy; (A.D.F.); (G.F.); (E.F.)
| | - Giulia Franco
- Department of Neurology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milano, Italy; (A.D.F.); (G.F.); (E.F.)
| | - Emanuele Frattini
- Department of Neurology, IRCSS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milano, Italy; (A.D.F.); (G.F.); (E.F.)
| | - Laura Avanzino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, IRCSS Policlinico San Martino, 16132 Genoa, Italy; (L.A.); (E.P.); (C.O.)
- Department of Experimental Medicine, Section of Human Physiology (LA), University of Genoa, 16126 Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, IRCSS Policlinico San Martino, 16132 Genoa, Italy; (L.A.); (E.P.); (C.O.)
- Department of Experimental Medicine, Section of Human Physiology (LA), University of Genoa, 16126 Genoa, Italy
| | - Carla Ogliastro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, IRCSS Policlinico San Martino, 16132 Genoa, Italy; (L.A.); (E.P.); (C.O.)
- Department of Experimental Medicine, Section of Human Physiology (LA), University of Genoa, 16126 Genoa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Center for Neurodegenerative Diseases-Parkinson’s Disease and Movement Disorders, University of Pisa, 56126 Pisa, Italy; (R.C.); (G.P.); (L.T.); (D.F.)
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, Center for Neurodegenerative Diseases-Parkinson’s Disease and Movement Disorders, University of Pisa, 56126 Pisa, Italy; (R.C.); (G.P.); (L.T.); (D.F.)
| | - Luca Tommasini
- Department of Clinical and Experimental Medicine, Center for Neurodegenerative Diseases-Parkinson’s Disease and Movement Disorders, University of Pisa, 56126 Pisa, Italy; (R.C.); (G.P.); (L.T.); (D.F.)
| | - Daniela Frosini
- Department of Clinical and Experimental Medicine, Center for Neurodegenerative Diseases-Parkinson’s Disease and Movement Disorders, University of Pisa, 56126 Pisa, Italy; (R.C.); (G.P.); (L.T.); (D.F.)
| | - Lucilla Parnetti
- Ospedale Santa Maria della Misericordia, 06156 Perugia, Italy; (L.P.); (N.T.); (P.N.); (S.S.)
| | - Nicola Tambasco
- Ospedale Santa Maria della Misericordia, 06156 Perugia, Italy; (L.P.); (N.T.); (P.N.); (S.S.)
| | - Pasquale Nigro
- Ospedale Santa Maria della Misericordia, 06156 Perugia, Italy; (L.P.); (N.T.); (P.N.); (S.S.)
| | - Simone Simoni
- Ospedale Santa Maria della Misericordia, 06156 Perugia, Italy; (L.P.); (N.T.); (P.N.); (S.S.)
| | - Peter Schmidt
- NYU Langone Health, Department of Neurology, New York, NY 10016, USA
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Navas-Otero A, Pineda-Nogueras A, Ortiz-Rubio A, Calvache Mateo A, Torres-Sánchez I, Carmen Valenza M, Granados-Santiago M. Effects of Tai-Chi on Quality of Life in People With Neurodegenerative Diseases. A systematic Review of Randomised Clinical Trials. Am J Health Promot 2024:8901171241233095. [PMID: 38430055 DOI: 10.1177/08901171241233095] [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: 03/03/2024]
Abstract
OBJECTIVE This systematic review aimed to evaluate the effects of Tai Chi on the health-related quality of life (HRQoL) of people with neurodegenerative diseases. DATA SOURCE This review followed the guidelines of the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. A systematic search in five electronic databases (Medline via PubMed, Web of Science, Scopus, PEDro, and OTseeker) was performed. STUDY INCLUSION AND EXCLUSION CRITERIA Randomized control trials (RCTs) examining Tai Chi interventions to improve HRQoL in patients with neurodegenerative diseases published through March 2023 were included. DATA EXTRACTION Data were extracted from each study by two independent researchers into a data extraction form based on the Cochrane recommendations. Methodological quality and risk of bias were assessed. DATA SYNTHESIS A meta-analysis was performed using Review Manager 5.3 software. RESULTS Of the 439 records that were screened, eight RCTs met the eligibility criteria. They assessed cognitive decline (n = 2) or Parkinson's disease (n = 6). RCT comparison groups included active interventions or usual care. The duration of Tai Chi therapy ranged from 8 to 24 weeks. A sensitivity analysis using a fixed effect model indicated that Tai Chi therapy significantly increased HRQoL [P < 001, SMD (95% CI) = .41 [.21, .60], I2 = 4%]. CONCLUSION Tai Chi can effectively improve the HRQoL of people with neurodegenerative diseases, but the heterogeneity across intervention was relatively high. Further studies are needed as research into the benefits of Tai Chi in neurodegenerative disease rehabilitation is still limited.
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Affiliation(s)
- Alba Navas-Otero
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Andrés Calvache Mateo
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Liu Z, Huang M, Liao Y, Xie X, Zhu P, Liu Y, Tan C. Long-term efficacy of hydrotherapy on balance function in patients with Parkinson's disease: a systematic review and meta-analysis. Front Aging Neurosci 2023; 15:1320240. [PMID: 38152605 PMCID: PMC10751311 DOI: 10.3389/fnagi.2023.1320240] [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: 10/12/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023] Open
Abstract
Background Hydrotherapy can improve the motor and non-motor symptoms of Parkinson's disease (PD), but the long-term effects of hydrotherapy on PD are still unclear. Objective The purpose of this systematic evaluation and meta-analysis was to explore the long-term effects of hydrotherapy on balance function in PD patients. Methods A systematic search of five databases was conducted to identify appropriate randomized controlled trials (RCTs) according to the established inclusion and exclusion criteria. The general characteristics and outcome data (balance, exercise, mobility, quality of life, etc.) of the included studies were extracted, and the quality of the included studies was evaluated using the Cochrane risk of bias assessment tool. Finally, the outcome data were integrated for meta-analysis. Results A total of 149 articles were screened, and 5 high-quality RCTs involving 135 PD patients were included. The results of the meta-analysis showed positive long-term effects of hydrotherapy on balance function compared to the control group (SMD = 0.69; 95% CI = 0.21, 1.17; p = 0.005; I2 = 44%), However, there were no significant long-term effects of hydrotherapy on motor function (SMD = 0.06; 95% CI = -0.33, 0.44; p = 0.77; I2 = 0%), mobility and quality of life (SMD = -0.21; 95% CI = -0.98, 0.57; p = 0.6; I2 = 71%). Interestingly, the results of the sensitivity analysis performed on mobility showed a clear continuation effect of hydrotherapy on mobility compared to the control group (SMD = -0.80; 95% CI = -1.23, -0.37; p < 0.001; I2 = 0%). Conclusion The long-term effects of hydrotherapy on PD patients mainly focus on balance function, and the continuous effects on motor function, mobility, and quality of life are not obvious.
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Affiliation(s)
- Zicai Liu
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
| | - Miao Huang
- School of Rehabilitation Medicine Gannan Medical University, Ganzhou, China
| | - Ya Liao
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
| | - Xiuying Xie
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
| | - Pingan Zhu
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
| | - Yangyou Liu
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
| | - Cheng Tan
- Department of Rehabilitation Medicine, Shaoguan First People’s Hospital, Shaoguan, China
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