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Raccagni C, Goebel G, Gaßner H, Granata R, Ndayisaba JP, Seebacher B, Schoenherr G, Mitterhuber J, Hendriks P, Kaindlstorfer C, Eschlboeck S, Fanciulli A, Krismer F, Seppi K, Poewe W, Bloem BR, Klucken J, Wenning GK. Physiotherapy improves motor function in patients with the Parkinson variant of multiple system atrophy: A prospective trial. Parkinsonism Relat Disord 2019; 67:60-65. [PMID: 31621609 DOI: 10.1016/j.parkreldis.2019.09.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/26/2019] [Accepted: 09/23/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Gait impairment and reduced mobility are disabling symptoms of multiple system atrophy. While physiotherapy is increasingly recognized as a valuable supplement to pharmacotherapy for patients with Parkinson's disease, data on the efficacy of physiotherapy for multiple system atrophy are lacking. This study aimed to explore the feasibility of two consecutive exercise-based interventions in patients with multiple system atrophy. SUBJECTS AND METHODS We included 10 patients with the parkinsonian variant of multiple system atrophy and 10 patients with Parkinson's disease, matched for gender and Hoehn & Yahr stage (≤3). Interventions consisted of a five-day inpatient physiotherapy program followed by a five-week unsupervised home-based exercise program. Outcomes included instrumented gait analysis, patient questionnaires, clinical rating scales and physical tests. Patients were examined at baseline, after the first inpatient treatment and again after the home-based intervention. Additionally, a structured telephone interview was performed immediately after the second intervention period. RESULTS Both patient groups exhibited a similar improvement of gait after the interventions, as measured by instrumented gait analysis. These effects reached their maximum level after inpatient physiotherapy and remained stable following the home-based exercise program. Patient questionnaires also showed improvements after the interventions, but motor clinical rating scales did not. CONCLUSION Our pilot results suggest that a short-term bout of physiotherapy is feasible, safe and improves gait performance in patients with multiple system atrophy. This highlights the potential of physiotherapy for this disabling condition where pharmacotherapy typically achieves poor effects. The present findings warrant a larger controlled study.
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Affiliation(s)
- C Raccagni
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - G Goebel
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck University, Innsbruck, Austria
| | - H Gaßner
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University, Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Roberta Granata
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Barbara Seebacher
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Gudrun Schoenherr
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Jakob Mitterhuber
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Pascalle Hendriks
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Sabine Eschlboeck
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Florian Krismer
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - J Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University, Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Gregor K Wenning
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
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Pasluosta C, Hannink J, Gaßner H, Von Tscharner V, Winkler J, Klucken J, Eskofier B. Motor output complexity in Parkinson’s disease during quiet standing and walking: Analysis of short-term correlations using the entropic half-life. Hum Mov Sci 2018; 58:185-194. [DOI: 10.1016/j.humov.2018.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 11/25/2022]
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