Efficacy of rehabilitation program in addition to pharmacological treatment during 8 months in Parkinson patients

Jesús Seco Calvo, Inés Gago Fernández, Juan Azael Herrero Alonso, Javier González Gallego, Nuria Garatachea Vallejo

Faculty of Health Sciences, University of León, Ponferrada, Spain.
Institute of Biomedicine (IBIOMED), University of León, León, Spain.
Institute of Biomedicine (IBIOMED), University of León, León, Spain;.
Research Center on Physical Disability, ASPAYM Castilla y León, Valladolid, Spain.

DOI: 10.4236/apd.2012.12003                

Abstract

Objective: To compare 8-month effects ofmedical treatment plusrehabilitation on UPDRS scores ofparkinsonian patientswith that ofmedical treatment withoutrehabilitation.Design: Longtudinal randomized study. Participants:27 parkinsonian patients (69.50 ± 10.34 years). We divided our patient into two groups: control group (n = 9, received only medication therapy) and experiment- tal group (n = 18, received physiccal therapy and medication therapy). Intervention:The 8-month exercise interventions were twice-weekly 90-min sessions in group. UPDRS scales were measured before and after the interventions. Results: Two- factor ANOVA analyses revealed a significant main effect fromrehabilitation (p < 0.01) on UPDRS motor, ADL, and total, but not on UPDRS mental (p > 0.05). Post-hoc analysis shows that UPDRS motor increased in control group (+37%) meanwhile decreased in experimental group (–17%). UPDRS ADL increased significantly more in control group (+26%) than experimental group (+5%).UPDRS total increased in control group (+33%) meanwhile decreased in experimental group(–11%). Conclusions:The results of the study suggest that exercise interventions should be a necessary ongoing adjunct toparkinson’s diseasemedication.

Keywords

Parkinson; Rehabilitation; UPDRS

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Kwakkel, G., de Goede, C.J. and van Wegen, E.E. (2007) Impact of physical therapy for Parkinson’s disease: A critical review of the literature. Parkinsonism & Related Disorders, 13, S478-S487. doi:10.1016/S1353-8020(08)70053-1
[2]	Crizzle, A.M. and Newhouse, I.J. (2006) Is physical exercise beneficial for persons with Parkinson’s disease? Clinical Journal of Sport Medicine, 16, 422-425. doi:10.1097/01.jsm.0000244612.55550.7d
[3]	Reuter, I., Engelhardt, M., Stecker, K. and Baas, H. (1999) Therapeutic value of exercise training in Parkinson’s disease. Medicine & Science in Sports & Exercise, 31, 1544-1549. doi:10.1097/00005768-199911000-00008
[4]	Miyai, I., Fujimoto, Y., Ueda, Y.,Yamamoto, H., Nozasaki, S., Saito, T., et al. (2000) Treadmill training with body weight support: Its effect on Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 81, 849-852. doi:10.1053/apmr.2000.4439
[5]	Dibble, L.E., Hale, T.F., Marcus, R.L., Gerber, J.P. and LaStayo, P.C. (2009) High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: A preliminary study. Parkinsonism & Related Disorders, 15, 752-757. doi:10.1016/j.parkreldis.2009.04.009
[6]	Scandalis, T.A., Bosak, A., Berliner, J.C., Helman. L.L. and Wells, M.R. (2001) Resistance training and gait function in patients with Parkinson’s disease. American Journal of Physical Medicine & Rehabilitation, 80, 38-43. doi:10.1097/00002060-200101000-00011
[7]	Bergen, J.L., Toole, T., Elliott, R.G., Wallace, B., Robinson, K. and Maitland, C.G. (2002) Aerobic exercise intervention improves aerobic capacity and movement initiation in Parkinson’s disease patients. NeuroRehabilitation, 17, 161-168.
[8]	Hackney, M.E. and Earhart, G.M. (2009) Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism & Related Disorders, 15, 644-648. doi:10.1016/j.parkreldis.2009.03.003
[9]	Nocera, J., Horvat, M. and Ray, C.T. (2009) Effects of home-based exercise on postural control and sensory organization in individuals with Parkinson disease. Parkinsonism & Related Disorders, 15, 742-745. doi:10.1016/j.parkreldis.2009.07.002
[10]	Hirayama, M.S., Gobbi, S., Gobbi, L.T and Stella, F. (2008) Quality of life (QoL) in relation to disease severity in Brazilian Parkinson’s patients as measured using the WHOQOL-BREF. Archives of Gerontology and Geriatrics, 46, 147-160. doi:10.1016/j.archger.2007.03.007
[11]	Schmitz-Hübsch, T., Pyfer, D., Kielwein, K., Fimmers, R., Klockgether, T and Wüllner, U. (2006) Qigong exercise for the symptoms of Parkinson’s disease: A randomized, controlled pilot study. Movement Disorders, 21,543-548. doi:10.1002/mds.20705
[12]	J?bges, E., Spittler-Schneiders, H., Renner, C. and Hummelsheim, H. (2007) Clinical relevance of rehabilitation programs for patients with idiopathic Parkinson syndrome. II: Symptom-specific therapeutic approaches. Parkinsonism & Related Disorders, 13, 203-213. doi:10.1016/j.parkreldis.2006.07.018
[13]	Fahn, S. and Elton, R.L. (1987) Unified Parkinson’s disease rating scale. In: Fahn, S., Marsden, C.D., Calne, D. and Goldstein, M., Eds., Recent Developments in Parkinson’s Disease, Macmillan Health Care Information, Florham Park, 153-163.
[14]	Richards, M., Marder, K., Cote, L. and Mayeux, R. (1994) Interrater reliability of the unified Parkinson’s disease rating scale motor examination. Movement Disorders, 9, 89-91. doi:10.1002/mds.870090114
[15]	Van Hilten, J.J., van der Zwan, A.D., Zwinderman, A.H. and Roos, R.A. (1994) Rating impairment and disability in Parkinson’s disease: Evaluation of the unified Parkinson’s disease rating scale. Movement Disorders, 9, 84-88. doi:10.1002/mds.870090113
[16]	Taylor, A.H., Cable, N.T., Faulkner, G., Hillsdon, M., Narici, M. and Van Der Bij, A.K. (2004) Physical activity and older adults: A review of health benefits and the effectiveness of interventions. Journal of Sports Sciences, 22, 703-725. doi:10.1080/02640410410001712421
[17]	Morris, M.E., Iansek, R. and Kirkwood, B. (2009) A randomized controlled trial of movement strategies compared with exercise for people with Parkinson’s disease. Movement Disorders, 24, 64-71. doi:10.1002/mds.22295
[18]	Sutoo, D. and Akiyama, K. (2003) Regulation of brain function by exercise. Neurobiology of Disease, 13, 1-14. doi:10.1016/S0969-9961(03)00030-5
[19]	Glendinning, D.S. and Enoka, R.M. (1994) Motor unit behavior in Parkinson’s disease. Physical Therapy, 74, 61-70.
[20]	Ceravolo, M.G. (2009) Rehabilitation goals and strategies in Parkinson’s disease. European Journal of Physical and Rehabilitation Medicine, 45, 205-208.
[21]	Falvo, M.J., Schilling, B.K and Earhart, G.M. (2008) Parkinson’s disease and resistive exercise: Rationale, review, and recommendations. Movement Disorders, 23, 1-11. doi:10.1002/mds.21690