ABSTRACT
ObjectiveTo investigate the current trend of non-drug therapy for gait abnormality of Parkinson's disease. MethodsThe clinical trials about non-drug therapy for gait abnormality of Parkinson's disease were retrieved from the clinical trial registration platform ClinicalTrials.gov, from inception to October 25th, 2022. The records were screened by two researchers independently, and the registration time, registration count, sample sizes, interventions, primary outcome measurements and study design, etc., were summarized and analyzed, according to the PICOS principle. ResultsA total of 218 eligible records were included. The registration count increased in recently years. Almost all of the trials (93.6%) were with a relatively small sample size less than 100, mainly 21 to 30 cases. The major intervention approach was the neuromodulation technique, however, virtual reality and robot-assisted gait training were coming to use in recent years. The primary outcome measurements were the clinical scales, the questionnaires and the exercise examinations. Randomized parallel controlled trials were the most (111, 50.9%). ConclusionThe number of non-drug therapy for gait abnormality of Parkinson's disease increased year by year. The new technologies such as virtual reality and robot-assisted gait training may be used more in the future.
ABSTRACT
@# Neurofeedback may improve cognitive function and behaviour by regulating the cerebral neural activities. Neurofeedback works as a kind of therapy for patients with Parkinson's disease, primarily based on electroencephalogram signals and hemodynamic signals. It regulates abnormal neuronal rhythm oscillations in the cortical-spinal system by electroencephalogram neurofeedback and sensory motor rhythm as the main adjustment frequency band, and modulates activation in the cortical-basal ganglia-thalamic-cortical network of brain with the supplementary motor area as the target area via functional magnetic resonance imaging neurofeedback. Neurofeedback effectively improves the motor symptoms of Parkinson's patients, both dynamic and static. However, the number of samples is limited in these researches, and the assessments before and after neurofeedback training are not yet comprehensive. Neurofeedback technology might be a potential effective rehabilitation for patients with Parkinson's disease.
ABSTRACT
@#Virtual reality is an integrated technology which simulates the real world via the computer, with characteristics of immersion, interaction and imagination. It is widely used in neurological rehabilitation. Freezing of gait (FOG) is a destructive symptom which appears in late stage of Parkinson's disease, which can be divided into subtypes of moving forward with very small steps, leg trembling in place and total akinesia, and often results in fall and injury of the patients. Virtual reality can simulate the environment of FOG to provide a new idea for the assessment. Virtual reality combined with treadmill training can provide challenging functional training in a complex environment to improve the gait. How it works is remained unclear.
ABSTRACT
@#Dysphagia commonly occurs in Parkinson's disease (PD) at any stage, which may result in serious complications. The mechanism is uncertain. Swallowing Disturbance Questionnaire (SDQ) and Munich Dysphagia Test-Parkinson's Disease (MDT-PD) are often used for screening dysphagia in PD patients. But Non-motor Symptoms Questionnaire (NMSQ) and Unified Parkinson's Disease Rating Scale (UPDRS) underestimate the severity of dysphagia in PD patients. Videofluoroscopic Swallowing Examination (VFSE) and Videoendoscoptic Swallowing Study (VESS) are the gold standards for the dysphagia. There is no systemic management yet. Interventions includes medication, deep brain stimulation, etc. Early diagnosis and management facilitate to decrease the complications.
ABSTRACT
@#The core symptoms of Parkinson's disease include motor symptoms and non-motor symptoms. For the motor symptoms, the rehabilitation includes the basic training of joints, gait training, the training of core muscle group and posture balance, the training of oral, facial, neck muscle and pharyngeal reflex, the training of lip movement, vocalization, sound volume, rhythm and speed, and the training of deep breathing exercises and abdominal pressure. For the non-motor symptoms, the rehabilitation includes the training of memory, attention, problem solving ability, activities of daily living and others, psychotherapy, family support, social participation, and other comprehensive treatments combined with medicine.