ABSTRACT
OBJECTIVE: To evaluate the effects of body weight-supported overground gait training (BWSOGT) on motor abilities, such as gait and balance, in patients with Parkinson's disease (PD). DESIGN: Retrospective case-controlled observational study with a 4-week follow-up. SETTING: Inpatient rehabilitation. PARTICIPANTS: We selected 37 of 68 patients with PD. Inclusion criteria were (1) Hoehn & Yahr stage II-IV, (2) no medication adjustment during the study period, (3) at least 1 week since last medication adjustment, and (4) ability to walk more than 10 meters on their own. Exclusion criteria were (1) cerebrovascular disease or other complications affecting movement, (2) difficulty in measurement, (3) early discharge, (4) medication change during the study, and (5) development of complications. INTERVENTIONS: Patients were divided into two groups. Patients in Group I underwent 20 minutes of BWSOGT with a mobile hoist in addition to the standard exercises; Group II performed 20 minutes of gait training in place of BWSOGT. In both groups, training was performed for a total of 15 times/4 weeks. MAIN OUTCOME MEASURE(S): Participants were evaluated using the Unified Parkinson's Disease Rating Scale total, part II, and part III; 10-m walk test; velocity; stride length; 6-minute walk test; timed up and go test; Berg Balance Scale; and freezing of gait before and after the intervention. RESULTS: There were significant decreases in the Unified Parkinson's Disease Rating Scale total, part II, and part III in both groups; however, 6-minute walk test, timed up and go test, and freezing of gait results only improved in Group I. CONCLUSIONS: BWSOGT for patients with PD improves gait ability and dynamic balance more than standard gait training.
Subject(s)
Exercise Therapy , Gait Disorders, Neurologic/epidemiology , Parkinson Disease/epidemiology , Weight Lifting , Aged , Body Weight , Female , Gait/physiology , Gait Disorders, Neurologic/rehabilitation , Humans , Male , Middle Aged , Parkinson Disease/rehabilitation , Postural Balance/physiology , Time and Motion Studies , Walking/physiologyABSTRACT
PURPOSE: The goal of the present study was to clarify the clinical characteristics and laboratory results of parkinsonian symptoms among patients with and without camptocormia. METHODS: Seventy-eight Parkinson's disease (PD) patients with camptocormia and 78 PD patients without camptocormia underwent a neurological examination, a blood test, and spinal magnetic resonance imaging (MRI). PD with camptocormia group and PD with non-camptocormia group were matched on age, age at PD onset, and sex. PRINCIPAL RESULTS: Camptocormia group had significantly higher prevalence of compression fractures, more severe parkinsonian symptoms, and a greater incidence of dementia than those without camptocormia. Serum creatine kinase levels in camptocormia group significantly elevated compared with non-camptocormia group. There were higher prevalence of abnormal findings in spine MRI including compression fractures and paravertebral muscle changes in camptocormia group compared with non-camptocormia group. MAJOR CONCLUSIONS: Camptocormia is associated with a greater prevalence of compression fractures and associated with greater UPDRS part II, part III score, axial score, and lower MMSE in this cross-sectional study. Thus, it can be concluded that camptocormia in PD is predominantly myopathic.
Subject(s)
Muscular Atrophy, Spinal/etiology , Parkinson Disease/complications , Spinal Curvatures/etiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Incidence , Japan/epidemiology , Male , Muscular Atrophy, Spinal/epidemiology , Muscular Atrophy, Spinal/pathology , Muscular Atrophy, Spinal/physiopathology , Parkinson Disease/epidemiology , Parkinson Disease/pathology , Parkinson Disease/physiopathology , Spinal Curvatures/epidemiology , Spinal Curvatures/pathology , Spinal Curvatures/physiopathologyABSTRACT
The coastal area of Fukushima prefecture is usually called "Hamadori", and Iwaki city occupies the southernmost part of Hamadori. Our hospital locates in the seashore of Iwaki city. The Fukushima Dai-ichi nuclear power plant, which developed a catastrophic accident after the Great East Japan Earthquake, locates in the middle part of Hamadori. On the 11th of March 2011, tsunamis caused by the great earthquake severely damaged our hospital and we were forced to evacuate inpatients to other hospitals for several months. Today the air radiation dose around our hospital is sufficiently low, but the anxiety for the re-attack of tsunami still remains. We are now planning the removal of our hospital to an inland estate. In the vicinity of the Fukushima Dai-ichi nuclear power plant, residence is still prohibited because of the grave radioactive contamination. On the other hand, the northern and southern parts of Hamadori are restoring their functions. The population of these areas is increasing gradually, but the number of medical staff is far from satisfactory level. As to neurology, only nine specialists work in Hamadori, so we strongly hope the recruitment of enthusiastic neurologists.
