In-patient multidisciplinary rehabilitation for Parkinson's disease: A randomized controlled trial.

PURPOSE: This study was undertaken to evaluate the effects of an inpatient 2-month multidisciplinary rehabilitative program of task-oriented exercises, cognitive-behavioral training, and occupational therapy on motor impairment, activities of daily living, and quality of life (QoL) in subjects with long-duration Parkinson's disease (PD). METHODS: Subjects were randomly selected for an experimental (multidisciplinary rehabilitative care) and a control group (general physiotherapy) and were assessed before treatment, after 8 weeks (post-treatment), and 12 months after the end of treatment. Medications were not adjusted during training. Outcome measures were the Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (primary outcome), the Berg Balance Scale, the Functional Independence Measure, and the 39-Parkinson's Disease Questionnaire. A linear mixed model for repeated measures was used for each outcome. RESULTS: Seventy subjects with PD (46 females; mean age, 74 ± 7 years; mean disease duration,15 ± 3 years, modified Hoehn & Yahr stage, 2.5-4) were randomized, 64 completed the study (experimental = 32; control = 32). A significant effect of time, group, and time by group interaction were noted for all outcomes. The primary outcome showed a between-group difference in favor of the experimental group of 25 points after training, which was maintained at follow-up. After training, the Berg Balance Scale score of the experimental group was greater than 43.5, a value previously identified as a cutoff between fallers and nonfallers for subjects with PD. CONCLUSION: Our findings suggest that multidisciplinary rehabilitative care is useful in changing the course of motor impairment, balance, activities of daily living, and QoL. The effects lasted for at least 1 y after the intervention.

Leg extension test, sEMG and vibratory stimuli to assess functional recovery following knee joint surgery.

OBJECTIVE: the purpose of this study was to introduce new procedure to determine the magnitude of functional recovery after knee surgery. DESIGN: we compared the performance in the leg extension test and the response in the sEMG activity to vibration in the operated to the non-operated leg. Thirty-eight patients with knee operation and 14 healthy subjects participated in these experiments. RESULTS: during leg extension test, the mechanical power of the operated leg showed a lower value (P<0.001) than the contralateral one, while no differences were noted in the sEMG activity. The sEMG activity during vibration treatment was higher in the operated compared to non-operated leg (P<0.001). It has been suggested that the reduced motility trigger functional adaptations that are exhibited via the vibration test. CONCLUSIONS: results of our study suggest that combination of vibration and sEMG recordings may detect the impairment as well as monitoring progress of the rehabilitation programs.