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Design and Development of Rehabilitation in Individuals with Parkinson’s Disease

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 19013

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Dr. Angela L. Ridgel

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Guest Editor

Kent State University, Kent, OH, USA
Interests: Neurobiology of Exercise, Aging, Neuroplasticity

Special Issue Information

Dear Colleagues,

Parkinson's disease is a neurological disorder that results in the progressive deterioration of motor and non-motor function including tremor, bradykinesia, rigidity, depression/anxiety, gait/posture deficits, cognitive dysfunction, speech/swallowing disorders and sensory deficits. Physical therapy, occupational therapy, exercise/movement therapy, speech therapy, music therapy and cognitive therapy have been shown to improve symptoms of Parkinson's disease. However, one of the primary challenges with the development of rehabilitation therapies for this population is the heterogeneity in the types and severity of symptoms and dysfunction. Furthermore, the progressive nature of Parkinson's disease requires that therapies be individualized and adaptive over time. The design and development of novel, engaging and adaptive rehabilitation therapies for the variety of Parkinson's disease symptoms could delay disability, prevent injury and improve quality of life in these individuals. This Special Issue of the International Journal of Environmental Research and Public Health, “Design and Development of Rehabilitation in Individuals with Parkinson’s Disease", offers an opportunity to publish high-quality research related to rehabilitation therapies that directly address the challenges with this disease. We are particularly interested in novel intervention research that targets these outcomes in either community-based or at-home settings. We also welcome papers investigating how these programs empower individuals with Parkinson's disease to overcome the barriers to participation in therapy over the long term. All manuscripts will be rigorously peer-reviewed by experts in the field.

Dr. Angela L. Ridgel
Guest Editor

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Keywords

rehabilitation
physical therapy
occupational therapy
cognitive therapy
neurorehabilitation
exercise
physical activity
speech therapy
adaptive
movement disorders

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Research

13 pages, 1768 KiB

Open AccessArticle

Predictive Model of Quality of Life in Patients with Parkinson’s Disease

by Eduardo Candel-Parra, María Pilar Córcoles-Jiménez, Victoria Delicado-Useros, Marta Carolina Ruiz-Grao, Antonio Hernández-Martínez and Milagros Molina-Alarcón

Int. J. Environ. Res. Public Health 2022, 19(2), 672; https://doi.org/10.3390/ijerph19020672 - 7 Jan 2022

Cited by 8 | Viewed by 2734

Abstract

Parkinson’s disease is a chronic, progressive, and disabling neurodegenerative disease which evolves until the end of life and triggers different mood and organic alterations that influence health-related quality of life. The objective of our study was to identify the factors that negatively impact the quality of life of patients with Parkinson’s disease and construct a predictive model of health-related quality of life in these patients. Methods: An analytical, prospective observational study was carried out, including Parkinson’s patients at different stages in the Albacete Health Area. The sample consisted of 155 patients (T0) who were followed up at one (T1) and two years (T2). The instruments used were a purpose-designed data collection questionnaire and the “Parkinson’s Disease Questionnaire” (PDQ-39), with a global index where a higher score indicates a worse quality of life. A multivariate analysis was performed by multiple linear regression at T0. Next, the model’s predictive capacity was evaluated at T1 and T2 using the area under the ROC curve (AUROC). Results: Predictive factors were: sex, living in a residence, using a cane, using a wheelchair, having a Parkinson’s stage of HY > 2, having Alzheimer’s disease or a major neurocognitive disorder, having more than five non-motor symptoms, polypharmacy, and disability greater than 66%. This model showed good predictive capacity at one year and two years of follow-up, with an AUROC of 0.89 (95% CI: 0.83–0.94) and 0.83 (95% CI: 0.76–0.89), respectively. Conclusions: A predictive model constructed with nine variables showed a good discriminative capacity to predict the quality of life of patients with Parkinson’s disease at one and two years of follow-up. Full article

(This article belongs to the Special Issue Design and Development of Rehabilitation in Individuals with Parkinson’s Disease)

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16 pages, 2668 KiB

Open AccessArticle

Analysis of Movement Entropy during Community Dance Programs for People with Parkinson’s Disease and Older Adults: A Cohort Study

by Peter Gates, Fred M. Discenzo, Jin Hyun Kim, Zachary Lemke, Joan Meggitt and Angela L. Ridgel

Int. J. Environ. Res. Public Health 2022, 19(2), 655; https://doi.org/10.3390/ijerph19020655 - 7 Jan 2022

Cited by 3 | Viewed by 3444

Abstract

Dance therapy can improve motor skills, balance, posture, and gait in people diagnosed with Parkinson’s disease (PD) and healthy older adults (OA). It is not clear how specific movement patterns during dance promote these benefits. The purpose of this cohort study was to identify differences and complexity in dance movement patterns among different dance styles for PD and OA participants in community dance programs using approximate entropy (ApEn) analysis. The hypothesis was that PD participants will show greater ApEn during dance than OA participants and that the unique dance style of tango with more pronounced foot technique and sharp direction changes will show greater ApEn than smoother dance types such as foxtrot and waltz characterized by gradual changes in direction and gliding movement with rise and fall. Individuals participated in one-hour community dance classes. Movement data were captured using porTable 3D motion capture sensors attached to the arms, torso and legs. Classes were also video recorded to assist in analyzing the dance steps. Movement patterns were captured and ApEn was calculated to quantify the complexity of movements. Participants with PD had greater ApEn in right knee flexion during dance movements than left knee flexion (p = 0.02), greater ApEn of right than left hip flexion (p = 0.05), and greater left hip rotation than right (p = 0.03). There was no significant difference in ApEn of body movements (p > 0.4) or mean body movements (p > 0.3) at any body-segment in OA. ApEn analysis is valuable for quantifying the degree of control and predictability of dance movements and could be used as another tool to assess the movement control of dancers and aid in the development of dance therapies. Full article

(This article belongs to the Special Issue Design and Development of Rehabilitation in Individuals with Parkinson’s Disease)

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21 pages, 1070 KiB

Open AccessArticle

Gamified Dual-Task Training for Individuals with Parkinson Disease: An Exploratory Study on Feasibility, Safety, and Efficacy

by Lee-Kuen Chua, Yu-Chen Chung, David Bellard, Laura Swan, Nicole Gobreial, Amanda Romano, Ryan Glatt, Michael A. Bonaguidi, Darrin J. Lee, Yi Jin, Charles Y. Liu and Beth E. Fisher

Int. J. Environ. Res. Public Health 2021, 18(23), 12384; https://doi.org/10.3390/ijerph182312384 - 25 Nov 2021

Cited by 10 | Viewed by 5687

Abstract

Objectives: The feasibility and safety of the use of neurorehabilitation technology (SMARTfit^® Trainer system) by physical therapists in implementing a gamified physical-cognitive dual-task training (DTT) paradigm for individuals with Parkinson disease (IWPD) was examined. Additionally, the efficacy of this gamified DTT was compared to physical single-task training (STT), both of which were optimized using physio-motivational factors, on changes in motor and cognitive outcomes, and self-assessed disability in activities of daily living. Methods: Using a cross-over study design, eight participants with mild-to-moderate idiopathic PD (including one with mild cognitive impairment) completed both training conditions (i.e., gamified DTT and STT). For each training condition, the participants attended 2–3 sessions per week over 8.8 weeks on average, with the total amount of training being equivalent to 24 1 h sessions. A washout period averaging 11.5 weeks was inserted between training conditions. STT consisted of task-oriented training involving the practice of functional tasks, whereas for gamified DTT, the same task-oriented training was implemented simultaneously with varied cognitive games using an interactive training system (SMARTfit^®). Both training conditions were optimized through continual adaptation to ensure the use of challenging tasks and to provide autonomy support. Training hours, heart rate, and adverse events were measured to assess the feasibility and safety of the gamified DTT protocol. Motor and cognitive function as well as perceived disability were assessed before and after each training condition. Results: Gamified DTT was feasible and safe for this cohort. Across participants, significant improvements were achieved in more outcome measures after gamified DTT than they were after STT. Individually, participants with specific demographic and clinical characteristics responded differently to the two training conditions. Conclusion: Physical therapists’ utilization of technology with versatile hardware configurations and customizable software application selections was feasible and safe for implementing a tailor-made intervention and for adapting it in real-time to meet the individualized, evolving training needs of IWPD. Specifically in comparison to optimized STT, there was a preliminary signal of efficacy for gamified DTT in improving motor and cognitive function as well as perceived disability in IWPD. Full article

(This article belongs to the Special Issue Design and Development of Rehabilitation in Individuals with Parkinson’s Disease)

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11 pages, 1023 KiB

Open AccessArticle

Exercise Intolerance and Oxygen Desaturation in Patients with Parkinson’s Disease: Triggers for Respiratory Rehabilitation?

by Michele Vitacca, Adriana Olivares, Laura Comini, Giuliana Vezzadini, Annamaria Langella, Alberto Luisa, Anna Petrolati, Gianluigi Frigo and Mara Paneroni

Int. J. Environ. Res. Public Health 2021, 18(23), 12298; https://doi.org/10.3390/ijerph182312298 - 23 Nov 2021

Cited by 2 | Viewed by 3247

Abstract

The role that oxygen desaturation plays in exercise tolerance and its rehabilitative implications in patients with Parkinson’s disease (PD) are unclear. We aimed to test exercise tolerance and oxygen saturation levels both during exercise and at night in PD patients to better define their rehabilitative needs. In clinically stable PD patients, undergoing inpatient rehabilitation, and in “ON” phase, we prospectively assessed clinical data, sleepiness, comorbidities, PD severity (Hoehn&Yahr, HY), motor function (ADLs, UPDRSII and UPDRSIII, Barthel Index, Functional Independence Measure), balance, spirometry, respiratory muscles (MIP/MEP), peak cough expiratory flow (PCEF), continuous night oxygen monitoring, and meters at 6MWT. Of 55 patients analyzed (28 with moderate–severe PD, HY ≥ 2.5), 37% and 23% showed moderate–severe impairment on UPDRSII and UPDRSIII, respectively; 96% had reduced exercise tolerance and severe respiratory muscles impairment (MIP/MEP < 45% pred.); 21.8% showed desaturations during exercise; and 12.7% showed nocturnal desaturations. At multiple regression, low exercise tolerance and low mean nocturnal and exercise-induced saturation correlated with several respiratory and motor function and disability indices (all p < 0.03). Exercise tolerance, exercise-induced desaturations, and nocturnal desaturations were extremely frequent in PD patients and were worse in more severe PD patients. This suggests considering a combined role for motor and respiratory rehabilitation in these patients. Full article

(This article belongs to the Special Issue Design and Development of Rehabilitation in Individuals with Parkinson’s Disease)

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8 pages, 331 KiB

Open AccessArticle

Drooling, Swallowing Difficulties and Health Related Quality of Life in Parkinson’s Disease Patients

by Gladis Yohana Arboleda-Montealegre, Roberto Cano-de-la-Cuerda, César Fernández-de-las-Peñas, Carlos Sanchez-Camarero and Ricardo Ortega-Santiago

Int. J. Environ. Res. Public Health 2021, 18(15), 8138; https://doi.org/10.3390/ijerph18158138 - 31 Jul 2021

Cited by 9 | Viewed by 2942

Abstract

Background: Parkinson’s disease (PD) is the most common neurodegenerative disorder associated with motor and nonmotor symptoms. Drooling, one of the nonmotor symptoms, can be present in 70–80% of patients with PD. The aim of this paper is to study the characteristics of PD patients with drooling compared to those without in terms of age, gender, disease duration, stage of the disease, swallowing difficulties, and health-related quality of life; methods: a cross-sectional study was conducted. The sample was divided into two groups: PD with drooling (n = 32) and PD without drooling (n = 30). Age, gender, disease duration and Hoehn & Yahr (H & Y) stage, Sialorrhea Clinical Scale for Parkinson’s Disease (SCS-PD), the 10-item Eating Assessment Tool (EAT-10), and the 39-item Parkinson’s Disease Questionnaire (PDQ-39) were compared between groups; Results: 62 individuals with PD, 40 men and 22 women (mean age 73 ± 8 years), were included. Overall, 32 patients reported drooling, and 30 did not exhibit it. The ANCOVA found significant differences between groups for the EAT-10 score (0.83, 95% CI = 5.62–9.03; p = 0.016) and SCS-PD score (1.48, 95% CI = 0.86–6.81; p < 0.001). Analysis of the PDQ-39 scores revealed no significant differences between groups for the PDQ-39 total score (p > 0.057) and in all subscales. The inclusion of gender, age, disease duration, and H & Y as covariates did not influence the results (all p > 0.05). Conclusions: drooling is related to swallowing difficulties assessed with EAT-10 but not with health-related quality of life assessed with PDQ-39 in PD patients with drooling compared to PD patients without it. Age, gender, duration of the disease, and the H & Y state of PD patients with and without drooling seem to be similar. Full article

(This article belongs to the Special Issue Design and Development of Rehabilitation in Individuals with Parkinson’s Disease)

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