Tuesday, 13 December 2011 / Parkinsonism and Related Disorders 18S2 (2012) S81âS159 S155 trained care assistant (Group B); usual care, no coordinated rehabilitation (Group C). Primary outcomes are Self-assessment Parkinsonâs Disease Disability Scale (patients) and Modiï¬ed Carer Strain Index (carers). Secondary outcomes include patient mobility, falls, speech, pain, self efï¬cacy, health and social care use; carer general health; patient and carer social functioning, psychological wellbeing, health related quality of life. Assessments will be conducted at baseline and 6, 24 and 36 weeks. Semi structured interviews with providers (team members, care assistants), service commissioners, and patients and carers in groups A and B, will indicate the acceptability of the interventions. Discussion: The trial investigates components of recent national policy recommendations for people with Parkinsonâs, and will provide cost-effectiveness evidence about two service delivery models to inform local service planning. This project was funded by the National Institute for Health Research Service Delivery and Organisation programme (project number 08/1909/251). The views and opinions expressed therein are those of the authors and do not necessarily reï¬ect those of the NIHR SDO programme or the Department of Health. 2.356 POSSIBILITIES AND LIMITS OF REHABILITATION PROGRAM IN PARKINSONâS DISEASE AND PARKINSONIAN SYNDROMES A.S. Nica1 , G. Mologhianu2 , A. Murgu2 , C. Brailescu2 , L. Miron2 , B. Mitoiu2 , M. Ivascu2 , T. Papacocea2 . 1 Rehabilitation, University of Medicine & Pharmacy Carol Davila/National institute of Rehabiliatation, 2 Rehabilitation, UMF Carol Davila Bucharest, Bucharest, Romania Introduction and goals: Parkinsonâs Disease and other extrapiramidal syndromes can develop disturbances of the voluntary motor control system. This complex function of the organism depend on integrity of the cortical and subcortical centers who are affected by the disease. An increased number of patients with stroke (in chronic phase) can develop extrapyramidal symptomes. The study aims to analyze the efï¬cacy of the physical treatment in functional rehabilitaton, to identify and improve movement stereotypes, equilibrium and gait observing differential response of the patients. Material and Method: We took under observation a heterogenic group of 27 patients with Parkinsonâs disease or extrapyramidal manifestations after stroke (chronic phase). They received a complex rehabilitation program for two weeks. We evaluated the patients at the begginig and at the end of the rehabilitation program, from clinical and functional point of view, using ADL, Quality of Life and MMSE. Results: After the completion of the rehabilitation program, we observed an improvement in gait, movements and balance and coordination. The patiens have been cooperative, despite some initial manifestations of depresion. Conclusion: The complex rehabilitation program has obvious beneï¬ts in improving the clinical and functional status for the patients with Prakinsonâs disease and extrapyramidal manifestation after stroke. The results are better for patiens who are cooperative and who have family support. 2.357 USING ECOLOGICAL EVENT-BASED ACOUSTIC GUIDES TO CUE GAIT IN PARKINSONâS DISEASE PATIENTS W. Young, M. Rodger, C. Craig. Psychology, Queenâs University Belfast, Belfast, Ireland Alterations in gait parameters such as stride amplitude will, presumably, be manifest in the acoustics resulting from foot contact with the ground. The ï¬rst aim of the study was to design eventbased, ecological acoustic guides that convey both spatial and temporal information relating to gait parameters. The second aim was to assess if PD patients can perceive and adapt their gait patterns according to gait parameters conveyed in the acoustic guide. We asked a young healthy adult male to walk along an 8m walkway at a range of stride amplitudes (speciï¬ed by horizontal lines on ï¬oor) of, or between 50â100 cm and cadences (speciï¬ed by metronome) of, or between 500â1000ms. Twenty ground reaction force (GRF) vectors were recorded for each speciï¬ed gait parameter using a portable AMTI force plate. The changes in GRF were used to create synthesized stepping sounds using an adapted âPure Dataâ software patch. Ten PD patients were asked to walk along an 8m walkway whilst listening to a range of acoustic cues that comprising either a metronome or a simulation of successive footfall sounds. We have established a method for synthesizing stepping sounds over a continuous and wide range of stride lengths and frequencies, using measures of GRF. Our results show that participants were able to perceive relative changes (in stride amplitude and cadence) in the acoustic guide and adapt their gait patterns accordingly. The current study identiï¬es the potential for using ecological event based sounds for cueing gait in PD patients. 2.358 POSTURAL STABILITY IN PARKINSONâS DISEASE PATIENTS AFTER TAI CHI TRAINING: A RANDOMIZED CONTROLLED TRIAL F. Li1 , K. Fitzgerald2 . 1 Oregon Research Institute, 2 Oregon Medical Group, Eugene, OR, USA Background: Patients with Parkinsonâs disease experience signiï¬cant balance impairment, leading to diminished functional ability and increased risk of falling. Although exercise is routinely encouraged by healthcare providers, few programs have been proven effective. Methods: A randomized, controlled trial was conducted to determine whether a tailored Tai Chi program could improve postural control in patients with idiopathic Parkinsonâs disease. One-hundred ninety-ï¬ve patients (Hoehn-Yahr 1â4) were randomly assigned to receive Tai Chi, resistance training, or a stretching control, in 60-minute sessions twice weekly for 24 weeks. The primary outcomes were changes from baseline in the Limits of Stability test (maximum excursion, directional control). Secondary outcomes included measures of stride length, walking velocity, Functional Reach, Timed Up & Go, motor scores of the Uniï¬ed Parkinsonâs Disease Rating Scale, and number of falls. Results: The Tai Chi group performed consistently better than the resistance and stretching groups in maximum excursion (11.98%, 95%, conï¬dence interval [CI], 7.21 to 16.74; 5.55%, 95% CI, 1.12 to 9.97, respectively) and directional control (11.38%, 95% CI, 5.50 to 17.27; 10.45%, 95% CI, 3.89 to 17.00, respectively). Tai Chi participants also performed better than the stretching group in all secondary outcomes and outperformed the resistance group in stride length and Functional Reach. Tai Chi lowered the incidence of falls compared to stretching but not to resistance. No adverse events were observed. Conclusions: Tai Chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinsonâs disease, with additional beneï¬ts of improved functional ability and reduced falls. 2.359 QUALITY OF LIFE SCALE IN PARKINSONâS DISEASE IN RELATION TO AMBULATORY INDEPENDENCY C.M. Kwok1 , C.Y. Yick2 . 1 Physiotherapy Department, 2 Physiotherapy Department, IRS, Tseung Kwan O Hospital, Hong Kong, Hong Kong S.A.R. Introduction: Quality of Life (QoL) has been increasingly recognized as an important outcome measure for Parkinsonâs disease (PD) patients because motor and non-motor symptoms are evaluated. However its relationship with ambulatory capacity is under determined.
Parkinsonism & Related Disorders – Elsevier
Published: Jan 1, 2012
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