Four-week trunk-specific exercise program decreases forward trunk flexion in Parkinson's disease: A single-blinded, randomized controlled trial

Gandolfi, Marialuisa; Tinazzi, Michèle; Magrinelli, Francesca; Busselli, Giulia; Dimitrova, Eleonora; Polo, Niccolò; Manganotti, Paolo; Fasano, Alfonso; Smania, Nicola; Geroin, Christian

doi:10.1016/j.parkreldis.2019.05.006

Cited by 43 publications

(69 citation statements)

References 22 publications

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“…Nonetheless, less severe degrees of trunk bending-though not classified as CC, PS, or AC-should be monitored (i.e., quantitively by using apps) (32) and promptly treated (i.e., physiotherapy) (33) to prevent progression and worsening and to avoid permanent deformity. Physiotherapy should include active selfcorrection, trunk stabilization exercises (i.e., strengthening of compensatory paraspinal muscles) and functional tasks, along with pharmacological intervention such as botulinum toxin injection to reduce muscle hyperactivity (4,14,33,34).…”

Section: Discussionmentioning

confidence: 99%

Does the Degree of Trunk Bending Predict Patient Disability, Motor Impairment, Falls, and Back Pain in Parkinson's Disease?

et al. 2020

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Background: Postural abnormalities in Parkinson's disease (PD) form a spectrum of functional trunk misalignment, ranging from a "typical" parkinsonian stooped posture to progressively greater degrees of spine deviation. Objective: To analyze the association between degree of postural abnormalities and disability and to determine cutoff values of trunk bending associated with limitations in activities of daily living (ADLs), motor impairment, falls, and back pain. Methods: The study population was 283 PD patients with ≥5 • of forward trunk bending (FTB), lateral trunk bending (LTB) or forward neck bending (FNB). The degrees were calculated using a wall goniometer (WG) and software-based measurements (SBM). Logistic regression models were used to identify the degree of bending associated with moderate/severe limitation in ADLs (Movement Disorders Society Unified PD Rating Scale [MDS-UPDRS] part II ≥17), moderate/severe motor impairment (MDS-UPDRS part III ≥33), history of falls (≥1), and moderate/severe back pain intensity (numeric rating scale ≥4). The optimal cutoff was identified using receiver operating characteristic (ROC) curves. Results: We found significant associations between modified Hoehn & Yahr stage, disease duration, sex, and limitation in ADLs, motor impairment, back pain intensity, and history of falls. Degree of trunk bending was associated only with motor impairment Geroin et al.

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Section: Discussionmentioning

confidence: 99%

Does the Degree of Trunk Bending Predict Patient Disability, Motor Impairment, Falls, and Back Pain in Parkinson's Disease?

et al. 2020

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“…Previous studies have evaluated exercise-based interventions that specifically focused on trunk deformities in patients with PD. Bartolo et al [7] and Gandolfi et al [8] revealed that patients with PD achieved significant improvements in postural control and trunk mobility after a 4-week rehabilitation program. However, these studies were limited to a short-term intervention; therefore, they could not provide a reliable basis on the effects of interventions.…”

Section: Introductionmentioning

confidence: 99%

Impact of Trunk Resistance and Stretching Exercise on Fall-Related Factors in Patients with Parkinson’s Disease: A Randomized Controlled Pilot Study

Youm

Kim

Noh

et al. 2020

Sensors

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Background: This study aimed to examine the effect of a 12-week progressive trunk resistance and stretching exercise program on fall-related factors in patients with Parkinson’s disease (PD). Methods: A randomized study assessed a progressive trunk resistance and stretching exercise program over a 12-week period. A total of 17 patients with PD participated and wererandomly allocated into an exercise group (n = 10) or a control group (n = 7). Participants in the exercise group completed the exercise program in 60- to 90-min sessions for three days per week. Primary and secondary outcome measures included the trunk mobility scale, functional fitness test, standing balance, and sit-to-walk test. Results: The exercise group showed improvements in functional fitness, trunk mobility, standing balance, and dynamic stability compared with the control group (all p < 0.05). The 2.44 m timed up and go test (odds ratio (OR): 0.125) and the 2 min step test (OR: 10.584) of the functional fitness test, and the first-step length (OR: 3.558) and first-toe clearance height (OR: 4.777) of the sit-to-walk test, were different between the groups following the exercise program. Conclusion: This 12-week exercise program improved fall-related factors in patients with PD and may lead to prevention of fall-related injuries.

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“…As motor and non-motor components are involved in the neural control of PA, three main elements are fundamental for effective rehabilitation: active self-correction techniques, stabilization exercises, and functional tasks. Based on this, Tinazzi and collaborators (16,17,118) have found that a 4-week trunk-specific rehabilitation program improved passive and active control of the trunk and was maintained at 1-month post-treatment. The benefits of training were evident even when PA were assessed through the Unified Parkinson Disease Rating Scale-motor subscale (122,124).…”

Section: Motor Abnormalities and Physical Activitymentioning

confidence: 94%

“…Finally, clinical evaluations found rehabilitation strategies, such as a promising non-drug-based approach able to influence the progression of PD lasting long after the program break, therefore suggesting the involvement of the anatomical substrate accompanying the disease (16,17).…”

Section: Introductionmentioning

confidence: 99%

From the Gut to the Brain and Back: Therapeutic Approaches for the Treatment of Network Dysfunction in Parkinson's Disease

Paolone

2020

Front. Neurol.

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Parkinson's disease (PD) is a complex, multisystem, progressive, degenerative disorder characterized by severe, debilitating motor dysfunction, cognitive impairments, and mood disorders. Although preclinical research has traditionally focused on the motor deficits resulting from the loss of nigrostriatal dopaminergic neurons, up to two thirds of PD patients present separate and distinct behavioral changes. Loss of basal forebrain cholinergic neurons occurs as early as the loss of dopaminergic cells and contributes to the cognitive decline in PD. In addition, attentional deficits can limit posture control and movement efficacy caused by dopaminergic cell loss. Complicating the picture further is intracellular α-synuclein accumulation beginning in the enteric nervous system and diffusing to the substantia nigra through the dorsal motor neurons of the vagus nerve. It seems that α-synuclein's role is that of mediating dopamine synthesis, storage, and release, and its function has not been completely understood. Treating a complex, multistage network disorder, such as PD, likely requires a multipronged approach. Here, we describe a few approaches that could be used alone or perhaps in combination to achieve a greater mosaic of behavioral benefit. These include (1) using encapsulated, genetically modified cells as delivery vehicles for administering neuroprotective trophic factors, such as GDNF, in a direct and sustained means to the brain; (2) immunotherapeutic interventions, such as vaccination or the use of monoclonal antibodies against aggregated, pathological α-synuclein; (3) the continuous infusion of levodopa-carbidopa through an intestinal gel pad to attenuate the loss of dopaminergic function and manage the motor and non-motor complications in PD patients; and (4) specific rehabilitation treatment programs for drug-refractory motor complications.

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Four-week trunk-specific exercise program decreases forward trunk flexion in Parkinson's disease: A single-blinded, randomized controlled trial

Cited by 43 publications

References 22 publications

Does the Degree of Trunk Bending Predict Patient Disability, Motor Impairment, Falls, and Back Pain in Parkinson's Disease?

Does the Degree of Trunk Bending Predict Patient Disability, Motor Impairment, Falls, and Back Pain in Parkinson's Disease?

Impact of Trunk Resistance and Stretching Exercise on Fall-Related Factors in Patients with Parkinson’s Disease: A Randomized Controlled Pilot Study

From the Gut to the Brain and Back: Therapeutic Approaches for the Treatment of Network Dysfunction in Parkinson's Disease

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