Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease: A Pilot Randomized Cross-Over Study

Varalta, Valentina; Poiese, Paola; Recchia, Serena; Montagnana, Barbara; Fonte, Cristina; Filippetti, Mirko; Tinazzi, Michèle; Smania, Nicola; Picelli, Alessandro

doi:10.3390/jpm11080687

Cited by 4 publications

(23 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This improvement was not maintained in the follow-up. In contrast to our results, previous studies reported no changes in this function after motor treatment [ 47 , 48 , 49 ], possibly owing to differences in the type, frequency or duration of the interventions. The abovementioned studies focused on gait and balance treatment, whereas we trained the upper limbs exclusively.…”

Section: Discussioncontrasting

confidence: 99%

“…Specifically, previous studies indicated no improvements in global cognitive functioning after anaerobic lower limb treatment [ 22 , 47 ], whereas a significant change in the MoCA score has been reported after aerobic programs (e.g., dance or bodyweight exercise treatments) [ 19 , 21 ]. It is possible that different types of exercise (aerobic vs. anaerobic) have different effects on global cognitive functioning.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Parkinson’s disease is characterized by motor and cognitive deficits that usually have an impact on quality of life and independence. To reduce impairment, various rehabilitation programs have been proposed, but their effects on both cognitive and motor aspects have not been systematically investigated. Furthermore, most intervention is focused on lower limb treatment rather than upper limbs. In the present study, we investigated the effect of 3-week upper limb vibratory stimulation training on cognitive functioning in 20 individuals with Parkinson’s disease. We analyzed cognitive (Montreal Cognitive Assessment, Trial Making Test, Digit Symbol, Digit Span Forward and Backward and Alertness) and motor performance (Unified Parkinson’s Disease Rating Scale—part III; Disability of the Arm, Shoulder and Hand Questionnaire) before treatment, at the end of treatment and one month post treatment. After rehabilitation, a statistically significant improvement was observed in terms of global cognitive status, attention, global motor functioning and disability. The results suggest an impact of upper limb motor rehabilitation on cognition in Parkinson’s disease. Future studies on neuromotor interventions should investigate their effects on cognitive functioning to improve understanding of cognitive motor interaction in Parkinson’s disease.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most studies (27 [59%]) were published after 2016 (Table 1 and eAppendix 2 in Supplement 1). More than half of the trials were conducted in Italy (19 [41%]), Brazil (5 [11%]), or the US (5 [11%]) . A fraction of the remaining trials was conducted in the UK (4 [9%]) .…”

Section: Resultsmentioning

confidence: 99%

“…The number of participants per trial ranged between 15 and 762 participants. Thirty-two studies (70%) involved 50 participants or less, and 8 studies (17%) enrolled more than 100 participants . Only 2 studies had sample sizes exceeding 500 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Type, Timing, Frequency, and Durability of Outcome of Physical Therapy for Parkinson Disease

El Hayek,

Lobo Jofili Lopes,

LeLaurin

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceParkinson disease (PD) is a neurodegenerative syndrome affecting approximately 1% of the population older than 60 years, and a major goal of treatment is preservation of physical function through physical therapy (PT). Although PT outcomes for PD are well documented, aggregate information on the parameters of PT are needed to guide implementation.ObjectiveTo evaluate current evidence on the types, timing, frequency, duration, and outcomes of PT regimens applied for PD.Data SourcesPubMed, Embase, Medline, and the Web of Science Core Collection were searched for articles published from January 1, 2000, to August 10, 2022. Search terms included terms related to Parkinson disease, PT interventions, and PT-related outcomes.Study SelectionIncluded studies were peer-reviewed randomized clinical trials available in English of any PT intervention for patients with PD that included PT-related outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed.Data Extraction and SynthesisTwo reviewers extracted data and assessed quality using the Cochrane Risk of Bias Tool. Data were analyzed using a random-effects model.Main Outcomes and MeasuresA meta-analysis compared outcomes of nonstandard PT vs standard PT and standard PT vs no intervention for Unified Parkinson’s Disease Rating Scale (UPDRS) score and measures of gait and balance.ResultsA total of 46 trials with 3905 patients were included (range of mean ages, 61-77 years). Ten trials (22%) compared 2 types of nonstandard PT interventions; 26 (57%), nonstandard PT vs standard PT; and 10 (22%), PT vs no intervention. The most common nonconventional PT intervention was aquatic physiotherapy (5 trials [11%]). Durations of PT regimen ranged from 2 to 12 weeks in 39 trials (85%), and PT was most commonly performed with frequencies of either twice or 3 times weekly (27 [59%]). In most trials (39 [85%]), PT session length ranged from 30 to 60 minutes. Across trials, PT outcomes were reported for gait (14 trials [30%]), balance (10 [22%]), quality of life (3 [9%]), and cognition (1 [2%]). Approximately half of the trials (22 [48%]) documented durability of some level of benefit after completion of the prescribed regimen. Meta-analysis showed no significant difference for PT vs no intervention in UPDRS scores (standardized mean difference [SMD], −1.09; 95% CI, −2.50 to 0.33) or for nonstandard PT vs standard PT in measures of gait (SMD, 0.03; 95% CI, −0.53 to 0.59), balance (SMD, 0.54; 95% CI, −0.03 to 1.12), and UPDRS score (SMD, −0.49; 95% CI, −1.04 to 0.06). Meta-analytic regression of moderators revealed no significant differences in outcomes by frequency of PT per week (SMD, 0.17; 95% CI, –0.03 to 0.36).Conclusions and RelevanceThe findings suggest that although a wide range of types and regimens of PT for PD have been tested, comparative effectiveness of different models of care and implementation strategies as well as long-term durability of their outcomes remain undetermined.

show abstract

Towards multimodal cognition-based treatment for cognitive impairment in Parkinson's disease: drugs, exercise, non-invasive brain stimulation and technologies

Mantovani,

Bressan,

Tinazzi

et al. 2024

Current Opinion in Neurology

View full text Add to dashboard Cite

Purpose of review Cognitive impairment is one of the most challenging non-motor symptoms of Parkinson's disease (PD) and may occur during all PD stages. There are no established pharmacological treatments for PD-related cognitive impairment, which may be improved by cognition-based interventions (i.e., cognitive stimulation, cognitive training, cognitive rehabilitation). Multimodal cognition-based interventions by adjunctive drugs, exercise, non-invasive brain stimulation and technologies may be effective in PD. Recent findings Exercise combined with cognitive training may enhance global, memory, visuospatial and executive functioning, transcranial direct current stimulation delivered alongside cognitive training may improve attention and executive functioning, and exergames, semi-immersive virtual reality (VR) and telerehabilitation plus non-immersive VR combined with cognitive training may ameliorate global and executive functioning in PD patients. Summary The evidence reviewed here, despite preliminary, is very encouraging and suggests strong rationale for combining pharmacological and non-pharmacological interventions with cognition-based treatments in PD. To overcome limitations of current studies, we propose some recommendations for future trials on drugs, exercise, non-invasive brain stimulation and technologies combined with cognition-based treatments for cognitive impairment in PD.

show abstract

Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease: A Pilot Randomized Cross-Over Study

Cited by 4 publications

References 42 publications

Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study

Effect of Upper Limb Motor Rehabilitation on Cognition in Parkinson’s Disease: An Observational Study

Type, Timing, Frequency, and Durability of Outcome of Physical Therapy for Parkinson Disease

Towards multimodal cognition-based treatment for cognitive impairment in Parkinson's disease: drugs, exercise, non-invasive brain stimulation and technologies

Contact Info

Product

Resources

About