Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study
Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study
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DOI：
10.1191/0269215506cr913oa
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发表时间：
2006-01-01
影响因子：
3
通讯作者：
Abbruzzese, G
中科院分区：
文献类型：
--
作者：
Brichetto, G;Pelosin, E;Abbruzzese, G
目的：步态冻结是帕金森病常见的致残症状，多巴胺能药物治疗效果差。我们调查了帕金森病患者步态冻结的康复方案的短期有效性。设计：开放标签设计的前瞻性、非对照的试点研究。设置：神经系统疾病康复门诊服务。受试者：12名患者（8名男性，4名女性;年龄59-78岁; Hoehn-Yahr分期：2-3;平均病程：14.29 +/- SD 4.1年）。患者每周参加三次（45分钟）的物理治疗，为期六周，重点是改善平衡、姿势控制和行走，并学习克服步态冻结的新策略。主要结果指标：采用临床评定量表对患者在康复前（T0）、康复结束时（T1）和康复后1个月（T2）进行评定（统一帕金森病评定量表-运动部分;步态冻结问卷;帕金森病生活质量评分）和步态参数（步数、步幅和速度）。结果：治疗后（T1），步态冻结问卷和帕金森病生活质量问卷评分（但帕金森病统一评定量表-运动部分评分无明显改善）显著改善。步态参数在T1和T2时显著改善。结论：我们显示了帕金森病步态冻结的康复方法的潜在短期疗效。通过临床评分量表和客观步态评估记录了积极的结果。临床获益的快速可逆性表明，需要进一步研究以更好地确定最佳治疗频率和持续时间。
Objective: Freezing of gait is a frequently disabling symptom in Parkinson's disease, poorly responding to dopaminergic treatment. We investigated the short-term effectiveness of a rehabilitation protocol in parkinsonian patients with freezing of gait.Design: Prospective, uncontrolled pilot study with open label design.Setting: Outpatient service for rehabilitation of neurological disorders.Subjects: Twelve patients (8 male, 4 female; aged 59-78 years; Hoehn-Yahr stage: 2-3; mean disease duration: 14.29 +/- SD 4.1 years).Interventions: Patients attended three (45 min) sessions every week, over a six-week period, of physical therapy focused to improve balance, postural control and walking, and to learn new strategies for overcoming freezing of gait.Main outcome measures: Patients were evaluated before (T0), at the end (T1), and one month after (T2) rehabilitation by means of clinical rating scales (Unified Parkinson Disease Rating Scale - Motor Section; Freezing of Gait Questionnaire; Parkinson Disease Quality of Life Score) and gait parameters (number of strides, stride length and velocity) during a standardized walking test.Results: The scores of Freezing of Gait Questionnaire and of Parkinson Disease Quality of Life Questionnaire (but not of the Unified Parkinson Disease Rating Scale - Motor Section) were significantly improved after treatment (T1). Gait parameters were significantly improved at T1 and T2.Conclusions: We showed the potential short-term efficacy of a rehabilitative approach to freezing of gait in Parkinson's disease. The positive outcome was documented by clinical rating scales and objective gait evaluation. The rapid reversibility of the clinical benefit suggests that further studies are needed to better define the optimal frequency and duration of treatment.