Relationships between activity and well-being in people with parkinson's disease

Identification of Age and Underlying Disease Characteristics in Patients with Mild to Moderate Depression Comorbid with Parkinson's Disease: A Retrospective Case-control Study

BACKGROUND

Depression is a widely recognized neuropsychiatric condition that often occurs as a comorbidity with various medical illnesses, including neurodegenerative disorders like Parkinson's disease (PD). This study aimed to identify the age of onset and underlying disease characteristics associated with patients exhibiting mild to moderate depression comorbid with PD.

METHODS

This retrospective case-control study included 114 elderly patients (age ≥65 years) diagnosed with Parkinson's disease. The patients were divided into two groups: the non-depressed group (n = 65) and the mild to moderate depression group (n = 49). Patients' emotional and affective symptoms, cognitive function, and clinical characteristics were assessed using standardized scales. Statistical analyses, including chi-square tests, Wilcoxon rank-sum tests, and logistic regression analysis, were performed to evaluate associations and correlations between the variables of interest.

RESULTS

Our findings revealed that patients in the mild to moderate depression group exhibited a significantly lower onset age of PD (52.33 ± 3.87 years) compared to the non-depressed group (59.27 ± 3.62 years, p < 0.001). Furthermore, patients with mild to moderate depression showed significantly higher scores in mood and affective symptoms measures, including the Hamilton Anxiety Scale (HAM-A) (p < 0.001) and Apathy Scale (p < 0.001). Additionally, the duration of Parkinson's disease was significantly longer in the mild to moderate depression group (6.78 ± 2.01 years) compared to the non-depressed group (3.45 ± 1.52 years, p < 0.001). Similarly, patients in the mild to moderate depression group exhibited significantly poorer performance on the Mini-Mental State Examination (MMSE) (p < 0.001), Montreal Cognitive Assessment (MoCA) (p = 0.025), verbal fluency (p < 0.001), and Trail Making Test (p = 0.005). Additionally, correlation and logistic regression analysis revealed associations and predictive value of these variables with the presence of mild to moderate depression in Parkinson's disease.

CONCLUSION

The study highlights the complex interaction of age and underlying disease characteristics in patients with mild to moderate depression comorbid with Parkinson's disease. Early recognition and tailored management of depressive symptoms, mood and affective disturbances, cognitive impairment, and disease-specific characteristics are crucial for optimizing patient care and improving outcomes in individuals with Parkinson's disease. These findings underscore the need for a comprehensive, patient-centered approach that considers the diverse interaction of demographic, clinical, and cognitive variables.

Measurement of Physical Activity Divided Into Inside and Outside the Home in People With Parkinson's Disease: A Feasibility Study

RATIONALE

In people with Parkinson's disease (PD), quantitative assessment of activities inside and outside the home is crucial for planning effective rehabilitation tailored to a person's living conditions and characteristics.

AIMS AND OBJECTIVES

We examined the feasibility of combining a physical activity metre and a daily activity diary for people with PD.

METHODS

Physical activity was evaluated using a triaxial accelerometer and recorded in a daily activity diary by the participant. The feasibility outcome was the data adoption rate, which was the physical activity rate calculated from the activity metre wearing time and the missing times from the daily activity diary.

RESULTS AND CONCLUSION

Of the 10 participants, nine had a complete data set (adoption rate 90%). The mean physical activity metre wearing time was 14.12 ± 2.26 h/day, with a mean missing time of 25.7 ± 18.1 min/day in the daily activity diary. Combining a physical activity metre and a daily activity diary is feasible in people with PD, particularly when planning rehabilitation protocols to enhance daily physical activity.

Factors Associated With Physical Activity and Sedentary Behavior in People With Parkinson Disease: A Systematic Review and Meta-Analysis

OBJECTIVE

The goal of this review was to investigate factors associated with physical activity and sedentary behavior in people with Parkinson disease (PD). The magnitude of these associations was investigated in line with the International Classification of Functioning, Disability and Health components.

METHODS

A systematic literature review was conducted until February 2023, searching four databases (PubMed, EMBASE, Web of Science, and Scopus) for original articles investigating associations with physical activity or sedentary behavior in people with PD. Two independent researchers performed data extraction, and the risk of bias in the included studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses were conducted to determine the magnitude of the associations, and significant regression models from the included studies were described.

RESULTS

Forty-two studies were included. Twenty-one factors associated with overall physical activity were identified. Higher levels of physical activity had a small association with cognition and body mass index and a fair association with 17 factors related to self-efficacy, physical function, mobility, quality of life, age, PD symptoms, and more. Better manual dexterity and functional gait had moderate to good associations with higher levels of physical activity. The regression model with the higher magnitude was composed mostly of contextual factors, except for the body max index. The magnitude of factors associated with physical activity intensity or sedentary behavior could not be identified.

CONCLUSION

Functional gait and manual dexterity were the strongest factors related to physical activity in people with PD. Further investigation is needed to understand the factors associated with physical activity intensity and sedentary behavior.

IMPACT

This study emphasizes the significance of considering contextual factors alongside body function and structure, activity and participation, and the health condition to enhance physical activity improvement during the rehabilitation process. By adopting such a holistic approach, rehabilitation professionals can optimize the overall health and well-being of individuals with Parkinson disease.

The potential of arts therapies in Parkinson's disease rehabilitation: A comprehensive review

BACKGROUND AND PURPOSE

Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies.

METHODS

This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD.

RESULTS

From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively.

CONCLUSION

The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities.

Clinical Markers of 6 Pre-dominant Coping Behaviors in Living With Parkinson Disease: A Convergent Mixed Methods Study

People with Parkinson's disease (PwP) experience a variety of symptoms and fluctuations in these, which they have to cope with every day. In tailoring a person-centered treatment to PwP there is a lack of knowledge about the association between pre-dominant coping behaviors and clinical markers among PwP. To describe and compare specific clinical markers between 6 suggested coping behaviors. Thirty-four PwP, who previously had been classified into 6 different pre-dominant coping behaviors, were included in this mixed methods study. Six primary variables were included in the descriptive analysis; motor function (UPDRS-III), non-motor symptoms score (NMS-Quest), change in bradykinesia score, apathy score (LARS), personality traits (NEO-FFI), and cognitive status (evaluated by a neuropsychologist). The merged results of this mixed methods study indicate that clinical markers as apathy, burden of non-motor symptoms, cognitive impairments and personality traits, have the potential to impact the coping behavior in PwP. In a clinical setting the markers; NMS-burden, degree of apathy, cognition, and personality traits may indicate specific coping behavior. Three of the six suggested typologies of coping behaviors differed from the other groups when comparing descriptive data. In order to improve patient care and guide the development of person-centered therapies, each PwP should be approached based on those typologies.

Kinesiophobia in Stroke Patients, Multiple Sclerosis and Parkinson's Disesase

BACKGROUND

Stroke (S), multiple sclerosis (MS), Parkinson's disease (PD) are chronic neurological diseases that are a challange for public health and represent a real social problem. Physical activity (PA) improves functional performance, reduces various symptoms in PD and MS, in stroke- reduced neurological impairment of patients and provides a chance for independence. One of the main obstacles in successful rehabilitation is patients' movement passivity. The reason might be the psychological aspects, in particular fear of movement-kinesiophobia. Aim: To determine how many patients with S, MS, and PD suffer from kinsiophobia and what factors influence this process.

METHODS

Fifty patients after stroke, eighty one MS patients and sixty one PD patients were consecutively recruited from hospital and outpatients clinics. The sociodemographic data, self- assesment of fitness, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK) and The Modified Baecke Questionnarie for Older Adults for physical activity were collected. A score >37 was considered to indicate a high level of kinesiophobia according to the TSK.

RESULTS

High level of kinesiophobia was shown in 66.67% of the subjects. TSK medians in particular illnesses were above the cut-off score and amounted: S-42.50 points; MS-38 points; PD-42.00 points. Regression showed 15% of fluctuation of variance (R2 = 0.1498; p < 0.0001), where regression factor showed: for mobility self-assessment: b = -0.2137 and for the age b = 0.0065.

CONCLUSIONS

Kinesiophobia among the patients suffering from S, MS and PD concerns most of the subjects. Predictors of kinesiophobia are: limitations connected with functioning and age. The meaning of kinesiophobia in neurological disorders requires further research.

Functional Recovery in Parkinson's Disease: Current State and Future Perspective

Parkinson’s disease (PD) is one of the most frequent neurodegenerative disorders, affecting not only the motor function but also limiting the autonomy of affected people. In the last decade, the physical exercises of different intensities carried out by kinetic therapeutic activities, by robotic technologies or with the participation of sensory cues, have become increasingly appreciated in the management of Parkinson’s disease impairments. The aim of this paper was to evaluate the impact of physical exercises with and without physical devices on the motor and cognitive variables of PD patients. In order to achieve our objectives, we performed a systematic review of available original articles based on the impact of kinetic therapeutic activity. Through the search strategy, we selected original papers that were laboriously processed using characteristics related to physical therapy, or the tools used in physiological and psychological rehabilitation strategies for PD patients. In this study, we presented the most current intervention techniques in the rehabilitation programs of patients with Parkinson’s disease, namely the use of assisted devices, virtual imagery or the performing of physical therapies that have the capacity to improve walking deficits, tremor and bradykinesia, to reduce freezing episodes of gait and postural instability, or to improve motor and cognitive functions.

Role of microtubule-associated protein 6 glycosylated with Gal-(β-1,3)-GalNAc in Parkinson's disease

Aberrant glycosylation of proteins has major implications for human diseases. To determine whether protein glycosylation contributes to the pathogenesis of Parkinson’s disease (PD), a mouse model of PD was established by injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Induction of PD-like features was verified by assessing motor impairment and confirming reductions in biological markers, including dopamine, 5-hydroxytryptamine and tyrosine hydroxylase, as well as the aggregation of α-synuclein. Altered glycosylation was detected using biotinylated agaracus bisporus lectin, which specifically binds exposed Gal-(β-1,3)-GalNAc linked to glycoproteins. Subsequent lectin affinity chromatography coupled with mass spectrometry revealed enhanced glycosylation of microtubule-associated protein 6 (MAP6) in PD mice as compared to healthy controls. In situ dual co-immunofluorescence analysis and immunoblotting confirmed that MAP6 is glycosylated with Gal-(β-1,3)-GalNAc oligosaccharides, which in turn alters the distribution and structure of MAP6 complexes within neurons. This is the first study to described MAP6 as a glycoprotein containing Gal-(β-1,3)-GalNAc oligosaccharides and to show that hyperglycosylation of MAP6 is strongly associated with the pathogenesis of PD. These findings provide potentially valuable information for developing new therapeutic targets for the treatment of PD as well as reliably prognostic biomarkers.

A Qualitative Study on the Impact of First Steps-A Peer-led Educational Intervention for People Newly Diagnosed with Parkinson's Disease

Aim: The dual aim of this research was to consider the impact of providing the First Steps program on the stories of people with Parkinson's Disease (PD) and to investigate the psychosocial and emotional mechanisms which may explain this impact. Methods: A qualitative study using a subtle realist paradigm and hermeneutic phenomenological methodology was undertaken. A single semi-structured interview was used to consider the impact and experiences of people with PD who completed either the intervention (2-day peer-led behavior intervention using storytelling 6-8 weeks apart) or received telephone support calls as part of the active control group. Descriptive statistics and a narrative analysis were undertaken on the results. Results: Forty-two participants were invited to participate, forty of whom completed the interview. This included 18 from the intervention group and 22 from the active control group. The intervention group identified the value of the program as worth-while, demonstrating improved exercise behavior and coping mechanisms following the intervention. Three major stories (the affirmed, the validated and the transformed story) identified the impact of the intervention. Three internal mechanisms (perceived control, hope and action, and the individual's mind set) alongside three social mechanisms (social comparison, social control and the first opportunity to share with peers) appeared to explain this impact. Conclusion: This study provides exciting and novel evidence of the impact of a peer-led psycho-educational intervention for people newly diagnosed with PD. Further research is needed to consider the impact of stories-based approaches on participants and consider a critical evaluation of the mechanisms which may explain changes in stories and self-reported behaviour.