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Putortì A, Corrado M, Avenali M, Martinelli D, Allena M, Cristina S, Grillo V, Martinis L, Tamburin S, Serrao M, Pisani A, Tassorelli C, De Icco R. The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait. Front Neurol 2021; 12:723468. [PMID: 34557151 PMCID: PMC8453149 DOI: 10.3389/fneur.2021.723468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The sequence effect (SE), defined as a reduction in amplitude of repetitive movements, is a common clinical feature of Parkinson's disease (PD) and is supposed to be a major contributor to freezing of gait (FOG). During walking, SE manifests as a step-by-step reduction in step length when approaching a turning point or gait destination, resulting in the so-called destination sequence effect (dSE). Previous studies explored the therapeutic effects of several strategies on SE, but none of them evaluated the role of an intensive rehabilitative program. Objectives: Here we aim to study the effects of a 4-week rehabilitative program on dSE in patients with PD with and without FOG. Methods: Forty-three patients (30 males, 70.6 ± 7.5 years old) with idiopathic PD were enrolled. The subjects were divided into two groups: patients with (PD + FOG, n = 23) and without FOG (PD - FOG, n = 20). All patients underwent a standardized 4-week intensive rehabilitation in-hospital program. At hospital admission (T0) and discharge (T1), all subjects were evaluated with an inertial gait analysis for dSE recording. Results: At T0, the dSE was more negative in the PD + FOG group (-0.80 ± 0.6) when compared to the PD - FOG group (-0.39 ± 0.3) (p = 0.007), even when controlling for several clinical and demographic features. At T1, the dSE was reduced in the overall study population (p = 0.001), with a more pronounced improvement in the PD + FOG group (T0: -0.80 ± 0.6; T1: -0.23 ± 0.4) when compared to the PD - FOG group (T0: -0.39 ± 0.3; T1: -0.22 ± 0.5) (p = 0.012). At T1, we described in the overall study population an improvement in speed, cadence, stride duration, and stride length (p = 0.001 for all variables). Conclusions: dSE is a core feature of PD gait dysfunction, specifically in patients with FOG. A 4-week intensive rehabilitative program improved dSE in PD patients, exerting a more notable beneficial effect in the PD + FOG group.
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Affiliation(s)
- Alessia Putortì
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Michele Corrado
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Micol Avenali
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Daniele Martinelli
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marta Allena
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvano Cristina
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Valentina Grillo
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Luca Martinis
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
- Movement Analysis Laboratory, Policlinico Italia, Rome, Italy
| | - Antonio Pisani
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Roberto De Icco
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Mikołajewska E. Bobath and traditional approaches in post-stroke gait rehabilitation in adults. BIOMEDICAL HUMAN KINETICS 2017. [DOI: 10.1515/bhk-2017-0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Study aim: The aim of this study was to compare the outcomes of a study of post-stroke gait reeducation using the Bobath neuro‑developmental treatment (NDT-Bobath) method and the traditional approach.
Material and methods: The study included 30 adult patients after ischemic stroke, aged 32-82. Patients were randomly assigned to one of the treatment groups: the study group (treated with the NDT-Bobath method combined with the traditional approach, ten sessions), and a reference group (treated with the traditional method only, ten sessions). The measurements (spatio-temporal gait parameters based on 10 m walking test: gait velocity, normalized gait velocity, cadence, normalized cadence, stride length, and normalized stride length) were administered twice: on admission (before the therapy) and after the last therapy session.
Results: Statistically significant and favorable changes in the gait velocity, cadence and stride length regarding their normalized values were observed. Moderate and high correlations among changes of assessed spatio-temporal gait parameters were observed in both groups.
Conclusions: The NDT-Bobath method may be regarded as a more effective form of gait post-stroke rehabilitation in young adults compared to traditional rehabilitation.
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Affiliation(s)
- Emilia Mikołajewska
- Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń , Poland
- Neurocognitive Laboratory, Centre for Modern Interdysciplinary Technologies, Nicolaus Copernicus University in Toruń , Poland
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