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Romanato M, Guiotto A, Spolaor F, Bakdounes L, Baldassarre G, Cucca A, Peppe A, Volpe D, Sawacha Z. Changes of biomechanics induced by Equistasi® in Parkinson's disease: coupling between balance and lower limb joints kinematics. Med Biol Eng Comput 2021; 59:1403-1415. [PMID: 34085136 DOI: 10.1007/s11517-021-02373-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/28/2021] [Indexed: 12/01/2022]
Abstract
Axial disorders, including postural deformities, postural instability, and gait disturbances, are among the most disabling symptoms of Parkinson's disease (PD). Equistasi®, a wearable proprioceptive stabilizer device, has been proposed as neurological rehabilitative device for this set of symptoms. To investigate the effects of the device on gait and balance, 24 participants affected by PD were enrolled in this crossover double-dummy, randomized, controlled study. Subjects were assessed four times before and after 8 weeks treatment with either active or placebo device; one-month wash-out was taken between treatments, in a 20-week timeframe. Gait analysis and instrumented Romberg test were performed with the aid of a sterofotogrammetric system and two force plates. Joint kinematics, spatiotemporal parameters of gait and center of pressure parameters were extracted. Paired T-test (p < 0.05) was adopted after evidence of normality to compare the variables across different acquisition sessions; Wilcoxon was adopted for non-normal distributions. Before and after the treatment with the active device, statistically significant improvements were observed in trunk flexion extension and in the ankle dorsi-plantarflexion. Regarding balance assessment, significant improvements were reported at the frequencies corresponding to vestibular system. These findings may open new possibilities on PD's rehabilitative interventions. Research question, tailored design of the study, experimental acquisition overview, main findings, and conclusions.
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Affiliation(s)
- Marco Romanato
- Department of Information Engineering, University of Padua, Via Gradenigo 6B, 35131, Padua, Italy
| | - Annamaria Guiotto
- Department of Information Engineering, University of Padua, Via Gradenigo 6B, 35131, Padua, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padua, Via Gradenigo 6B, 35131, Padua, Italy
| | - Leila Bakdounes
- Fresco Parkinson Center, Villa Margherita, S. Stefano, Vicenza, Italy
| | | | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano, Vicenza, Italy.,The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY, USA
| | - Antonella Peppe
- Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano, Vicenza, Italy
| | - Zimi Sawacha
- Department of Information Engineering, University of Padua, Via Gradenigo 6B, 35131, Padua, Italy. .,Department of Medicine, University of Padua, Padua, Italy.
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Ferrazzoli D, Ortelli P, Cucca A, Bakdounes L, Canesi M, Volpe D. Motor-cognitive approach and aerobic training: a synergism for rehabilitative intervention in Parkinson's disease. Neurodegener Dis Manag 2020; 10:41-55. [PMID: 32039653 DOI: 10.2217/nmt-2019-0025] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) results in a complex deterioration of motor behavior. Effective pharmacological or surgical treatments addressing the whole spectrum of both motor and cognitive symptoms are lacking. The cumulative functional impairment may have devastating socio-economic consequences on both patients and caregivers. Comprehensive models of care based on multidisciplinary approaches may succeed in better addressing the overall complexity of PD. Neurorehabilitation is a highly promising non-pharmacological intervention for managing PD. The scientific rationale beyond rehabilitation and its practical applicability remain to be established. In the present perspective, we aim to discuss the current evidence supporting integrated motor-cognitive and aerobic rehabilitation approaches for patients with PD while suggesting a practical framework to optimize this intervention in the next future.
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Affiliation(s)
- Davide Ferrazzoli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Paola Ortelli
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy.,The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY 10017, USA
| | - Leila Bakdounes
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
| | - Margherita Canesi
- Fresco Parkinson Center, Department of Parkinson's disease, Movement Disorders & Brain Injury Rehabilitation, 'Moriggia-Pelascini' Hospital - Gravedona ed Uniti, Como, 22015, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, 36057, Italy
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Galozzi P, Maghini I, Bakdounes L, Ferlito E, Lazzari V, Ermani M, Chia M, Gatti D, Masiero S, Punzi L. Prevalence of low back pain and its effect on health-related quality of life in 409 scholar adolescents from the Veneto region. Reumatismo 2019; 71:132-140. [DOI: 10.4081/reumatismo.2019.1229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/23/2019] [Indexed: 11/23/2022] Open
Abstract
Low back pain (LBP) is a common condition with profound effects on well-being. We aimed to define the prevalence and the characteristics of LBP and to investigate its impact on the quality of life (QoL) of 409 students (265 females and 144 males), all high-school adolescents from the Veneto region. LBP was measured with a structured, self-report questionnaire, while the SF-36 questionnaire was used to measure physical and mental QoL. 253 students (61.3%) reported one or more episodes of LBP, with female predominance. Adolescents with LBP treated with drugs and rehabilitation cares have significantly poor belief in pain resolution (p=0.005), but more belief in a prevention program (p=0.006) than the others. After adjustment for sex, a significant association between the SF-36 dimension of vitality and the presence of LBP in males was observed. All SF-36 domains except mental health were significantly higher in females with LBP. Our study confirmed that LBP is frequent in Italian scholar adolescents and has an impact on QoL. Strategies for reducing the effects of LBP on QoL should be an important purpose for clinicians and health policy makers.
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Peppe A, Paravati S, Baldassarre MG, Bakdounes L, Spolaor F, Guiotto A, Pavan D, Sawacha Z, Bottino S, Clerici D, Cau N, Mauro A, Albani G, Avenali M, Sandrini G, Tassorelli C, Volpe D. Proprioceptive Focal Stimulation (Equistasi®) May Improve the Quality of Gait in Middle-Moderate Parkinson's Disease Patients. Double-Blind, Double-Dummy, Randomized, Crossover, Italian Multicentric Study. Front Neurol 2019; 10:998. [PMID: 31620071 PMCID: PMC6760030 DOI: 10.3389/fneur.2019.00998] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/02/2019] [Indexed: 01/17/2023] Open
Abstract
Objective: The object of the study was to evaluate the efficacy of Proprioceptive Focal Stimulation on Gait in middle—advanced Parkinson (PD) patients by a crossover, randomized, double Blind double dummy study using Equistasi®, a nano-technological device of the dimension of a plaster which generates High Frequency Vibration (FV). Background: The efficacy of Gait Analysis (GA) on evaluating gait modification on Parkinson's disease (PD) Patients is already well-known. Therefore, GA was recorded in a group of PD patients using Equistasi® device and its placebo. Methods: Forty PD patients on optimal therapy were enrolled in the study. Patients were randomly assigned to receive active or sham stimulation for 8 weeks and, following a wash-out period, switched to an additional 8-week period with the reverse intervention. GA was performed at baseline and at the end of both 8-weeks treatment periods Clinical state was monitored by MDUPDRS part III. Results: Active stimulation induced a significant improvement in Mean Velocity (Velocity), Stride Length (SL), Stance (STA), and Double Support (DST) percentage, both in left and right stride. The ANOVA analysis using H&Y stage as a factor, showed that DST and MDUPDRS III scores improved significantly more in the more severely affected subjects. Conclusions: The findings obtained in this randomized controlled study show the efficacy of mechanical focal vibration, as stimulation of the proprioceptive system, in PD and encourage further investigation. The effect of the device on more severe patients may open a new possibility to identify the most appropriate candidate for the management of gait disturbances and postural instability with FV delivered with Equistasi®.
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Affiliation(s)
| | | | - Maria Giulia Baldassarre
- Parkinson Excellence Center of the Fresco Institute for Italy, Villa Margherita Clinic of Vicenza, Vicenza, Italy
| | - Leila Bakdounes
- Parkinson Excellence Center of the Fresco Institute for Italy, Villa Margherita Clinic of Vicenza, Vicenza, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Padua, Italy
| | - Annamaria Guiotto
- Department of Information Engineering, University of Padova, Padua, Italy
| | - Davide Pavan
- Department of Information Engineering, University of Padova, Padua, Italy
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padua, Italy
| | | | - Daniela Clerici
- Department of Neurology, Italian Auxological Institute, IRCCS, Verbania, Italy
| | - Nicola Cau
- Department of Neurology, Italian Auxological Institute, IRCCS, Verbania, Italy.,Politecnico of Milano, Milan, Italy
| | - Alessandro Mauro
- Department of Neurology, Italian Auxological Institute, IRCCS, Verbania, Italy.,University of Torino, Turin, Italy
| | - Giovanni Albani
- Department of Neurology, Italian Auxological Institute, IRCCS, Verbania, Italy
| | - Micol Avenali
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Department of Neurology and Neurorehabilitation, Mondino Foundation, Pavia, Italy
| | - Giorgio Sandrini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Department of Neurology and Neurorehabilitation, Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Department of Neurology and Neurorehabilitation, Mondino Foundation, Pavia, Italy
| | - Daniele Volpe
- Parkinson Excellence Center of the Fresco Institute for Italy, Villa Margherita Clinic of Vicenza, Vicenza, Italy
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Masiero S, Maghini I, Mantovani ME, Bakdounes L, Koutsikos K, Del Felice A, Sale P. Is the aquatic thermal environment a suitable place for providing rehabilitative treatment for person with Parkinson's disease? A retrospective study. Int J Biometeorol 2019; 63:13-18. [PMID: 30397861 DOI: 10.1007/s00484-018-1632-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/06/2018] [Accepted: 10/09/2018] [Indexed: 05/24/2023]
Abstract
Many authors showed that aquatic physiotherapy could improve quality of life and reduce postural instability and risk of falling in elderly subjects. The aim of this research was to explore if the thermal aquatic environment is a suitable place for rehabilitative training in person with Parkinson disease (PwP) with results comparable to the standard physiotherapy. A retrospective study was conducted on a database of 14 persons with Parkinson who were admitted to a thermal aquatic rehabilitation to undergo treatments made to improve gait and balance impairments. The rehabilitation training consisted of 45-min sessions conducted twice a week, on non-consecutive days, over 4 weeks of functional re-education and kinesitherapy in the thermal pool. Educational and prevention instructions were also given to the patients during each session. Additionally, nutrition (diet), health education, and cognitive behavioral advice were given to our patients by therapists. The clinical characteristics of the sample were age 66 ± 9, disease duration 7 ± 5, and Hoehn and Yahr 1.5 ± 0.5. The statistical analysis showed a statistically significant improvement for the UPDRS p = 0.0005, for The Berg Balance Scale p = 0.0078, for the PDQ8 p = 0.0039, Tinetti p = 0.0068, and for Mini BESTest p = 0.0002. Our data suggest that this intervention could become a useful strategy in the rehabilitation program of PwP. The simplicity of treatment and the lack of side effects endorse the use of thermal aquatic environment for the gait and balance recovery in PwP.
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Affiliation(s)
- Stefano Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Irene Maghini
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Maria Eleonora Mantovani
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Leila Bakdounes
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Kostas Koutsikos
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Alessandra Del Felice
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Patrizio Sale
- Rehabilitation Department, Sant'Isidoro Hospital, Federazione Europea Ricerca Biomedica (FERB) Onlus, Trescore Balneario, BG, Italy.
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Volpe D, Pelosin E, Bakdounes L, Masiero S, Bertagnoni G, Sorbera C, Giantin MG. Effects of a sensory-motor orthotic on postural instability rehabilitation in Parkinson's disease: a pilot study. J Clin Mov Disord 2017; 4:11. [PMID: 28694983 PMCID: PMC5498915 DOI: 10.1186/s40734-017-0058-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 05/11/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Proprioceptive deficits have been largely documented in PD patients, thus external sensory signals (peripheral sensory feedback) are often used to compensate the abnormalities of proprioceptive integration. This pilot study aims to evaluate the feasibility and the effectiveness of a rehabilitation-training program, combined with the use of a sensory-motor orthotic in improving balance in a small sample of PD patients. METHODS Twenty PD patients were randomly allocated into two groups: (i) the Experimental group, where participants were asked to wear a sensory-motor orthotic during the balance training program and (ii) the Control group, where subjects performed an identical training program without wearing any kind of orthotics. In all, the training program lasted 10 sessions (5 days a week for 2 weeks) and the clinical and instrumental assessments were performed at baseline, immediately after the end of the training and 4 weeks after the rehabilitative program was stopped. RESULTS All clinical outcome measures tested improved significantly at post and follow-up evaluations in both groups. Interestingly, at the end of the training, only the experimental group obtained a significant improvement in the functional reaching test (sway area - eyes closed) measured by means of stabilometric platform and this result was maintained in the follow-up evaluation. CONCLUSIONS Our preliminary results suggested that the use of a sensory-motor orthotic, in combination with a tailored balance training, is feasible and it seems to positively impact on balance performance in Parkinson's disease. TRIAL REGISTRATION EudraCT N. 003020-36 - 2013.
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Affiliation(s)
- Daniele Volpe
- Department of Physical Medicine and Rehabilitation, Neurorehabilitation Unit "Villa Margherita,", Via Costacolonna n.6 Arcugnano, Vicenza, Italy
| | - Elisa Pelosin
- Department of Neuroscience, University of Genoa, Genoa, Italy
| | - Leila Bakdounes
- Department of Physical Medicine and Rehabilitation, Neurorehabilitation Unit "Villa Margherita,", Via Costacolonna n.6 Arcugnano, Vicenza, Italy
| | - Stefano Masiero
- School of Physical Medicine and Rehabilitation, University of Padua, Padua, Italy
| | | | - Chiara Sorbera
- Department of Physical Medicine and Rehabilitation, Neurorehabilitation Unit "Villa Margherita,", Via Costacolonna n.6 Arcugnano, Vicenza, Italy
| | - Maria Giulia Giantin
- Department of Physical Medicine and Rehabilitation, Neurorehabilitation Unit "Villa Margherita,", Via Costacolonna n.6 Arcugnano, Vicenza, Italy
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Bakdounes L, Galozzi P, Maghini I, Oliviero F, Caputo E, Chia M, Ermani M, Masiero S, Punzi L. SAT0518 Low Back Pain Prevalence in Italian Adolescents and Its Association with Quality of Life. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Armanini D, Bordin L, Donà G, Sabbadin C, Bakdounes L, Ragazzi E, Giorgino FL, Fiore C. Polycystic ovary syndrome: Implications of measurement of plasma aldosterone, renin activity and progesterone. Steroids 2012; 77:655-8. [PMID: 22387621 DOI: 10.1016/j.steroids.2012.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 01/31/2012] [Accepted: 02/14/2012] [Indexed: 11/24/2022]
Abstract
A positive correlation between aldosterone, inflammatory parameters, blood pressure and metabolic abnormalities in polycystic ovary syndrome (PCOS) has been reported in the early estrogenic phase. The aim of the study was to measure plasma aldosterone, plasma renin activity (PRA) and progesterone on the 21st day of the cycle, in women with PCOS and to consider the interrelationships between these hormones. Sixty-six consecutive normal BMI women with PCOS (median age 24 years, range 21-28 years) and 53 age- and body mass index-matched healthy controls were enrolled in the study. Aldosterone, aldosterone/PRA ratio (ARR) and Homeostasis Model Assessment (HOMA) index were significantly higher (p<0.0001) in PCOS women than controls. Positive correlations were found in PCOS but not in controls between (i) progesterone and aldosterone, (ii) aldosterone and PRA, (iii) PRA and progesterone. Mean blood pressures were within the normal range but significantly higher in PCOS than controls. The increase of plasma aldosterone, ARR and blood pressure in PCOS compared with controls is consistent with an increased mineralocorticoid effector mechanism in PCOS; prolonged therapy with spironolactone could counteract both the hyperandrogenism and reduce future cardiovascular risk.
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Affiliation(s)
- Decio Armanini
- Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Italy.
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