Physical Therapy and Deep Brain Stimulation in Parkinson Disease: Safety, Feasibility, and Preliminary Efficacy.

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Lauren E Tueth, Kerri S Rawson, Linda R Van Dillen, Gammon M Earhart, Joel S Perlmutter, Ryan P Duncan
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Abstract

Background and purpose: Subthalamic nucleus deep brain stimulation (STN-DBS) effectively treats some of the motor manifestations of Parkinson disease (PD). However, previous work suggests STN-DBS may lead to worsening of balance and gait in some people with PD. Physical therapy (PT) is often used to improve balance and gait in PD, but its safety, feasibility, and efficacy have not been tested in people with STN-DBS. The purpose of this study was to test the safety, feasibility, and preliminary efficacy of PT for improving gait and balance in persons with PD and STN-DBS.

Methods: This randomized pilot study compared the effects of an 8-week PT intervention (n = 15) on balance and gait to a usual care control group (n = 14) among people with PD with STN-DBS. Individuals were evaluated in the on medication/on stimulation state as well as off medication/off stimulation state.

Results: PT was safe as there were no serious adverse events during treatment. PT was feasible as the average percentage of session attendance was 93%. PT significantly improved balance as measured by the Balance Evaluation Systems Test (BESTest) in the on medication/on stimulation state but did not significantly improve gait. No significant differences between groups were found in the off medication/off stimulation state.

Discussion and conclusions: PT was safe, feasible, and may improve balance for individuals with PD with STN-DBS. Further work is needed to understand how modifying the frequency and intensity of PT interventions may impact balance and gait in individuals with STN-DBS.

帕金森病的物理治疗和深部脑刺激:安全性、可行性和初步疗效。
背景与目的:丘脑底核深部脑刺激(STN-DBS)能有效治疗帕金森病(PD)的部分运动表现。然而,先前的研究表明,STN-DBS可能会导致一些PD患者的平衡和步态恶化。物理治疗(PT)常用于改善PD患者的平衡和步态,但其安全性、可行性和有效性尚未在STN-DBS患者中得到验证。本研究的目的是测试PT改善PD和STN-DBS患者步态和平衡的安全性、可行性和初步疗效。方法:这项随机先导研究比较了8周PT干预(n = 15)和常规护理对照组(n = 14)在PD合并STN-DBS患者中对平衡和步态的影响。个体在服药/刺激状态和停药/停刺激状态下被评估。结果:PT在治疗过程中无严重不良事件发生,安全性好。PT是可行的,因为会话的平均出勤率为93%。通过平衡评估系统测试(BESTest),在药物/刺激状态下,PT显着改善了平衡,但没有显着改善步态。断药/断刺激状态组间无显著差异。讨论和结论:PT是安全、可行的,可以改善伴有STN-DBS的PD患者的平衡能力。需要进一步的工作来了解改变PT干预的频率和强度如何影响STN-DBS患者的平衡和步态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Neurologic Physical Therapy
Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION
CiteScore
5.70
自引率
2.60%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.
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