Effectiveness of Intensive Rehabilitation in Advanced Stages of Parkinson's Disease.
- Conditions
- Parkinson Disease
- Interventions
- Behavioral: MIRT
- Registration Number
- NCT02731170
- Lead Sponsor
- Ospedale Generale Di Zona Moriggia-Pelascini
- Brief Summary
this study is aimed to evaluate the effectiveness of an Multidisciplinary Intensive Rehabilitation Treatment in Advanced Stages of Parkinson's Disease.
In the last years, several evidences highlighted the need of a multidisciplinary and intensive approach to achieve good results in early stage of disease.
Hypothesis is that this approach is effectiveness also in moderate and advanced stages of disease
- Detailed Description
Parkinson's Disease (PD) is a progressive neurodegenerative disease clinically characterized by motor and non-motor symptoms.
Dopamine replacement therapy (DRT) is the standard treatment for the motor symptom of PD, however DRT does not reduce axial PD symptoms such as freezing of gait, postural instability and balance disturbances. Further, long-term DRT could negatively impact on cognitive and motivational functions and leads to different motor and behavioural side effects. Therefore, the pharmacological approach becomes less effective in the moderate and advanced stages of disease.
The investigators testing the hypothesis that this approach is effectiveness also in moderate and advanced stages of disease In according with Hoehn and Yahr scale (H\&Y) we identified 353 parkinsonian patients on stage 3, 79 subjects on stage 4 and 7 subjects on stage 5.
Clinical scores were assessed at baseline and after 4 weeks by neurologists and physiotherapists expert in movement disorders. All evaluations were performed in the morning, one hour after taking drugs. The assessment included: Unified Parkinson's Disease Rating Scale (UPDRS), for clinical evaluation, Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Six Minutes Walking Test (6MWT), Freezing of Gait Questionnaire (FOGQ) and Abnormal Involuntary Movements Scale (AIMS) for motor symptoms evaluation and, finally, Parkinson's Disease Disability Scale (PDDS), for evaluation of the functional impact of the disease. Since in the advanced stages of PD one of the most troublesome complication includes cognitive disorders, a Neuropsychologist performed a cognitive assessment at the admission. The neuropsychological profile was explored using the Mini Mental State Examination (MMSE), a tool for screening of cognitive impairment, and the Frontal Assessment Battery (FAB) for the evaluation of frontal lobe dysfunctions.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 439
clinica diagnosis of Parkinson Disease
comorbidity with other neurological conditions
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description rehabilitation treatment (MIRT) MIRT MIRT consists of a 4-week physical therapy. daily sessions are subdivided in: motor treatment (2 hour), occupational therapy (1 hour) and speech Therapy (1 hour)
- Primary Outcome Measures
Name Time Method Unified Parkinson Disease Rating Scale 4 weeks six-minutes walking test 4 weeks Time up and go Test 4 weeks Berg Balance Scale 4 weeks Parkinson's Disease Disability Scale 4 weeks Freezing of Gait Questionnaire 4 weeks
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Department of Parkinson's Disease and Brain Injury Rehabilitation, of the 'Moriggia-Pelascini' Hospital
🇮🇹Gravedona ed Uniti, Como, Italy