A four-week, specific exercise routine at home can help improve stability and turning abilities, and reduce the severity of disease for those suffering from early-to mid-stage Parkinson’s an insignificant study suggests.
The Parkinson’s program is focused specifically on turning the parts of the body that are most engaged in turning. It could be a viable alternative rehabilitation plan for people who suffer from trunk stiffness, which can make turning difficult and increases the risk of falling, according to the research team.
This study “Benefits from a task-based movement programme on en bloc turn during Parkinson’s illness: a randomised controlled trial” is published in Physiotherapy Research International.
Trunk stiffness is a frequent sign of Parkinson’s disease. Instead of bending the body in a top-down manner which involves the head first moving followed by the shoulders, and finally the hips, patients prefer to move all the body parts together, also known as “en the bloc.”
This rigidity in movement could alter balance and turn, and increase the chance of falling, the team observed. While treatments for Parkinson’s disease such as levodopa therapy or deep brain stimulation seek to alleviate these issues but they are most effective in conjunction with exercise as well, they added.
The way that task-specific movements can aid in “en blocks” turn-taking in people with Parkinson’s disease, however, isn’t discussed.
Researchers at researchers at Mahidol University in Thailand evaluated the effects of a month-long, task-specific training program for turning and the clinical outcomes of disease in the small group of patients.
They recruited 22 early- to mid-stage Parkinson’s patients , matched in age and severity. Half were randomly assigned an exercise group, while the remaining half continued on regular medication as an uncontrolled group. The results of turning movements and clinical outcomes, as determined through measures such as measures such as the Unified Parkinson’s Disease Rating Scale or UPDRS and were evaluated prior to as well as after exercise.
Task-specific exercises were given in three weekly, physiotherapist-supervised sessions at a clinic for two weeks, then as two supervised and two at-home exercise sessions in the third week, followed by five at-home exercises for the fourth and final week.
The principal exercise plan consisted of 45 minutes of rotation 10 times at a time, and different areas of the bodythe shoulders, head and hips, for example. — in different positions such as standing, sitting and lying down. Its aim is to increase the flexibility and mobility of every part of the body.
The participants then took part for five minutes with throwing tasks to increase their balance. Then they walked for 10 minutes, they took turns in all directions while walking to improve the range of their body rotation. A 15-minute warm-up , followed by a cooling down period that included stretching and deep breathing were conducted prior to and after the exercise.
To assess turning movements (kinematics) and step motion, sensors were placed in the middle of the forehead, the middle chest, and feet. Participants did a half-circle while the team also recorded the time delays or latencies in the motion of each body section during their turn, as well as their speed as well as their steps.
Based on the study of the study, participants who participated in the exercise routines had lower time to move, or more rapid movements, across every body part such as the chest, head leading foot, the trailing foot, when compared to people in the controls. In general the average onset latency was significantly reduced, indicating the speed of movement’s onsetin the exercise group alone.
As the half-circle was rotated, the size of the step, the total number of steps, the duration of each step and speed of turning significantly improved in patients in the exercise group in comparison to the control group.
“This result can be due to the fact that the repeated practice of the desired motion [180-degree turns] and the task-specific training can improve motor learning by reducing difficulty of planning motor movements and reducing the dependence on feedback from sensory input,” the researchers said in their paper.
UPDRS scores revealed that those who exercised group were significantly less (improved) UPDRS motor, total and rigidity scores when compared to their scores prior to the program, suggesting a decrease in the severity of Parkinson’s disease in the participants.
The exercise program also improved balance, as determined through the function-based reach test and lessened anxiety about falling determined by the fall-related efficacy scale, which is a self-report test used to assess the fear of falling among an older population.
“The principal conclusion of this study is that a four-week home-based exercise programthat focused on TSM [task-specific movements], could help improve en bloc turn and clinical outcomes for patients with early-to mid-stage Parkinson’s disease”” researchers have written.
A study limitation could be that the study’s control group wasn’t receiving the same level of attention to the exercise group. As such the study “cannot be excluded as a cause for the differences between groups,” they said.
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