Fundarò Cira, Cavalieri Carlo, Pinna Gian Domenico, Giardini Anna, Mancini Francesca, Casale Roberto
Neurophysiopathology Unit, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy.
Neuromotory Rehabilitation Unit 1, Istituti Clinici Scientifici Maugeri, IRCSS, Montescano, Italy.
Front Neurol. 2020 Feb 14;11:40. doi: 10.3389/fneur.2020.00040. eCollection 2020.
In Parkinson's disease, reaching movements are conditioned by motor planning and execution deficiency. Recently, rehabilitation, aided by high technological devices, was employed for Parkinson's disease. We aimed to (1) investigate the changes in the upper limb motor performances in a sample of a patient with Parkinson's disease after a weightless training, with a passive exoskeleton, in an augmented-feedback environment; (2) highlight differences by motor parameters (performance, speed, and movement accuracy) and by type of movement (simple or complex); and (3) evaluate movement improvements by UPDRS II-III. Observational pilot study. Twenty right-handed patients with Parkinson's disease, Hohen and Yahr 2, Mini Mental State Examination ≥24 were evaluated. All patients underwent 5 day/week sessions for 4 weeks, 30 min for each arm; the training was performed with 12 exercises (single and multi-joints, horizontal and vertical movements). All the patients were assessed by UPDRS II-III and the evaluation tests provided by the device's software: a simple movement, the vertical capture, and a complex movement, the horizontal capture. For each test, we analyzed reached target percentage, movement execution time, and accuracy. After training, a significant improvement of accuracy and speed for simple movement on the dominant arm, of reached targets and speed for complex movement on both sides were shown. UPDRS II and III improved significantly after training. In our study, a motor training aided by a high technological device improves motor parameters and highlights differences between the type of movement (simple or complex) and movement parameters (speed and accuracy) in a sample of patients with Parkinson's disease.
在帕金森病中,伸手动作受运动计划和执行缺陷的制约。最近,借助高科技设备的康复治疗被应用于帕金森病。我们旨在:(1)研究帕金森病患者样本在失重训练后,在增强反馈环境中使用被动外骨骼时上肢运动表现的变化;(2)通过运动参数(表现、速度和运动准确性)以及运动类型(简单或复杂)突出差异;(3)通过统一帕金森病评定量表(UPDRS)II - III评估运动改善情况。观察性试点研究。对20名右利手帕金森病患者进行评估,其霍恩和亚尔分级为2级,简易精神状态检查表得分≥24分。所有患者每周进行5次训练,共4周,每只手臂每次训练30分钟;训练通过12项练习进行(单关节和多关节、水平和垂直运动)。所有患者均通过UPDRS II - III以及设备软件提供的评估测试进行评估:一个简单动作,垂直抓取,以及一个复杂动作,水平抓取。对于每项测试,我们分析了到达目标的百分比、运动执行时间和准确性。训练后,优势手臂简单动作的准确性和速度、双侧复杂动作的到达目标情况和速度均有显著改善。训练后UPDRS II和III有显著改善。在我们的研究中,高科技设备辅助的运动训练可改善运动参数,并突出帕金森病患者样本中运动类型(简单或复杂)和运动参数(速度和准确性)之间的差异。