Sangarapillai Kishoree, Norman Benjamin M, Almeida Quincy J
Wilfrid Laurier University (Movement Disorders Research and Rehabilitation Centre), Waterloo, Ontario, Canada.
NeuroRehabilitation. 2020;46(4):589-593. doi: 10.3233/NRE-203025.
The cardinal motor symptoms of Parkinson's disease (PD) include postural instability, bradykinesia, tremor and rigidity. The overall Unified Parkinson's Disease Rating Scale (UPDRS-III) indicates, the gold-standard treatment for PD (dopaminergic-therapy) is very effective in improving these symptoms. However, recent research indicated that 2 of the 4 cardinal symptoms of PD (balance and tremor) remain unimproved by dopaminergic-therapy. This prompts the investigation of other alternative and adjunct treatments such as exercise rehabilitation. Unfortunately, like drug studies, exercise studies often focus on overall symptom improvement yet fail to monitor changes to specific symptoms. This may be problematic for individuals with different symptomatic phenotypes. If tremor/balance were the main concern, then adjunct therapies may be critically important when these symptoms may be dopa-resistant. Thus, it is important for all therapies to examine individual symptomatic-improvement. Interestingly, recent studies show PDSAFEx™ (a sensory integration therapy) to have a significantly improve motor symptoms in comparison to traditional exercise (14). Yet, the effects of PDSAFEx™ on individual PD symptoms is unknown.
To explore the effects of PDSAFEx™ on PD symptoms in adjunct to medications.
UPDRS-III scores of 229 cases were retrospectively examined and analysed in SPSS using Wilcoxon pairs singed-rank test to evaluate specific symptom-improvements.
PDSAFEx™ was confirmed to improve overall motor symptoms (p = 0.0001), but more importantly a significant improvement to tremor (p < 0.00001) and balance (p < 0.00001) were also identified.
These findings suggest that PDSAFEx™ is an important adjunct to medications, since it is able to address all four cardinal symptoms of PD.
帕金森病(PD)的主要运动症状包括姿势不稳、运动迟缓、震颤和僵硬。整体统一帕金森病评定量表(UPDRS-III)表明,PD的金标准治疗方法(多巴胺能疗法)在改善这些症状方面非常有效。然而,最近的研究表明,多巴胺能疗法对PD的4种主要症状中的2种(平衡和震颤)并无改善作用。这促使人们对其他替代和辅助治疗方法进行研究,如运动康复。不幸的是,与药物研究一样,运动研究通常侧重于整体症状的改善,却未能监测特定症状的变化。这对于具有不同症状表型的个体可能存在问题。如果震颤/平衡是主要关注点,那么当这些症状可能对多巴耐药时,辅助治疗可能至关重要。因此,所有疗法都检查个体症状改善情况非常重要。有趣的是,最近的研究表明,与传统运动相比,PDSAFEx™(一种感觉统合疗法)能显著改善运动症状(14)。然而,PDSAFEx™对个体PD症状的影响尚不清楚。
探讨PDSAFEx™作为药物辅助治疗对PD症状的影响。
回顾性检查并分析229例患者的UPDRS-III评分,在SPSS中使用Wilcoxon配对符号秩检验来评估特定症状的改善情况。
证实PDSAFEx™可改善整体运动症状(p = 0.0001),但更重要的是,还发现对震颤(p < 0.00001)和平衡(p < 0.00001)有显著改善。
这些发现表明,PDSAFEx™是一种重要的药物辅助治疗方法,因为它能够解决PD的所有四种主要症状。