Introduction.- Parkinson's disease (PD) is a highly prevalent disorder past 65 years of age, causing major motor deficiencies. Physical treatment is underused compared to chemical and surgical therapies. The present study compared immediate and late symptomatic changes after two different rehabilitation programs. Methods.- Fifty patients with mild to moderate PD (Hoehn and Yahr 2 to 3) are participating in 3 weekly 1-hour home rehabilitation sessions for 8 weeks. Patients have been randomised into 2 groups regarding the type of rehabilitation. Group 1: “Asymmetric motor training” program, designed to enhance only the agonist activity of the “body openers”, i.e. extension/ supination/abduction/external rotation - which is more reduced than their antagonist activity of flexion/pronation/adduction/internal rotation in PD - aiming at rebalancing forces around joints; Group 2: “Broad” program, with standard techniques of passive and active joint mobilisations, balance and gait training, relaxation techniques and respiratory work. Assessment is performed in the clinically defined OFF status (over 12 hours after the last levodopa intake). This includes UPDRS-III, GMT score (standing up from a supine position on the floor), rapid alternating movements, handwriting and spiralography (coefficient of symmetry), quality of life (PDQ-39), depression (GDS-15), video recording of 8 activities of daily living and biomechanical evaluations (gait parameters, extensor motor strength, spine posture and balance). UPDRS-III is also being assessed 1 hour after levodopa intake. These evaluations are performed before the rehabilitation period, at the end of the 8 weeks of rehabilitation and 3 months later. Conclusions.- If the asymmetric motor training proves superior to the standard rehabilitation program, this will bring about controlled evidence for the future prescription of rehabilitation techniques in PD. However, whichever program proves more efficient, it is hypothesized that the present study will provide quantifications of symptomatic improvement, the magnitude of which may help renew interest for rehabilitation in PD, particularly in the early stages.
Joudoux, S., Santiago, T., Hutin, E., Bayle, N., & Gracies, J. M. (2011). Randomised controlled single-blind trial comparing two rehabilitation programs in Parkinson’s disease at a moderate stage: Methodology. Annals of Physical and Rehabilitation Medicine, 54, e104. https://doi.org/10.1016/j.rehab.2011.07.073