Parkinson Disease Clinical Trial
Official title:
Effectiveness of Intensive Rehabilitation in Advanced Stages of Parkinson's Disease.
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
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.
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