QUALE RIABILITAZIONE

NEL FUTURO

PER LA MALATTIA DI PARKINSON

? DANIELE VOLPE

Casa di Cura “Villa Margherita”

Vicenza

GVDR Padova

Evidence: Systematic Reviews

Rapidly emerging research literature on physio exercise s for Parkinson’s

39 trials

1827 patients

Mild-moderate

Hoehn & Yahr 1-3 Claire Tomlinson

2012

REM sleep disorder

Hyposmia

Depression

Autonomic dysfunction

Resting tremor

Rigidity

Bradykinesia/Akinesia

Postural instability

Freezing of gait & Falls

Dementia

Psychosis

Disease onset of PD

Premotor Phase Early Phase Advanced Phase

Mild cognitive impairment

MOTOR LEARNING

PROCESS

PHYSICAL THERAPY

Roma,

9-11 Ottobre 2013

Traditional rehabilitation focuses on

compensation: behavior is changed to

meet individual or environmental

constraints

Modern rehabilitation aims at

physiological repair of neural

damage and may be seen as a

learning process where old skills

have to be re-acquired and new ones

have to be learned on the basis of

practice, combining motor and

cognitive training

7

Connectedness of healthcare professionals

involved in the treatment of patients with

Parkinson's disease: a social networks study

Michel Wensing, Martijn van der Eijk2, Jan Koetsenruijter1, Bastiaan R

Bloem2, Marten Munneke1,2 and Marjan Faber1

2011

Efficacy of community-based physiotherapy

networks for patients with Parkinson's

disease: a cluster-randomised trial

Munneke M, Nijkrake MJ, Keus SH, Kwakkel G, Berendse HW, Roos RA,

Borm GF, Adang EM, Overeem S, Bloem BR; ParkinsonNet Trial Study

Group.

2010

Improving Community Healthcare for Patients with

Parkinson's Disease: The Dutch Model

S. H. J. Keus,1 L. B. Oude Nijhuis,2 M.J. Nijkrake,3 B. R. Bloem,2 and M. Munneke1,4

2012

2012

Keus SH, Nijkrake MJ, Borm GF, Kwakkel G, Roos RA, Berendse

HW, Adang EM, Overeem S, Bloem BR, Munneke M; ParkinsonNet

Trial Study Group.

2011

Nijkrake MJ, Keus SH, Overeem S, Oostendorp RA, Vlieland TP,

Mulleners W, Hoogerwaard EM, Bloem BR, Munneke M.

2010

Moving from physician-centered care

towards patient-centered care for

Parkinson's disease patients

van der Eijk M, Nijhuis FA, Faber MJ, Bloem BR

2011

Paziente

Caregiver

MODELLO DI RIABILITAZIONE NEL FUTURO NEL PARKINSON

Paziente

e

Caregiver

AMBULATORIO

NEUROLOGICO

RIABILITAZIONE

INTENDIVA

COD 56

RIABILITAZIONE

ESTENSIVA

TEIIRRITORIO

ASSOCIAZIONI

PARKINSON

INTERVENTO

DOMICILIARE

LIFESTYLE PROBLEM PROBABLY DUE TO

TRADITIONAL PHYSIOTHERAPY

REHABILITATIVE INTEFRVENTIONS THAT STIMULATE

EMOTIONS AND MOTIVATION

2014

NEUROTRASMITTERS AND PARKINSON’S DISEASE

Courtesy of Ricciardi L 2008

Music and Parkinson’s disease

Amigdala is the neural substrate of emotional processing and

it is also involved in music processing

First neuroanatomical evidence on the association between

the amigdala and music

2014

Evidence for Dancing with Parkinson’s

Study N Dance style Dosage Outcomes

Heiberger, L., C. Maurer,

et al. (2011). "Impact of a

weekly dance class on the

functional mobility and on

the quality of life of

individuals with Parkinson's

disease"

11 Modified version of

Mark Morris “Dance

for Parkinson’s

disease”

60 min/week

for 8 months

Rigidity scores

improved

No improvement in

balance and movement

efficiency

Batson, G. (2010).

"Feasibility of an Intensive

Trial of Modern Dance for

Adults with Parkinson

Disease."

11 Contemporary

dance 3 x 85min/week

for 3 weeks

Dynamic balance

improved

No improvement in

movement efficiency

Duncan, R. P. and G. M.

Earhart (2012).

"Randomized controlled trial

of community-based

dancing to modify disease

progression in Parkinson

disease."

62 Argentine tango

compared to control

(no intervention)

2 x 60

min/week

for 12 months

Walking velocity,

balance, and endurance

improved in tango group

only.

Hackney, M. E. and G. M.

Earhart (2009). "Short

duration, intensive tango

dancing for Parkinson

disease: an uncontrolled

pilot study."

12 Argentine tango 5 x 90

min/week for 2

weeks

Dynamic balance

improved

Movement efficiency and

walking endurance didn’t

improve

Courtesy Rebecca Twyerould

Evidence for Dancing (continued)

Study N Dance genre Dosage Outcomes

Hackney, M. E. and G. M.

Earhart (2010). "Effects of

dance on gait and balance

in Parkinson's disease: a

comparison of partnered

and non partnered dance

movement."

39 Argentine tango:

Partnered

compared to non

partnered dance

2 x

60min/week

for 10 weeks

Dynamic balance, gait

velocity and cadence

improved equally in

both groups

Hackney, M. E., S.

Kantorovich, et al.

(2007). "Effects of ttango

on functional mobility in

Parkinson's disease: a

preliminary study."

19 Argentine tango

and a

Traditional exercise

comparison group

2 x 60

min/week for

13 weeks

Dynamic balance

improved in tango

group only. Both groups

improved on UPDRS

score.

Marchant, D., J. L.

Sylvester, et al. (2010).

"Effects of a short

duration, high dose

contact improvisation

dance workshop on

Parkinson disease: a pilot

study."

11 Contact

improvisation 5 x 90

min/week

For 2 weeks

Dynamic balance, step

length and score on

UPDRS III improved.

No improvement in

movement efficiency

and endurance

Volpe D et al. (2013). ”

A comparison if Irish set

dancing and exercises in

Parkinson’s disease: A

phase II feasibility study:"

24 Irish set dancing

compared to

control

(conventional

physiotherapy)

1 x 120

min/week for

24 weeks

Dynamic balance,

mobility, FOG, walking

endurance and quality

of life improved for both

dance groups more in

Irish group.

Courtesy Rebecca Twyerould

Irish Dancing for Parkinson’s Disease

Volpe et al. 2013

MOVE 4 PARKINSON

DUBLIN August 2014

GRAZIE PER LA VOSTRA ATTENZIONE