Axial Mobility Exercise Program

Quote:

Originally Posted by kinesys

Hello,

I would like to find the exercises program for PD patients, call Axial Mobility Exercise Program, from Duke's University.

Cheers

Is PD Parkinson's Disease? Please don't use random abbreviations in such short and unexplained posts.

There is some evidence that exercise programs are successful in certain tasks for the Parkinson's population. An interesting one whose abstract is shown below suggests that we might consider the use of outreach home programs to maximise the carry over to the home environment

THE EFFECT OF A HOME PHYSIOTHERAPY PROGRAM FOR PERSONS WITH PARKINSON'S DISEASE
Alice Nieuwboer, Willy De Weerdt, René Dom, Mieke Truyen, Luc Janssens, Yvo Kamsma

Abstract:
The purpose of this study was to evaluate the effect of a home physiotherapy program for persons with Parkinson's disease. Thirty-three patients took part in the study using a within-subject controlled design. Functional activities including walking and carrying out transfers were measured at home and in the hospital before and after a 6-week baseline period, after 6 weeks home physiotherapy and after 3 months follow-up. Spatiotemporal and plantar force variables of gait were determined with video and pododynography. Treatment provided by community physiotherapists consisted of teaching cueing and conscious movement control 3 times a week. The study revealed that patients had significantly higher scores on a functional activity scale after treatment in the home setting and to a lesser degree in hospital, a result, which was partly sustained at follow-up. However, duration of the transfer movements, spatiotemporal and plantar force variables were not significantly improved except for stride length. The results support application and development of the treatment concept and highlight that physiotherapy aimed at improving function in Parkinson's disease is best provided in the home situation.

Other studies have shown that a 10 week program can lead to a change in functional performance:

J Am Geriatr Soc. 1998 Oct;46(10):1207-16. Exercise to improve spinal flexibility and function for people with Parkinson's disease: a randomized, controlled trial. Schenkman M, Cutson TM, Kuchibhatla M, Chandler J, Pieper CF, Ray L, Laub KC.

Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina 27710, USA.

OBJECTIVES: The effectiveness of an exercise intervention for people in early and midstage Parkinson's disease (stages 2 and 3 of Hoehn and Yahr) in improving spinal flexibility and physical performance in a sample of community-dwelling older people is described.

DESIGN AND SETTING: Fifty-one men and women, aged 55-84 years, identified through advertisement, local support groups, and local neurologists were enrolled into a randomized, controlled trial. Subjects were assigned randomly to an intervention or a usual care arm (i.e., no specific exercise). Of the original 51 participants, 46 completed the randomized, controlled trial. Participants in the exercise arm (n = 23) received individual instruction three times per week for 10 weeks. Participants in the usual care arm (n = 23) were "wait listed" for intervention.

MEASUREMENTS: Changes over 10 weeks in spinal flexibility (i.e., functional axial rotation) and physical performance (i.e., functional reach, timed supine to stand) were the primary outcome measures. RESULTS: MANOVA conducted for the three primary outcome variables demonstrated significant differences (P < or = .05) between the two groups. Further analysis using ANOVA demonstrated significant differences between groups in functional axial rotation and functional reach for the intervention compared with the control group. There was no significant difference in supine to sit time.

CONCLUSION: Study results demonstrate that improvements in axial mobility and physical performance can be achieved with a 10-week exercise program for people in the early and midstages of PD.

Another trial of interest:

J Neurol. 2004 May;251(5):595-8. Physical therapy in Parkinson's disease: an open long-term rehabilitation trial.
Pellecchia MT, Grasso A, Biancardi LG, Squillante M, Bonavita V, Barone P.

Department of Neurological Sciences, University "Federico II", Ed. 17, Via Pansini 5, 80131, Naples, Italy. [email protected]

The aim of this study was to evaluate the effects of prolonged physical therapy on disability in patients with Parkinson's disease. The study was designed as an open long-term trial over 20 weeks. Twenty slightly to moderately affected parkinsonian patients were included (Hoehn & Yahr stages: 1.5-3). A comprehensive rehabilitation program was applied three times a week in all patients. Pharmacological treatment was kept stable. Evaluations were performed at baseline, at the end of treatment and after 3 months. Following physical rehabilitation, there was a significant improvement in UPDRS (ADL and motor sections) scores, Self-assessment Parkinson's disease Disability Scale, Ten-Meter Walk test and Zung scale for depression. At 3-month follow-up clinical improvements were largely maintained. A sustained improvement of motor skills in PD patients can be achieved with a long-term comprehensive rehabilitation program.

And this one

Funct Neurol. 2003 Jan-Mar;18(1):11-6. The influence of rotational exercises on freezing in Parkinson's disease.
Van Vaerenbergh J, Vranken R, Baro F.

Department of Neurorehabilitation, Faculty of Physical Education and Physiotherapy, Catholic University of Leuven, Leuven (Heverlee), Belgium. [email protected]

The advanced stage of Parkinson's disease (PD) is characterised by complex movement disturbances including freezing. Because freezing is resistant to drug therapy, there has recently been renewed interest in non-pharmacological treatment programmes. In this study the effect of rotational stimulation on freezing was investigated. Eight patients with idiopathic PD and freezing participated in the study. Switching from foot-lifting to 'stand up and walk' provoked freezing in all the tested patients. The mean OPMSP (Onset of Premotor Silence Period) in the EMG of the m. tibialis anterior during the 'foot-lifting' sessions preceding freezing was 124 msec. This value, together with a striking repetition of the EMG discharges in the m. tibialis anterior following the request to 'stand up and walk', was related to the inducement of freezing, as a decrease of 42 msec in the OPMSP (t = 2.61; p < or = 0.01) after rotational stimulation abolished freezing and the concomitant EMG disturbances. Rotational stimulation also reduced freezing frequency during daily life. Freezing periods fell to below 50% of the pre-treatment level the day following rotation (t = 5.58; p < or = 0.001). The OPMSP predicted the short and long-term effects of rotational exercises (R = 0.74; p < or = 0.03). The rather long-lasting effect of the stimulation suggests a possible modulation of neurochemical transmission. Further studies are required to shed more light on the point of action and to elucidate which neurotransmitter might be involved.