Quick Links
Archives
How
to
cite
this
Article:
Sarala
Khangare,
Maneesha
Deshpande
.
ASSESSMENT
OF
GAIT
AS
OUTCOME
MEASURE
FOLLOWING
SENSORY-
ENHANCED
THERAPY
IN
PARKINSON’S
DISEASE
USING
UNIFIED
PARKINSON’S
DISEASE
RATING
SCALE
(PART
III).
Int
J
Physiother
Res
2016;4(6):1757-1761. DOI: 10.16965/ijpr.2016.184.
Type of Article: Original Research
DOI: http://dx.doi.org/10.16965/ijpr.2016.184
Page No.: 1757-1761
ASSESSMENT
OF
GAIT
AS
OUTCOME
MEASURE
FOLLOWING
SENSORY-ENHANCED
THERAPY
IN
PARKINSON’S
DISEASE
USING
UNIFIED
PARKINSON’S
DISEASE RATING SCALE (PART III).
Sarala Khangare
*
1
,
Maneesha Deshpande
2
.
*1
Senior Physiotherapist, Physiotherapy School & Centre, Government Medical College & Hospital, Nagpur. (M.S), India.
Ph. D scholar, Seth G.S Medical College and KEM Hopsital, Parel, Mumbai.(M.S), India.
2
Principal and Professor, VSPM’s College of Physiotherapy, Hingna Road, Nagpur, India.
Address
for
correspondence:
Dr.
Sarala
Khangare
(PT),
Senior
Physiotherapist,
Physiotherapy
School
and
Centre,
Government
Medical
College
and
Hospital,
Medical square, Nagpur-440009, Maharashtra, India
. E-Mail:
saral.machhirke@gmail.com
Abstract:
Background
of
the
study:
Gait
and
mobility
problems
causes
disability
in
patients
with
Parkinson’s
Disease
(PD)
which
can
result
in
loss
of
independence,
falls
and
hospitalisation.
Cueing
is
defined
as
using
external
temporal
or
spatial
stimuli
to
facilitate
gait.
The
purpose
of
the
study
was
to
assess
the
effects
of
4
weeks
of
gait
training
with
sensory-enhanced
therapy
by
using
visual
and
auditory
cue
on
gait
score
on
tool
Unified
Parkinson’s
Disease
Rating
Scale
(UPDRS), step length, gait speed and cadence in patients with PD.
Materials
and
Methods:
Study
Design
was
experimental
study
with
total
sample
size
of
30
patients
with
confirmed
diagnosis
of
PD.
Patients
were
divided
into
experimental
group
(n=15)
and
age
and
disease
severity
matched
control
group(n=15).
Conventional
gait
training
was
commonly
administered
in
both
the
groups,
whereas
sensory-enhanced
therapy
(visual
and
auditory
cue)
was
given
along
with
gait
training
in
experimental
group
for
4
weeks.
The
outcome measures were recorded at the 1
st
day & at the end of 4
th
week in both experimental and control group.
Results:
The
data
collected
was
subjected
to
analysis
using
Statistical
Package
for
the
Social
Sciences
(SPSS).
All
data
were
expressed
in
mean±sd,
paired
t-
test
was
used
to
analyze
the
variables
within
the
experimental
and
control
group.
Unpaired
t-test
was
used
for
analyzing
the
variables
between
the
experimental
and
control
group.
A
significance
level
of
0.05
was
set
for
all
comparisons.
There
was
a
significant
decrease
in
gait
score
on
tool
UPDRS
(p=0.0002)
increase
in
step
length
(p<0.001),
gait
speed
(p<0.001)
and
cadence
(p=0.005)
in
experimental
group
following
4-weeks
of
sensory-enhanced
gait training as compared with the patients in the control group.
Conclusion
and
Clinical
Significance:
Sensory-enhanced
gait
training
can
be
a
useful
rehabilitation
strategy
for
the
improvement
of
gait
in
PD
patients
and
may prove to be valuable adjunct to traditional pharmacologic treatment of Parkinsonian gait.
KEY WORDS: Parkinson’s Disease, Gait Training, UPDRS, Visual Cue, Auditory Cue, Sensory-Enhanced Therapy, Basal Ganglia.
References
1
.
Parkinson J. An essay on the shaking palsy. J Neuropsychiatry Clin Neurosci. Spring 2002;14(2):223-236.
2
.
Columbia Encyclopedia. The Columbia Electronic Encyclopedia, 2003, 6
th
edition, Columbia University Press. [ www.cc.columbia.edu/cu/cup ]
3
.
Schenkman
M,
Cutson
T,
Kuchibatla
M
et
al.
Reliability
of
impairments
and
physical
performance
measures
of
persons
with
Parkinson’s
Disease.
Journal of Physical Therapy, Jan 1997;77;1:19-27.
4
.
Gourie-Devi
M.
Epidemiology
of
neurological
disorder
in
India
:
Review
of
background,
prevalence
and
incidence
of
epilepsy,
stroke,
Parkinson’s
Disease and tremors. Neurol India, 2014;62(6):588-598.
5
.
Sidaway
B,
Anderson
J,
Danielson
G,
Martin
L,
Smith
G.
Effects
of
long
term
gait
training
using
visual
cues
in
an
individual
with
Parkinson’s
Disease.
Journal of Physical Therapy, 2006;86:184-194.
6
.
Ahmad F, Goel V, Dhavan L, Maurya M. The effects of sensory cues on Parkinson’s gait after deep brain stimulation. Surgery 2007;1(1):1-3.
7
.
Sullivan
O’
S,
Parkinson’s
Disease.
In:
Sullivan
O’
S,
Schimtz
T.
Physical
Rehabilitation:
Assesment
and
Treatment.
2001,
4
th
edition,
New
Delhi.
Jaypee
Brothers Medical Publishers (P) Ltd. 747-782.
8
.
Lewis G, Byblow W, Walt S. Stride length regulation in Parkinson’s Disease: the use of extrinsic visual cues. Brain, Oct 2000;123(10):2077-2090.
9
.
Rubinstein
T,
Giladi
N,
Hausdorff
J.
The
power
of
cueing
to
circumvent
dopamine
deficits:
A
review
of
physical
therapy
treatment
of
gait
disturbances
in Parkinson’s Disease. Movement Disorders,2002;17(6):1148-1160.
1
0
.
Coutts F. Peripheral joints. In: Beeton K, Manual therapy Masterclasses. 2003, Elsevier Health Sciences, page 103
1
1
.
Perry Jacquelin. Stride analysis In: Gait Analysis: Normal and Pathological function, 1992, SLACK Incorporated. page 431
1
2
.
Richards
C,
Malouin
F,
Bedard
P,
Ciono
M.
Changes
induced
by
L-dopa
and
sensory
cues
on
the
gait
of
Parkinsonian
patients.
In:
Woollacott
M,
Horak
F, eds. Posture and gait: control mechanisms, Vol 2, Eugene OR: University of Oregan Books 1992;126-129
1
3
.
Jiang Y, Norman K. Effects of visual and auditory cues on gait initiation in people with Parkinson’s Disease. Clinical Rehabilitation, Jan 2006;21(3):36-45
1
4
.
Morris
M,
Iansek
R,
Matyas
T,
Summers
J.
Stride
length
regulation
in
Parkinson’s
Disease
:
Normalization
strategies
and
underlying
mechanisms.
Brain,
1996;119:551-568.
1
5
.
Morris M, Iansek R, Matyas , Summers J. The pathogenesis of gait hypokinesia in Parkinson’s Disease. Brain, 1994;117:1169-1181.
1
6
.
Ferrain
M,
Rabuffeti
M,
Tettamanti
M,
Pignatti
R,
Mauro
A,
Albani
G.
Effect
of
optical
flow
versus
attentional
strategy
on
gait
in
Parkinson’s
Disease:
A
study with a portable optical stimulating device. J Neuroeng Rehabilitation, 2008;5(3):1-9.
1
7
.
Azulay J, Mesure S, Amblard B, Blin O, Pouget J. Visual control of locomotion in Parkinnson’s Disease. Brain, Jan 1999;122(1):111-120.
1
8
.
Thaut
M,
McIntosh
G,
Rice
R,
Miller
R,
Rathbun
J,
Brautt
J.
Rhythmic
auditory
stimulation
in
gait
training
for
Parkinson’s
Disease
patients.
Movement
Disorders, Mar 1996;11(2):193-200.
1
9
.
Ito
N,
Hayshi
A,
Lin
W,
Ohkoshi
N,
Watanabe
M,
Shoji
S.
Music
therapy
in
Parkinson’s
Disease:
improvement
of
Parkinsonian
gait
and
depression
with
rhythmic auditory stimulation. In: Nakada T. Intergrated human brain science: theory, method, application. New York, Elsevier Science, 2000;435-443.
2
0
.
del
Olmo
F,
Cudeiro
J.
A
simple
procedure
using
auditory
stimuli
to
improve
movement
in
Parkinson’s
Disease
:
A
pilot
study.
Neurology
and
Clinical
Neurophysiology, 2003;2:1-7.