Working on asymmetry in Parkinson's disease: randomized, controlled pilot study

Area of Science:

• Neurology
• Rehabilitation Medicine
• Movement Disorders

Background:

• Parkinson's disease (PD) significantly impairs posture, gait, and balance.
• Parkinsonian gait is characterized by increased stride variability, reduced automaticity, and lower limb asymmetry, increasing the risk of freezing of gait (FOG) and falls.

Purpose of the Study:

• To investigate if modulating limb asymmetry through physiotherapy can enhance gait and reduce FOG in PD patients.
• To compare the effectiveness of targeted physiotherapy interventions (worst side improvement, best side improvement) against standard therapy for PD symptoms.

Main Methods:

• A double-blind, pilot feasibility controlled study involving 28 PD patients.
• Patients underwent a 3-month physiotherapy program (twice weekly) with random assignment to three arms: worst side improvement (WSI), best side improvement (BSI), or standard therapy (ST).
• Evaluations included UPDRS-III, Gait and Falls Questionnaire, Tinetti scale, SPPB, and EQ-5D.

Main Results:

• All treatment arms showed significant improvements in Tinetti and SPPB scores.
• The best side improvement (BSI) group demonstrated significantly greater improvements in UPDRS-III, Tinetti total score, and Tinetti gait subscore compared to standard therapy (ST).

Conclusions:

• Physical therapy is effective in managing Parkinson's disease symptoms.
• Physiotherapy interventions specifically tailored to address individual motor asymmetries, such as the BSI approach, may offer superior benefits over standard rehabilitation programs for improving gait and reducing FOG in PD.