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209 DESIGNING DANCE PROGRAMS FOR SPECIFIC REHABILITATION POPULATIONS
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Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
Conclusions: Improvement across all groups question the effectiveness of the interventions at tested doses on the primary outcomes of gait and balance. Attrition rates lead authors to suggest that future studies investigate delivery of care issues; most notably treatment dose and intervention location to ultimately limit subject burden. Acknowledgments: Funded by VA RR&D. Study #: O4006RA 208 PROTECTION AGAINST CHRONIC PARKINSON’S NEURODEGENERATION AND MITOCHONDRIAL DYSFUNCTION BY ENDURANCE EXERCISE Y.-S. Lau1 , K. Das-Panja2 , G. Patki2 , S.O. Ahmad3 . 1 Pharmacological Pharmaceutical Sciences, 2 University of Houston, Houston, TX, 3 University of Kansas Medical Center, Kansas City, KS, USA Neuronal mitochondria dysfunction has been implicated as a possible trigger for the onset and progression of Parkinson’s Disease (PD) neurodegeneration. There is growing clinical evidence suggesting that exercise can slow aging, prevent chronic diseases, and promote health. However, the impact of endurance exercise on PD-like neurodegeneration and on mitochondrial dysfunction has not been demonstrated. We have established that C57/BL mice when chronically treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPD) show persistent signs of neurobiological, pathological and behavioral derangements, which are correlated with a sustained inhibition of oxidative respiration, depletion of ATP, and loss of antioxidant enzymes in the striatal mitochondria for months. When the chronic MPD mice were exercise-trained 1 week before, 5 weeks during, and 12 weeks after the induction of PD-like syndrome on a motorized treadmill (running up to 15 m/min, 0° of inclination, 40 min/day, 5 days/week), the cardio-respiratory and metabolic functions in these animals were rehabilitated to the levels comparable to exercise-trained physical fitness in humans. Comparing to the sedentary counterparts, the striatal dopaminergic and mitochondrial deficits in the chronic MPD mice were significantly prevented after 18 weeks of exercise. These results suggest that mitochondrial dysfunction contributes at least in part to the induction of PD-like neurodegeneration. Long-term endurance exercise protects striatal mitochondria and dopaminergic neurons from undergoing degenerative process as demonstrated in the chronic MPD. The observations of this study further imply that mitochondria protective strategies may potentially slow down the progression of neurodegeneration. Supported by US NIH grant R01 NS47920. 209 DESIGNING DANCE PROGRAMS FOR SPECIFIC REHABILITATION POPULATIONS P. McKinley1,2,3 . 1 School of Physical and Occupational Therapy, McGill University, 2 Centre de Recherche Interdisciplinaire en R´eadaptation du Montr´eal M´etropolitain (CRIR), 3 R´eseau Provincial de Recherche en Adaptation-R´eadaptation (REPAR), Montreal, QC, Canada Dance is an intervention being used more and more frequently in the rehabilitation domain, especially for physical exercise (Keogh et al., JAPA, 2009). However, little thought goes into the planning of the type of dance activity that might target specific benefits of a particular population, especially those with, or at risk for, cognitive deficits. As well, the way in which dance is taught for various populations has not been well explored. This presentation will illuminate the ways in which a dance program might be chosen for a specific population, how it might be organized, and how one might choose outcome measures that are appropriate for the type of dance intervention. A decision tree has been developed and will be used to give examples of how a dance intervention might be constructed. Specifics will include: identification of dance movements and type of dances to match
the needs of a specific clientele; frequency, duration and intensity in the exercise domain; flow, mindfulness, pain and depression in the psychosocial domain; dual task and working memory in the cognitive domain; ethnic preferences and teaching techniques in the pedagogical domain. Specific examples, drawn from the author’s experience will be illustrated for persons with depression, risk for falls, Parkinson’s disease, and fibromyalgia. Issues related to adherence and implementation in the community setting will also be addressed. 210 GOOD IMPACT BUT LOW FEASIBILITY OF THE NEW FALL INTERVENTION PROGRAM IN FRAIL (COGNITIVELY IMPAIRED) OLDER FALLERS M.F. Reelick1 , M. Faes1 , R.A.J. Esselink2 , M.G.M. Olde Rikkert1 . 1 Department of Geriatrics, 2 Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Background and Aims: Specifically for frail (cognitively impaired) older fallers and their informal caregivers, we developed a fall intervention program. This study aims to describe experiences of participants and trainers, and possible barriers for implementation. Methods: Patients (N = 17, 12 females, mean age 79, MMSE 19–30), caregivers (N = 16, 11 females, age 41–82) and trainers (N = 3) filled out a questionnaire after the program and a random selection of participants was interviewed (N = 10). Results: Participants experienced multiple benefits from the program, most importantly: decrease in fear of falling and fall risk, and increase in activity, confidence and insight in and acceptance of their limitations. Participants highly appreciated training together with their spouse and in a group, because they could share stories and learn from each other. Trainers were able to deliver the program according to protocol, adapted to individual limitations where necessary (tailor made). They underlined benefits for the participants. However, the program reached only 20% of eligible subjects. The most important barriers for participation were the distance to and timing of the sessions, and the burden on the caregiver. Conclusions: The new fall intervention program is unique as in qualitative evaluation it, among others, lowers fear of falling in (cognitively impaired) older fallers. However, a group intervention at fixed location is proven not appropriate for large scale application and thus for trials. Adaptation of the program to a shorter individualized home-based prevention program is the next step, because the distance and caregiver burden are the most important barriers for adherence. 211 THE IMPACTS OF A PHYSICAL TRAINING INTERVENTION ON PHYSICAL CAPACITIES AND COGNITION IN FRAIL ELDERLY PATIENTS AFTER DAY HOSPITAL DISCHARGE F. Langlois1,2 , M. Saint-Martin3 , P. Campana3 , K. Chasse´ 3 , C. Genest3 , M. Renaud1,2 , L. Bherer1,2 . 1 Universit´e du Qu´ebec a ` Montr´eal, 2 Centre de Recherche de l’Institut Univesitaire de G´eriatrie de Montr´eal, 3 Institut Universitaire de G´eriatrie de Montr´eal, Montr´eal, QC, Canada Background: After discharge from a geriatric day hospital, frail elderly are still at risk of functional decline. Recent studies suggest that physical fitness training can improve physical capacities and cognition in normal older adults. However, whether such improvements can be observed in frail geriatric patients remains understudied. This is an important issue to reduce risks of falling and prevent functional decline. Objectives: This study aims at evaluating the impact of a 12-week physical training program on physical capacities and cognition in frail elderly patients following their discharge from day hospital. Methods: Fourteen patients (M = 84.29 years old) completed physical and cognitive tests before and after the intervention. The
Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
Conclusions: Improvement across all groups question the effectiveness of the interventions at tested doses on the primary outcomes of gait and balance. Attrition rates lead authors to suggest that future studies investigate delivery of care issues; most notably treatment dose and intervention location to ultimately limit subject burden. Acknowledgments: Funded by VA RR&D. Study #: O4006RA 208 PROTECTION AGAINST CHRONIC PARKINSON’S NEURODEGENERATION AND MITOCHONDRIAL DYSFUNCTION BY ENDURANCE EXERCISE Y.-S. Lau1 , K. Das-Panja2 , G. Patki2 , S.O. Ahmad3 . 1 Pharmacological Pharmaceutical Sciences, 2 University of Houston, Houston, TX, 3 University of Kansas Medical Center, Kansas City, KS, USA Neuronal mitochondria dysfunction has been implicated as a possible trigger for the onset and progression of Parkinson’s Disease (PD) neurodegeneration. There is growing clinical evidence suggesting that exercise can slow aging, prevent chronic diseases, and promote health. However, the impact of endurance exercise on PD-like neurodegeneration and on mitochondrial dysfunction has not been demonstrated. We have established that C57/BL mice when chronically treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPD) show persistent signs of neurobiological, pathological and behavioral derangements, which are correlated with a sustained inhibition of oxidative respiration, depletion of ATP, and loss of antioxidant enzymes in the striatal mitochondria for months. When the chronic MPD mice were exercise-trained 1 week before, 5 weeks during, and 12 weeks after the induction of PD-like syndrome on a motorized treadmill (running up to 15 m/min, 0° of inclination, 40 min/day, 5 days/week), the cardio-respiratory and metabolic functions in these animals were rehabilitated to the levels comparable to exercise-trained physical fitness in humans. Comparing to the sedentary counterparts, the striatal dopaminergic and mitochondrial deficits in the chronic MPD mice were significantly prevented after 18 weeks of exercise. These results suggest that mitochondrial dysfunction contributes at least in part to the induction of PD-like neurodegeneration. Long-term endurance exercise protects striatal mitochondria and dopaminergic neurons from undergoing degenerative process as demonstrated in the chronic MPD. The observations of this study further imply that mitochondria protective strategies may potentially slow down the progression of neurodegeneration. Supported by US NIH grant R01 NS47920. 209 DESIGNING DANCE PROGRAMS FOR SPECIFIC REHABILITATION POPULATIONS P. McKinley1,2,3 . 1 School of Physical and Occupational Therapy, McGill University, 2 Centre de Recherche Interdisciplinaire en R´eadaptation du Montr´eal M´etropolitain (CRIR), 3 R´eseau Provincial de Recherche en Adaptation-R´eadaptation (REPAR), Montreal, QC, Canada Dance is an intervention being used more and more frequently in the rehabilitation domain, especially for physical exercise (Keogh et al., JAPA, 2009). However, little thought goes into the planning of the type of dance activity that might target specific benefits of a particular population, especially those with, or at risk for, cognitive deficits. As well, the way in which dance is taught for various populations has not been well explored. This presentation will illuminate the ways in which a dance program might be chosen for a specific population, how it might be organized, and how one might choose outcome measures that are appropriate for the type of dance intervention. A decision tree has been developed and will be used to give examples of how a dance intervention might be constructed. Specifics will include: identification of dance movements and type of dances to match
the needs of a specific clientele; frequency, duration and intensity in the exercise domain; flow, mindfulness, pain and depression in the psychosocial domain; dual task and working memory in the cognitive domain; ethnic preferences and teaching techniques in the pedagogical domain. Specific examples, drawn from the author’s experience will be illustrated for persons with depression, risk for falls, Parkinson’s disease, and fibromyalgia. Issues related to adherence and implementation in the community setting will also be addressed. 210 GOOD IMPACT BUT LOW FEASIBILITY OF THE NEW FALL INTERVENTION PROGRAM IN FRAIL (COGNITIVELY IMPAIRED) OLDER FALLERS M.F. Reelick1 , M. Faes1 , R.A.J. Esselink2 , M.G.M. Olde Rikkert1 . 1 Department of Geriatrics, 2 Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Background and Aims: Specifically for frail (cognitively impaired) older fallers and their informal caregivers, we developed a fall intervention program. This study aims to describe experiences of participants and trainers, and possible barriers for implementation. Methods: Patients (N = 17, 12 females, mean age 79, MMSE 19–30), caregivers (N = 16, 11 females, age 41–82) and trainers (N = 3) filled out a questionnaire after the program and a random selection of participants was interviewed (N = 10). Results: Participants experienced multiple benefits from the program, most importantly: decrease in fear of falling and fall risk, and increase in activity, confidence and insight in and acceptance of their limitations. Participants highly appreciated training together with their spouse and in a group, because they could share stories and learn from each other. Trainers were able to deliver the program according to protocol, adapted to individual limitations where necessary (tailor made). They underlined benefits for the participants. However, the program reached only 20% of eligible subjects. The most important barriers for participation were the distance to and timing of the sessions, and the burden on the caregiver. Conclusions: The new fall intervention program is unique as in qualitative evaluation it, among others, lowers fear of falling in (cognitively impaired) older fallers. However, a group intervention at fixed location is proven not appropriate for large scale application and thus for trials. Adaptation of the program to a shorter individualized home-based prevention program is the next step, because the distance and caregiver burden are the most important barriers for adherence. 211 THE IMPACTS OF A PHYSICAL TRAINING INTERVENTION ON PHYSICAL CAPACITIES AND COGNITION IN FRAIL ELDERLY PATIENTS AFTER DAY HOSPITAL DISCHARGE F. Langlois1,2 , M. Saint-Martin3 , P. Campana3 , K. Chasse´ 3 , C. Genest3 , M. Renaud1,2 , L. Bherer1,2 . 1 Universit´e du Qu´ebec a ` Montr´eal, 2 Centre de Recherche de l’Institut Univesitaire de G´eriatrie de Montr´eal, 3 Institut Universitaire de G´eriatrie de Montr´eal, Montr´eal, QC, Canada Background: After discharge from a geriatric day hospital, frail elderly are still at risk of functional decline. Recent studies suggest that physical fitness training can improve physical capacities and cognition in normal older adults. However, whether such improvements can be observed in frail geriatric patients remains understudied. This is an important issue to reduce risks of falling and prevent functional decline. Objectives: This study aims at evaluating the impact of a 12-week physical training program on physical capacities and cognition in frail elderly patients following their discharge from day hospital. Methods: Fourteen patients (M = 84.29 years old) completed physical and cognitive tests before and after the intervention. The