- Email: [email protected]
Comparison of home-based and therapist-supervised balance training on gait variables of freezers
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Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
Results Eighty out of 420 records met the eligibility criteria. A low intensity (LIT) (39 cases) and a high intensity training (HIT) (41 cases) group were defined according to a total training duration of less or more than 1000 minutes, respectively. HIT group included a greater rate of responders than LIT (65% cases with a meaningful gain in the UPDRS-II, vs. 35%; Chi2 : 3.8; P = 0.04). At variance with the LIT group, HIT subjects also showed a persistent improvement in UPDRS scores (F: 14.5;P < 0.0001) and in FES (F: 6.7;P = 0.002) at the 4-month follow-up. No significant between-group differences were found comparing TUG, 6MWT and PDQ-39 changes. Conclusion A total training duration of 60/90 minute/session per 20 sessions of task-oriented and aerobic training is recommended in pwPD, in order to ensure a clinically meaningful and persistent reduction of their disease-related disability. Keywords Outpatient rehabilitation; Parkinson’s disease; Intensity Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.593 ISPR8-1968
Comparison of home-based and therapist-supervised balance training on gait variables of freezers
E. Atterbury ∗ , K. Welman Stellenbosch University, Sport Science Department, Stellenbsoch, Western Cape, South Africa ∗ Corresponding author. E-mail address: [email protected] (E. Atterbury) Introduction/Background Parkinson’s disease (PD) often manifests as dysfunctional mobility, with freezing of gait being one of the most prominent signs. Individuals who freeze (freezers) often have a greater loss of independence compared to their non-freezing counter parts. Exercise interventions have shown some benefit in reducing freezing of gait frequency and severity. However, research still need to establish what type of exercise and exercise delivery is most effective for freezers. Therefore, this study aimed to evaluate and compare the efficacy of home-based to therapist-supervised balance training on freezing of gait and gait parameters. Material and method Based on a sample of convenience, 40 participants with mild-to-moderate Parkinson’s disease (Hoehn & Yahr stages I–III) were allocated to a therapist-supervised (n = 24, age 65.4 ± 8.3 years) or home-based group (n = 16, age 64.9 ± 7.1 years). Within each group 50% of individuals reported experiencing freezing. Both groups followed 8 weeks of balance training; the therapist-supervised (TS) group attended classes, and the homebased (HB) group followed DVDs at home. Outcome measures included the instrumented Timed-Up-and-Go and the Activityspecific Balance confidence (ABC) scale. Results The freezers differed significantly from the non-freezers in both TS and HB groups at pre-test for gait variables (P < 0.03), including stride length, stride velocity and cadence, as well as selfperceived balance confidence (P < 0.05). The freezers in the TS group improved their gait variables over time and showed a strong tendency to improve ABC scores (P = 0.061) over time. Conclusion The improvements in gait of the TS freezers shows that balance training with a therapist could be an essential tool to improve the independence and confidence of freezers. This study reiterates the differences between freezers and non-freezers, and shows the complexities a therapist should keep in mind when working with a heterogeneous group, such as PD individuals. Keywords Freezing of gait; Parkinson’s disease; Balance training Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.594
ISPR8-1493
Slow oscillations of cerebral hemodynamics changes during low-level light therapy in the elderly with and without mild cognitive impairment: An fNIRS study A. Lee 1,2 , J. Kim 1 , J. Lee 1,2 , H. Kim 1 , S.J. Seol 2 , Y.I. Shin 3 , W.H. Chang 2 , Y.H. Kim 1,2,∗ 1 Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Department of Health Sciences and Technology, Seoul, Republic of Korea 2 Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Seoul, Republic of Korea 3 Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Department of Rehabilitation Medicine, Pusan, Republic of Korea ∗ Corresponding author. E-mail address: [email protected], [email protected] (Y.H. Kim) Introduction/Background Low-level light therapy (LLLT) is used to stimulate cell function or reduce pain by applying light emitting diodes (LED) to the skin. LLLT is known to contribute to the neuronal recovery during the reconstruction of brain tissue for the treatment of degenerative disorders. This research aims to confirm the slow oscillations of cerebral hemodynamics changes when LLLT is applied to the elderly and patients with mild cognitive impairment (MCI). Material and method Eight patients with MCI and 7 healthy elderly participated in this study. They were randomly divided into four groups; carotid artery stimulation, vertebral artery stimulation, simultaneous carotid and vertebral artery stimulation, or ® sham stimulation. The subjects received LLLT using Color DNA (Color Seven Co.) with a LED light source for 30 minutes a day during 20 days. The hemodynamic responses were recorded by an fNIRS ® system (NIRScout ) with 74 channels at the first and the 20th intervention days, before, during, and after the LLLT. The spectral power density over the very low-frequency oscillations (VLFO) of cerebral hemodynamics was calculated using Welch technique. Results In both healthy and MCI patients, VLFO increased in the whole cerebral area during LLLT compared to the resting state, and these changes are more contrasting in the condition with simultaneous carotid and vertebral artery stimulation condition. These characteristics were observed in both the first and 20th intervention days however, VLFO in the 20th intervention day were more increased than the first day. Conclusion Increase of very low frequency oscillations demonstrated increasing spontaneous activity of cerebrovascular tone and neuronal activation. These findings may suggest a possibility of modulating effect of LLLT on neuronal activity and blood vessel reconstruction. Keywords Mild cognitive impairment; Low-level light therapy; Functional near-infrared spectroscopy Disclosure of interest The authors declare that they have no competing interest. Acknowledgements This work was supported by the Korea Evaluation Institute of Industrial Technology (No. 10067221) and a grant from the NRF (NRF-2017R1A2A1A05000730) funded by the Korean government. https://doi.org/10.1016/j.rehab.2018.05.595
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
Results Eighty out of 420 records met the eligibility criteria. A low intensity (LIT) (39 cases) and a high intensity training (HIT) (41 cases) group were defined according to a total training duration of less or more than 1000 minutes, respectively. HIT group included a greater rate of responders than LIT (65% cases with a meaningful gain in the UPDRS-II, vs. 35%; Chi2 : 3.8; P = 0.04). At variance with the LIT group, HIT subjects also showed a persistent improvement in UPDRS scores (F: 14.5;P < 0.0001) and in FES (F: 6.7;P = 0.002) at the 4-month follow-up. No significant between-group differences were found comparing TUG, 6MWT and PDQ-39 changes. Conclusion A total training duration of 60/90 minute/session per 20 sessions of task-oriented and aerobic training is recommended in pwPD, in order to ensure a clinically meaningful and persistent reduction of their disease-related disability. Keywords Outpatient rehabilitation; Parkinson’s disease; Intensity Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.593 ISPR8-1968
Comparison of home-based and therapist-supervised balance training on gait variables of freezers
E. Atterbury ∗ , K. Welman Stellenbosch University, Sport Science Department, Stellenbsoch, Western Cape, South Africa ∗ Corresponding author. E-mail address: [email protected] (E. Atterbury) Introduction/Background Parkinson’s disease (PD) often manifests as dysfunctional mobility, with freezing of gait being one of the most prominent signs. Individuals who freeze (freezers) often have a greater loss of independence compared to their non-freezing counter parts. Exercise interventions have shown some benefit in reducing freezing of gait frequency and severity. However, research still need to establish what type of exercise and exercise delivery is most effective for freezers. Therefore, this study aimed to evaluate and compare the efficacy of home-based to therapist-supervised balance training on freezing of gait and gait parameters. Material and method Based on a sample of convenience, 40 participants with mild-to-moderate Parkinson’s disease (Hoehn & Yahr stages I–III) were allocated to a therapist-supervised (n = 24, age 65.4 ± 8.3 years) or home-based group (n = 16, age 64.9 ± 7.1 years). Within each group 50% of individuals reported experiencing freezing. Both groups followed 8 weeks of balance training; the therapist-supervised (TS) group attended classes, and the homebased (HB) group followed DVDs at home. Outcome measures included the instrumented Timed-Up-and-Go and the Activityspecific Balance confidence (ABC) scale. Results The freezers differed significantly from the non-freezers in both TS and HB groups at pre-test for gait variables (P < 0.03), including stride length, stride velocity and cadence, as well as selfperceived balance confidence (P < 0.05). The freezers in the TS group improved their gait variables over time and showed a strong tendency to improve ABC scores (P = 0.061) over time. Conclusion The improvements in gait of the TS freezers shows that balance training with a therapist could be an essential tool to improve the independence and confidence of freezers. This study reiterates the differences between freezers and non-freezers, and shows the complexities a therapist should keep in mind when working with a heterogeneous group, such as PD individuals. Keywords Freezing of gait; Parkinson’s disease; Balance training Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.594
ISPR8-1493
Slow oscillations of cerebral hemodynamics changes during low-level light therapy in the elderly with and without mild cognitive impairment: An fNIRS study A. Lee 1,2 , J. Kim 1 , J. Lee 1,2 , H. Kim 1 , S.J. Seol 2 , Y.I. Shin 3 , W.H. Chang 2 , Y.H. Kim 1,2,∗ 1 Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Department of Health Sciences and Technology, Seoul, Republic of Korea 2 Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Seoul, Republic of Korea 3 Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Department of Rehabilitation Medicine, Pusan, Republic of Korea ∗ Corresponding author. E-mail address: [email protected], [email protected] (Y.H. Kim) Introduction/Background Low-level light therapy (LLLT) is used to stimulate cell function or reduce pain by applying light emitting diodes (LED) to the skin. LLLT is known to contribute to the neuronal recovery during the reconstruction of brain tissue for the treatment of degenerative disorders. This research aims to confirm the slow oscillations of cerebral hemodynamics changes when LLLT is applied to the elderly and patients with mild cognitive impairment (MCI). Material and method Eight patients with MCI and 7 healthy elderly participated in this study. They were randomly divided into four groups; carotid artery stimulation, vertebral artery stimulation, simultaneous carotid and vertebral artery stimulation, or ® sham stimulation. The subjects received LLLT using Color DNA (Color Seven Co.) with a LED light source for 30 minutes a day during 20 days. The hemodynamic responses were recorded by an fNIRS ® system (NIRScout ) with 74 channels at the first and the 20th intervention days, before, during, and after the LLLT. The spectral power density over the very low-frequency oscillations (VLFO) of cerebral hemodynamics was calculated using Welch technique. Results In both healthy and MCI patients, VLFO increased in the whole cerebral area during LLLT compared to the resting state, and these changes are more contrasting in the condition with simultaneous carotid and vertebral artery stimulation condition. These characteristics were observed in both the first and 20th intervention days however, VLFO in the 20th intervention day were more increased than the first day. Conclusion Increase of very low frequency oscillations demonstrated increasing spontaneous activity of cerebrovascular tone and neuronal activation. These findings may suggest a possibility of modulating effect of LLLT on neuronal activity and blood vessel reconstruction. Keywords Mild cognitive impairment; Low-level light therapy; Functional near-infrared spectroscopy Disclosure of interest The authors declare that they have no competing interest. Acknowledgements This work was supported by the Korea Evaluation Institute of Industrial Technology (No. 10067221) and a grant from the NRF (NRF-2017R1A2A1A05000730) funded by the Korean government. https://doi.org/10.1016/j.rehab.2018.05.595