Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson's Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS).


Journal

Parkinson's disease
ISSN: 2090-8083
Titre abrégé: Parkinsons Dis
Pays: United States
ID NLM: 101539877

Informations de publication

Date de publication:
2019
Historique:
received: 03 02 2019
revised: 09 05 2019
accepted: 09 07 2019
entrez: 31 8 2019
pubmed: 31 8 2019
medline: 31 8 2019
Statut: epublish

Résumé

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the "off" state motor symptoms of Parkinson's disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectiveness of STN-DBS for postural instability is unclear, and the effect of rehabilitation following STN-DBS has remained uncertain. The purpose of this study was to examine changes in balance ability, gait function, motor performance, and ADLs following 2 weeks of postoperative rehabilitation in PD patients treated with STN-DBS. Sixteen patients were reviewed retrospectively from February 2016 to March 2017. All patients were tested in their "on" medication state for balance and gait performance using the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Timed "Up and Go" (TUG) test before the operation, after the operation, and during the discharge period. The UPDRS motor score (UPDRS-III) and Barthel Index (BI) were assessed before the operation and during the discharge period. Rehabilitation focused on muscle strengthening with stretching and proactive balance training. Friedman's test and the post hoc Wilcoxon's signed-rank test were used to analyze the balance assessments, and ANOVA and the post hoc Tukey's test were used to analyze gait performance. The significance level was During the discharge period, the Mini-BESTest and TUG were significantly improved compared with the preoperative and postoperative periods ( The results of this study suggest that postoperative rehabilitation improves balance and gait ability in patients with PD treated with STN-DBS.

Sections du résumé

BACKGROUND BACKGROUND
Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the "off" state motor symptoms of Parkinson's disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectiveness of STN-DBS for postural instability is unclear, and the effect of rehabilitation following STN-DBS has remained uncertain.
OBJECTIVE OBJECTIVE
The purpose of this study was to examine changes in balance ability, gait function, motor performance, and ADLs following 2 weeks of postoperative rehabilitation in PD patients treated with STN-DBS.
METHODS METHODS
Sixteen patients were reviewed retrospectively from February 2016 to March 2017. All patients were tested in their "on" medication state for balance and gait performance using the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Timed "Up and Go" (TUG) test before the operation, after the operation, and during the discharge period. The UPDRS motor score (UPDRS-III) and Barthel Index (BI) were assessed before the operation and during the discharge period. Rehabilitation focused on muscle strengthening with stretching and proactive balance training. Friedman's test and the post hoc Wilcoxon's signed-rank test were used to analyze the balance assessments, and ANOVA and the post hoc Tukey's test were used to analyze gait performance. The significance level was
RESULTS RESULTS
During the discharge period, the Mini-BESTest and TUG were significantly improved compared with the preoperative and postoperative periods (
CONCLUSION CONCLUSIONS
The results of this study suggest that postoperative rehabilitation improves balance and gait ability in patients with PD treated with STN-DBS.

Identifiants

pubmed: 31467660
doi: 10.1155/2019/7104071
pmc: PMC6701295
doi:

Types de publication

Journal Article

Langues

eng

Pagination

7104071

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Kazunori Sato (K)

Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, Japan.

Noriaki Aita (N)

Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, Japan.

Yoshihide Hokari (Y)

Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, Japan.

Eriko Kitahara (E)

Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, Japan.

Mami Tani (M)

Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Nana Izawa (N)

Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Kozo Hatori (K)

Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Ryota Nakamura (R)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Fuyuko Sasaki (F)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Satoko Sekimoto (S)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Takayuki Jo (T)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Genko Oyama (G)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Taku Hatano (T)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Yasushi Shimo (Y)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Hirokazu Iwamuro (H)

Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Atsushi Umemura (A)

Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Nobutaka Hattori (N)

Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Toshiyuki Fujiwara (T)

Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Classifications MeSH