Article

The present study was devised: (a) to test whether an
intensive (60 hours in 4 weeks) multidisciplinary rehabilitation treatment
(involving physiotherapy, exercises to improve gait and balance using treadmill
and stabilometric platform, occupational therapy) for Parkinsonian patients is
effective in improving dyskinesia and motor performance compared to a control
group undergoing a non-intensive non multidisciplinary rehabilitation treatment
(30 hours in 4 weeks involving physiotherapy only); and (b) to verify whether
rehabilitation may lead to a reduction in levodopa dosage. METHODS:
Forty Parkinsonian patients suffering from dyskinesias were admitted to study: 20
for an intensive multidisciplinary (Group1) and 20 for a non-intensive non
multidisciplinary rehabilitation treatment (Group2). The rating scales used for
the clinical evaluation were: Unified Parkinson's Disease Rating Scales (UPDRS)
II, III, IV, Parkinson's disease disability scale (PDDS), Abnormal Involuntary
Movement Scale (AIMS). RESULTS: All outcome measurements improved in both groups
of patients, but patients Group1 presented better results: UPDRS II was reduced
by 33% in Group1 and by 22% in Group2, UPDRS III 29% vs. 22%, UPDRS IV 74% vs.
10%, PDDS 18% vs. 12%, and AIMS 71% vs. 8%. A different behaviour was observed
for levodopa dosage at baseline and after treatment: dosage decreased by an
average value of 210 mg (p< 0.0001) in Group1 and was virtually unchanged (30 mg
reduction, p=0.08) in Group2. CONCLUSION: Our findings suggest that a
rehabilitation protocol should be considered as a valid non-invasive therapeutic
support for patients who show dyskinesias and that there are better results when
the treatment is intensive.

Langue : ANGLAIS