A strengthening protocol based on core tasks in Parkinson‘s disease: a pilot study
Notice bibliographique
Résumé
Background: Parkinson‘s disease (PD) is a neurodegenerative disease whose progression impairs the performance of activities of daily living (ADLs). Its main symptoms are tremor, bradykinesia, muscle rigidity and postural instability, making neurofunctional rehabilitation important for these individuals. Physical exercises are essential for reducing the PD progression and optimize the social participation of individuals. Despite numerous studies on the dose and type of exercise to be performed in PD, no strengthening protocol was found aimed the rehabilitation of core tasks. Objective: This is a pilot study that proposes a strengthening protocol aimed at maintaining the independence of PD patients in performing ADLs, with a focus on training core tasks (standing, walking, stepping up/down, and reaching/grasping/manipulating objects). Methods: This is a longitudinal study and case report with a 70-year-old man with PD for 12 years and stage 3 on the Hoehn and Yard scale. The protocol contains 9 exercises to be performed in ambulatorial environment and is divided into five weeks with the possibility of progression and regression in terms of difficulty and intensity. Fifteen sessions were realized and the volunteer was assessed using the Unified Parkinson‘s Disease Rating Scale adapted by the Movement Disorder Society (MDS-UPDRS), the Dynamic Gait Index (DGI), the Montreal Cognitive Assessment (MoCA) and the Parkinson‘s Disease Questionnaire (PDQ - 39). Results: The protocol included exercises for reaching (anterior, superior and diagonal), step up and down (with and without resistance), free and resisted lower limb exercises aimed at postural transfers, trunk strengthening, gait and balance. The sessions lasted 40 minutes and for each exercise was performed 3 series of 8 to 12 repetitions, which were associated with cognitive double tasks. After five weeks, improvements were seen in the UPDRS (12 points) and DGI (1 point) scores, as well as in the Mobility (12.5%), ADLs (2.5%), cognition (16.67%) and communication (6.25%) domains of the PDQ-39. There was a worsening in the scores of the other domains of the PDQ-39 (emotional well-being, stigma, social support and bodily discomfort) and the MoCA. Conclusion: This study developed a strengthening protocol for PD rehabilitation. The protocol was applied for five weeks, three times a week, for 40 minutes to an individual with PD. Improvements were seen in dynamic balance, motor symptoms, mobility, performance of ADLs, cognition and communication, as recorded by the DGI, UPDRS and PDQ-39 scales. No improvement was observed in executive functions and memory (MoCA), as well as in emotional well-being, stigma, social support and bodily discomfort. The protocol can be applied in an outpatient setting and needs to be applied to more volunteers to assess its effectiveness and feasibility.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».