The impact of cognitive reserve on the effectiveness of balance rehabilitation in Parkinson's disease
Bibliographic record
Abstract
BACKGROUND: Cognitive reserve (CR) can be considered an active expression of brain resilience in response to a damage. Several studies have shown the influence of CR on cognitive impairment and its relationship with cognitive function in Parkinson's disease (PD). AIM: The aim of the present study was to show if CR influences the effectiveness of balance rehabilitation in PD patients who performed a conventional rehabilitative treatment. DESIGN: Observational longitudinal study. SETTING: Neurology Outpatient Unit, University Hospital. POPULATION: Fifty-three patients affected by idiopathic PD, stage 2-3 at the Hoehn and Yahr Scale. METHODS: Each patient underwent 32 group sessions of conventional rehabilitative treatment. At baseline, patients' CR was assessed by the Cognitive Reserve Index questionnaire (CRIq). The primary outcome was the evaluation of static and dynamic balance modifications, induced by the treatment, through the Berg Balance Scale (BBS), assessed at T0 and T1. Mini Mental State Examination, Unified Parkinson's Disease Rating Scale Part III (clinician-scored monitored motor evaluation) and Brief Intelligence Test were assessed only at T0 and used as descriptive variables. RESULTS: Considering the clinically meaningful change, BBS improved in 26% of patients, worsened in 2% and was unchanged in 72%. BBS score significantly improved in older patients, and in those with lower CRI total score. A significant inverse correlation was observed between changes in BBS and work and education related CR. Patients with lower baseline BBS score showed better improvement in balance. CONCLUSIONS: We found an inverse correlation between CR level and balance improvement in PD patients who underwent conventional rehabilitation: higher improvement in BBS was observed in those with a lower CRI score. This may suggest that patients with higher CRI could benefit from more stimulating types of non-conventional rehabilitation (e.g. robotic, virtual reality). CLINICAL REHABILITATION IMPACT: Rehabilitation should be individually tailored considering CR as a significant variable.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".