Physiotherapy & Physical Rehabilitation

Introduction: Parkinsonism (Prk) is a neurodegenerative disorder, considered as a socially important disease with serious impact on autonomy and quality of life of patients. Primary clinical patterns include: static tremor, muscle rigidity (muscular and articular stiffness), brady-hypo-kinesia (including hypomimia), typical Prk-posture and Prk-gait, pulsion phenomena (antepulsio, retropulsio, lateropulsio). There is a lot of secondary autonomic and psychic signs and symptoms, especially anxiety or depression. In advanced Prk-cases some movement problems are observed, e.g. freezing and on-off phenomena; peek-of-dose-dyskinesias; etc. During last years we elaborated a complex neurorehabilitation (NR) programme, adapted to dysfunctions and problems in everyday life of Prkpatients,including physiotherapy, ergotherapy & patients’ education: analytic exercises for paravertebral muscles & for extremities; soft tissue techniques for rigid muscles; balance, transfer & coordination training; grasp & gait training; speech & mimic exercises; training in activities of daily living. Aim: The aim of current study was to realize a clinical approval of this complex NR-programme in parkinsonics. Material & Methods: We observed a total of 186 Prk-patients; randomized into two therapeutic groups (gr). In gr-1 we applied traditional physiotherapy; and in gr-2 - our complex NR-programme. For database management we used t-test (ANOVA) and Wilcoxon signed rank test. Results: The comparative analysis of the results demonstrate statistically significant amelioration (most relevant in gr-2) concerning: rigidity; mobility; pain; depression; autonomy and quality of life of Prk-patients; visualized by Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr scale; 6-Minutes Walk test, Timed Up and Go test, Balance scale and stabilometry. Conclusion: We recommend our own NR programme.