Long-term effects of automated mechanical peripheral stimulation on gait patterns of patients with Parkinson's disease

Fabrizio Stocchi, Patrizio Sale, Ana F R Kleiner, Miriam Casali, Veronica Cimolin, Francesca de Pandis, Giorgio Albertini, Manuela Galli, Fabrizio Stocchi, Patrizio Sale, Ana F R Kleiner, Miriam Casali, Veronica Cimolin, Francesca de Pandis, Giorgio Albertini, Manuela Galli

Abstract

New treatments based on peripheral stimulation of the sensory-motor system have been inspiring new rehabilitation approaches in Parkinson's disease (PD), especially to reduce gait impairment, levodopa washout effects, and the incidence of falls. The aim of this study was to evaluate the change in gait and the clinical status of PD patients after six sessions of a treatment based on automated mechanical peripheral stimulation (AMPS). Eighteen patients with PD and 15 age-matched healthy individuals (control group) participated in this study. A dedicated medical device delivered the AMPS. PD patients were treated with AMPS six times once every 4 days. All PD patients were treated in the off-levodopa phase and were evaluated with gait analysis before and after the first intervention (acute phase), after the sixth intervention, 48 h after the sixth intervention, and 10 days after the end of the treatment. To compare the differences among the AMPS interventions (pre, 6 AMPS, and 10 days) in terms of clinical scales, a t-test was used (α≤0.05). In addition, to compare the differences among the AMPS interventions (pre, post, 6 AMPS, 48 h and 10 days), the gait spatiotemporal parameters were analyzed using the Friedman test and the Bonferroni post-hoc test (α≤0.05). Also, for comparisons between the PD group and the control group, the gait spatiotemporal parameters were analyzed using the Mann-Whitney test and the Bonferroni post-hoc test (α≤0.05). The results of the study indicate that the AMPS treatment has a positive effect on bradykinesia because it improves walking velocity, has a positive effect on the step and stride length, and has a positive effect on walking stability, measured by the increase in stride length. These results are consistent with the improvements measured with clinical scales. These findings indicate that AMPS treatment seems to generate a more stable walking pattern in PD patients, reducing the well-known gait impairment that is typical of PD; regular repetition every 4 days of AMPS treatment appears to be able to improve gait parameters, to restore rhythmicity, and to reduce the risk of falls, with benefits maintained up to 10 days after the last treatment. The trial was registered online at ClinicalTrials.gov (number identifier: NCT0181528).

Figures

Fig. 1
Fig. 1
(a) The Gondola device; (b) two moving steels; (c) points of stimulation on the feet; (d) patient positioning.
Fig. 2
Fig. 2
The percentage of improvement postacute phase, post 6 AMPS, post 48 h, and post 10 days for (a) stride length; (b) step length; (c) mean velocity; (d) swing velocity; (e) cadence for the PD group. AMPS, automated mechanical peripheral stimulation; PD, Parkinson’s disease.

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Source: PubMed

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