Effect on Gait Speed, Balance, Motor Symptom Rating, and Quality of Life in Those with Stage I Parkinson's Disease Utilizing LSVT BIG®

Beth Millage, Erin Vesey, Marsha Finkelstein, Mattie Anheluk, Beth Millage, Erin Vesey, Marsha Finkelstein, Mattie Anheluk

Abstract

Individuals with Parkinson's Disease (PD) are often not referred to Physical Therapy (PT) until there are issues with mobility in later Hoehn and Yahr Stages. There have been no studies outlining the benefits of PT intervention in Stage I only. For persons with PD, deficits in motor function increase over time due to destruction of dopamine-producing cells. LSVT BIG, an exercise program for PD, has been shown to be effective in improving mobility. The purpose of this study was to assess participants functional improvement at a level of minimal clinically important difference (MCID) in one of four outcome measures: Gait Speed, Berg Balance Assessment, Functional Gait Assessment, and Unified Parkinson's Disease Rating Scale Motor Section. Case Description. Nine participants with Stage I PD received LSVT BIG 4x/week for 4 weeks followed by bimonthly participation in a community class. Outcome measurement occurred at baseline, after LSVT BIG, and three months after LSVT BIG. Outcomes. Eight of nine participants (88.9%) achieved MCID in at least one of the four measures at both after and 3 months after LSVT BIG training indicating improvement based on our criteria. Participants in Stage I of PD in this study completed LSVT BIG and demonstrated improved function.

Conflict of interest statement

The authors have no conflict of interests.

References

    1. Janssens J., Malfroid K., Nyffeler T., Bohlhalter S., Vanbellingen T. Application of LSVT BIG intervention to address gait, balance, bed mobility, and dexterity in people with Parkinson disease: a case series. Physical Therapy. 2014;94(7):1014–1023. doi: 10.2522/ptj.20130232.
    1. Bohlhalter S., Kaegi G. Parkinsonism: heterogeneity of a common neurological syndrome. Swiss Medical Weekly. 2011;141 doi: 10.4414/smw.2011.13293.w13293
    1. Farley B. G., Fox C. M., Ramig L. O., McFarland D. H. Intensive amplitude-specific therapeutic approaches for Parkinson's disease: toward a neuroplasticity-principled rehabilitation model. Topics in Geriatric Rehabilitation. 2008;24(2):99–114. doi: 10.1097/01.tgr.0000318898.87690.0d.
    1. Kleim J. A., Jones T. A., Schallert T. Motor enrichment and the induction of plasticity before or after brain injury. Neurochemical Research. 2003;28(11):1757–1769. doi: 10.1023/a:1026025408742.
    1. Fox C., Ebersbach G., Ramig L., Sapir S. LSVT LOUD and LSVT BIG: behavioral treatment programs for speech and body movement in Parkinson disease. Parkinson's Disease. 2012;2012:12. doi: 10.1155/2012/391946.391946
    1. Ebersbach G., Ebersbach A., Edler D., et al. Comparing exercise in Parkinson's disease—the Berlin LSVT BIG study. Movement Disorders. 2010;25(12):1902–1908.
    1. Ebersbach G., Ebersbach A., Gandor F., Wegner B., Wissel J., Kupsch A. Impact of physical exercise on reaction time in patients with Parkinson's disease—data from the berlin BIG study. Archives of Physical Medicine and Rehabilitation. 2014;95(5):996–999. doi: 10.1016/j.apmr.2013.10.020.
    1. Perera S., Mody S. H., Woodman R. C., Studenski S. A. Meaningful change and responsiveness in common physical performance measures in older adults. Journal of the American Geriatrics Society. 2006;54(5):743–749. doi: 10.1111/j.1532-5415.2006.00701.x.
    1. Donoghue D., Stokes EK. How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people. Journal of Rehabilitation Medicine. 2009;41(5):343–346. doi: 10.2340/16501977-0337.
    1. Shulman L. M., Gruber-Baldini A. L., Anderson K. E., Fishman P. S., Reich S. G., Weiner W. J. The clinically important difference on the unified Parkinson's disease rating scale. Archives of Neurology. 2010;67(1):64–70. doi: 10.1001/archneurol.2009.295.
    1. Fitzpatrick R., Norquist J. M., Jenkinson C. Distribution-based criteria for change in health-related quality of life in Parkinson's disease. Journal of Clinical Epidemiology. 2004;57(1):40–44. doi: 10.1016/j.jclinepi.2003.07.003.
    1. Farley B. G., Koshland G. F. Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson's disease. Experimental Brain Research. 2005;167(3):462–467. doi: 10.1007/s00221-005-0179-7.
    1. Ashburn A., Stack E., Pickering R. M., Ward C. D. A community‐dwelling sample of people with Parkinson's disease: characteristics of fallers and non‐fallers. Age and Ageing. 2001;30(1):47–52. doi: 10.1093/ageing/30.1.47.
    1. Pentecost C., Taket A. Understanding exercise uptake and adherence for people with chronic conditions: a new model demonstrating the importance of exercise identity, benefits of attending and support. Health Education Research. 2011;26(5):908–922. doi: 10.1093/her/cyr052.
    1. Gelb D. J., Oliver E., Gilman S. Diagnostic criteria for Parkinson disease. Archives of Neurology. 1999;56(1):33–39. doi: 10.1001/archneur.56.1.33.
    1. Brusse K. J., Zimdars S., Zalewski K. R., Steffen T. M. Testing functional performance in people with Parkinson disease. Physical Therapy. 2005;85(2):134–141.
    1. Leddy A. L., Crowner B. E., Earhart G. M. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with parkinson disease who fall. Physical Therapy. 2011;91(1):102–113. doi: 10.2522/ptj.20100113.
    1. Duncan R. P., Earhart G. M. Four Square Step Test performance in people with parkinson disease. Journal of Neurologic Physical Therapy. 2013;37(1):2–8. doi: 10.1097/NPT.0b013e31827f0d7a.
    1. Goetz C. C., Poewe W., Rascol O., et al. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. Movement Disorders. 2003;18(7):738–750. doi: 10.1002/mds.10473.
    1. Hagell P., Nygren C. The 39 item Parkinson's disease questionnaire (PDQ-39) revisited: implications for evidence based medicine. Journal of Neurology, Neurosurgery and Psychiatry. 2007;78(11):1191–1198. doi: 10.1136/jnnp.2006.111161.
    1. Peto V., Jenkinson C., Fitzpatrick R., Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Quality of Life Research. 1995;4(3):241–248. doi: 10.1007/BF02260863.
    1. Valldeoriola F., Coronell C., Pont C., et al. Socio-demographic and clinical factors influencing the adherence to treatment in Parkinson's disease: the ADHESON study. European Journal of Neurology. 2011;18(7):980–987. doi: 10.1111/j.1468-1331.2010.03320.x.
    1. Borg G. A. V. Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise. 1982;14(5):377–381.
    1. Abdullah R., Basak I., Patil K. S., Alves G., Larsen J. P., Møller S. G. Parkinson's disease and age: the obvious but largely unexplored link. Experimental Gerontology. 2015;68:33–38. doi: 10.1016/j.exger.2014.09.014.
    1. Ploughman M., Shears J., Harris C., et al. Effectiveness of a novel community exercise transition program for people with moderate to severe neurological disabilities. NeuroRehabilitation. 2014;35(1):105–112. doi: 10.3233/NRE-141090.
    1. States R. A., Spierer D. K., Salem Y. Long-term group exercise for people with Parkinson's disease: a feasibility study. Journal of Neurologic Physical Therapy. 2011;35(3):122–128. doi: 10.1097/npt.0b013e31822a0026.
    1. Radomski M. V. More than good intentions: advancing adherence to therapy recommendations. American Journal of Occupational Therapy. 2011;65(4):471–477. doi: 10.5014/ajot.2011.000885.
    1. Kremens D., Hauser R. A., Dorsey E. R. An update on Parkinson's disease: improving patient outcomes. The American Journal of Medicine. 2014;127(1, article no. S3) doi: 10.1016/j.amjmed.2013.06.016.
    1. Hu M. T. M., Szewczyk-Królikowski K., Tomlinson P., et al. Predictors of cognitive impairment in an early stage Parkinson's disease cohort. Movement Disorders. 2014;29(3):351–359. doi: 10.1002/mds.25748.

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