ABSTRACT
Objective : To demonstrate the importance of physical motor function using the unified Parkinson's disease rating scale (UPDRS) and three-dimensional motion analysis in Parkinson's disease rehabilitation strategies. Participants : Seventeen inpatients with Parkinson's disease. Intervention : Physical training to improve joint mobility, muscle strength and muscle stretch to increase physical capacity was conducted for about four weeks. Results: The mean total scores of UPDRS significantly decreased from 37.9±13.2 (before training) to 27.3±11.2 (after training). The ADL scores of the UPDRS decreased from 12.4±6.9 (before training) to 9.5±6.3 (after training). The motor scores decreased from 22.5±7.5 to 15.3±6.5. Furthermore, muscle rigidity and akinesia, two key Parkinson symptoms, were improved as shown by assessment of the UPDRS motor scores. And physical function of the trunk, and upper and lower extremities was also improved. Finally, the increment of stride length and walking velocity and range of motion (ROM) at the hip and pelvic joints were observed by assessment of three-dimensional motion analysis. Conclusion : This study suggests that improvement of Parkinson symptoms and increment of ROM at the pelvic and lower limbs by physical training may improve stride length and walking velocity.
ABSTRACT
The effectiveness of rehabilitation in patients with HTLV-1associated myelopathy (HAM) was evaluated. The HAM patient is characterized by chronic progressive spastic paraplegia with dysuria and muscular weakness of the lower trunk, as well as the pelvic and hip muscles. However, the muscular strength of the lower limbs and feet is relatively well maintained. The 12 subjects enrolled in this study included 2 men and 10 women. Their average age was 53.2 years, their average duration of disease was 20.5 years, and they were involved in training for an average of 41 days. The rehabilitation program involved muscular strength training of the lower trunk, pelvic, and hip muscles. After all patients completed the rehabilitation program, a significant improvement was seen in the truncal flexors, the truncal extensors, and the truncal rotators in the lower trunk. As for the hip muscles, a significant improvement was seen in the iliopsoas, the gluteus maximus, and the gluteus medius. The improvement was evaluated using Osame's Motor Disability Score (OMDS), the Functional Independence Measure (FIM) and the Barthel Index. The patients' improvements in motor function and ADL suggest that rehabilitation was effective.