Effectiveness of a dance-physiotherapy combined intervention in Parkinson's disease: a randomized controlled pilot trial.

BACKGROUND: Physical therapies have been recommended as crucial components in Parkinson's disease (PD) rehabilitation. OBJECTIVE: The study aims to examine the effectiveness of a new dance-physiotherapy combined intervention, called DArT method, in mild PD patients. METHODS: A prospective, randomized, single-blind, controlled pilot trial was conducted on 38 mild PD patients under dopaminergic therapy. The intervention consisted in an add-on protocol: the control group received 1 h of conventional physiotherapy followed by 1 h of conventional physiotherapy each day, 3 times a week, for 5 weeks. The experimental group received 1 h of conventional physiotherapy followed by 1 h of dance class each day, 3 times a week, for 5 weeks. The week before and after the training period, patients were assessed for motor, cognitive, emotional, and sensory components of PD, with MDS-UPDRS-III as primary outcome measure. RESULTS: DArT method was associated with a 2.72-point reduction in the post-treatment MDS-UPDRS-III total score compared to control group (95% CI - 5.28, - 0.16, p = 0.038, d = 0.71), and with a 2.16-point reduction in the post-treatment MDS-UPDRS-III upper body subscore (95% CI - 3.56, - 0.76, p = 0.003, d = 1.02). Conversely, conventional physiotherapy program was associated with a 2.95-point reduction in the post-treatment trait anxiety compared to the experimental group (95% CI 0.19, 5.71, p = 0.037, d = 0.70). Withdrawal and fall rates were equal to 0% in both groups. CONCLUSION: DArT method showed to be safe, well accepted, and more effective than an intensive program of conventional physiotherapy in improving motor impairment in mild PD.

Algo-Functional Indexes and Spatiotemporal Parameters of Gait after Sacroiliac Joint Arthrodesis.

Aims of the study were to evaluate the reliability and validity of the Italian version of the Majeed and Iowa questionnaires and to investigate the long-term surgical outcomes following sacroiliac joint arthrodesis. Twenty one patients who underwent a sacroiliac joint arthrodesis and 21 healthy subjects were evaluated. The experimental procedure consisted of gait analysis and a physical activity assessment (in both groups) and of administration of outcome questionnaires and pain assessment (in the patient group). The Majeed and Iowa questionnaires showed excellent reliability, excellent (for the Majeed questionnaire) and good (for the Iowa questionnaire) construct validity, and poor convergent validity (for both questionnaires) relative to walking speed. Most of the patients reported no pain and minimum pain-related disability and their physical activity profile was comparable to healthy controls. Patients showed an impaired walking performance (i.e., they walked slower and using shorter steps) compared with healthy controls. Long-term walking pattern abnormalities following sacroiliac joint arthrodesis may occur despite excellent clinical results. Given their excellent reliability and construct validity, the Majeed and Iowa questionnaires can be used in combination with the assessment of spatiotemporal gait parameters for the prognostic assessment and/or follow-up of surgical patients.

Movements and body ownership: Evidence from the rubber hand illusion after mechanical limb immobilization.

There is no consensus on whether, and to what extent, actions contribute to constructing awareness of one's own body. Here we investigated at both physiological and behavioral level whether a prolonged limb immobilization affects body ownership. We tested a group of healthy participants, whose left-hand movements were prevented by a cast for one week, and a control group without any movement restriction. In both groups, we measured the strength of the rubber hand illusion (i.e., proprioceptive shift and questionnaire on ownership) and the physiological parameters known to be modulated by short-term arm immobilization (i.e., resting motor threshold, motor evoked potentials and force parameters) before and after the week of immobilization. Our results showed stronger illusory effects on the immobilized hand on both behavioral indexes and weaker illusory effects on the non-immobilized hand on the questionnaire. Additionally, the increased proprioceptive shift was positively correlated to the motor threshold of the contralateral hemisphere. Our findings show at both behavioral and physiological level that altering those movement-related signals which constantly stem from our own body parts, modulates the experience of those body parts as mine. This, in turn, supports the view of a direct role of actions in the developing and maintaining a coherent body ownership.