Short- and long-term efficacy of intensive rehabilitation treatment on balance and gait in parkinsonian patients: a preliminary study with a 1-year followup.

Parkinson's disease (PD) is a neurodegenerative disease in which gait and balance disturbances are relevant symptoms that respond poorly to pharmacological treatment. The aim of this study was to investigate whether a 4-week inpatient multidisciplinary intensive rehabilitation treatment (MIRT) is effective in improving balance and gait and whether improvements persist at a one-year followup. We studied 20 PD inpatients (stage 3 Hoehn-Yahr) who underwent a MIRT. Outcome measures were UPDRS items for balance (30), falls (13), and walk (29), Berg Balance Scale, six-minute walking test, Timed Up and Go Test, and Comfortable-Fast gait speeds. Patients were evaluated at admission, at the end of the 4-week treatment, and at a 1-year followup. Pharmacological therapy was unchanged during MIRT and follow-up. All outcome measures improved significantly at the end of treatment. At 1-year follow-up control, UPDRS walk and Comfortable-Fast gait speeds still maintained better values with respect to admission (P = 0.009, P = 0.03, and P = 0.02, resp.), while the remaining scales did not differ significantly. Our results demonstrate that the MIRT was effective in improving balance and gait and that the improvement in gait performances was partially maintained also after 1 year.

[Chronic chondromalacia of the patella: comparison of morphological (magnetic resonance) and functional findings (isokinetic parameters) after rehabilitation]. / Sofferenze condrali rotulee croniche: confronto fra dati morfologici (Risonanza Magnetica) e funzionali (parametri isocinetici) dopo rieducazione.

The knee is a common site for injuries of the cartilage, capsule and ligament, which calls for the use of noninvasive techniques to assess injury severity properly and to plan adequate rehabilitation. Our study was aimed at comparing MR with isokinetic findings. To this purpose, 40 patients were examined; they were all affected with chondromalacia patellae, grades I-III, previously diagnosed at arthroscopy. Namely, 8 patients had grade I and 32 grades II and III chondromalacia. After MR and isokinetic exams, all patients were submitted to a standardized rehabilitation program. Our results indicate a marked decrease in quadriceps strength, especially in the most severe cases; in less severe cases, recovery was complete at 6 months, while the deficit remained in grades II and III injuries. MR yield was not relevant in 4 of 8 cases, while isokinetic findings were negative in one case. Both methods were positive in the most severe cases. At 6 months, both functional and MR findings were normal in grade I injuries, while some alterations remained in the others.

[Isokinetic evaluation and gait study in patients undergoing arthroplasty of the knee: verification of the efficacy of rehabilitation]. / Valutazione isocinetica e studio del passo in pazienti sottoposti ad artroprotesi di ginocchio: verifica di efficacia riabilitativa.

In this work the Authors have studied the efficacy of a standardized rehabilitative trial in patients with knee arthroplasty using an isokinetic technique and walking evaluation. 20 patients affected by gonarthrosis were evaluated: each of them underwent on one side an isokinetic evaluation before and 60 days after surgery, and on the other side a step evaluation, at the begin of limb charging and 60 days after surgery. The isokinetic parameters (strength, work, power) showed a sharp decrease of absolute values as compared to the preoperative situation, while in the walking evaluation the time reduction still remains in the first impact of the foot.

[Control of muscle reinforcement with the isokinetic endurance test in patients undergoing reconstruction of the anterior cruciate ligament of the knee]. / Controllo del rinforzo muscolare con il test di endurance isocinetico in pazienti sottoposti a ricostruzione di legamento crociato anteriore di ginocchio.

In the present study authors analyzed a group of fifty patients (mean age 24.3 years) affected by a chronic lesion of the anterior cruciate ligament of the knee, who underwent a ACL reconstruction by free patellar tendon in arthroscopy. Each of these patients carried out a standardized rehabilitative training and underwent an isokinetic evaluation immediately before and at 3, 4 and 6 months after ACL reconstruction. The considered parameters were the increasing of both strength and work in the standardized times at the angular speed of 60 and 180 degrees/sec. Our results, compared to the pre surgery, showed a high decrease of both strength and work at the third month after surgery, especially regarding the extensor muscles (-44% and -38% respectively); we observed an increase between the third and the fourth month, even if the parameters of the extensors still remain much lower than the controlateral healthy side.