Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS)
Background. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the “off” state motor symptoms of Parkinson’s disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectivene...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2019/7104071 |
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| author | Kazunori Sato Noriaki Aita Yoshihide Hokari Eriko Kitahara Mami Tani Nana Izawa Kozo Hatori Ryota Nakamura Fuyuko Sasaki Satoko Sekimoto Takayuki Jo Genko Oyama Taku Hatano Yasushi Shimo Hirokazu Iwamuro Atsushi Umemura Nobutaka Hattori Toshiyuki Fujiwara |
| author_facet | Kazunori Sato Noriaki Aita Yoshihide Hokari Eriko Kitahara Mami Tani Nana Izawa Kozo Hatori Ryota Nakamura Fuyuko Sasaki Satoko Sekimoto Takayuki Jo Genko Oyama Taku Hatano Yasushi Shimo Hirokazu Iwamuro Atsushi Umemura Nobutaka Hattori Toshiyuki Fujiwara |
| author_sort | Kazunori Sato |
| collection | DOAJ |
| description | Background. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the “off” state motor symptoms of Parkinson’s disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectiveness of STN-DBS for postural instability is unclear, and the effect of rehabilitation following STN-DBS has remained uncertain. Objective. The purpose of this study was to examine changes in balance ability, gait function, motor performance, and ADLs following 2 weeks of postoperative rehabilitation in PD patients treated with STN-DBS. Methods. Sixteen patients were reviewed retrospectively from February 2016 to March 2017. All patients were tested in their “on” medication state for balance and gait performance using the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Timed “Up and Go” (TUG) test before the operation, after the operation, and during the discharge period. The UPDRS motor score (UPDRS-III) and Barthel Index (BI) were assessed before the operation and during the discharge period. Rehabilitation focused on muscle strengthening with stretching and proactive balance training. Friedman’s test and the post hoc Wilcoxon’s signed-rank test were used to analyze the balance assessments, and ANOVA and the post hoc Tukey’s test were used to analyze gait performance. The significance level was p<0.05. Results. During the discharge period, the Mini-BESTest and TUG were significantly improved compared with the preoperative and postoperative periods (p<0.05). There were no differences between preoperative and postoperative periods in the Mini-BESTest (p=0.12) and TUG (p=0.91). The BI and motor sections of the UPDRS did not differ significantly between the preoperative and postoperative periods (p=0.45, p=0.22). Conclusion. The results of this study suggest that postoperative rehabilitation improves balance and gait ability in patients with PD treated with STN-DBS. |
| format | Article |
| id | doaj-art-8777d06e77254e6680b753dfd8d77174 |
| institution | Kabale University |
| issn | 2090-8083 2042-0080 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-8777d06e77254e6680b753dfd8d771742025-02-03T01:10:27ZengWileyParkinson's Disease2090-80832042-00802019-01-01201910.1155/2019/71040717104071Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS)Kazunori Sato0Noriaki Aita1Yoshihide Hokari2Eriko Kitahara3Mami Tani4Nana Izawa5Kozo Hatori6Ryota Nakamura7Fuyuko Sasaki8Satoko Sekimoto9Takayuki Jo10Genko Oyama11Taku Hatano12Yasushi Shimo13Hirokazu Iwamuro14Atsushi Umemura15Nobutaka Hattori16Toshiyuki Fujiwara17Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Neurology, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanBackground. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a surgical treatment to reduce the “off” state motor symptoms of Parkinson’s disease (PD). Postural instability is one of the major impairments, which induces disabilities of activities of daily living (ADLs). The effectiveness of STN-DBS for postural instability is unclear, and the effect of rehabilitation following STN-DBS has remained uncertain. Objective. The purpose of this study was to examine changes in balance ability, gait function, motor performance, and ADLs following 2 weeks of postoperative rehabilitation in PD patients treated with STN-DBS. Methods. Sixteen patients were reviewed retrospectively from February 2016 to March 2017. All patients were tested in their “on” medication state for balance and gait performance using the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Timed “Up and Go” (TUG) test before the operation, after the operation, and during the discharge period. The UPDRS motor score (UPDRS-III) and Barthel Index (BI) were assessed before the operation and during the discharge period. Rehabilitation focused on muscle strengthening with stretching and proactive balance training. Friedman’s test and the post hoc Wilcoxon’s signed-rank test were used to analyze the balance assessments, and ANOVA and the post hoc Tukey’s test were used to analyze gait performance. The significance level was p<0.05. Results. During the discharge period, the Mini-BESTest and TUG were significantly improved compared with the preoperative and postoperative periods (p<0.05). There were no differences between preoperative and postoperative periods in the Mini-BESTest (p=0.12) and TUG (p=0.91). The BI and motor sections of the UPDRS did not differ significantly between the preoperative and postoperative periods (p=0.45, p=0.22). Conclusion. The results of this study suggest that postoperative rehabilitation improves balance and gait ability in patients with PD treated with STN-DBS.http://dx.doi.org/10.1155/2019/7104071 |
| spellingShingle | Kazunori Sato Noriaki Aita Yoshihide Hokari Eriko Kitahara Mami Tani Nana Izawa Kozo Hatori Ryota Nakamura Fuyuko Sasaki Satoko Sekimoto Takayuki Jo Genko Oyama Taku Hatano Yasushi Shimo Hirokazu Iwamuro Atsushi Umemura Nobutaka Hattori Toshiyuki Fujiwara Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) Parkinson's Disease |
| title | Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) |
| title_full | Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) |
| title_fullStr | Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) |
| title_full_unstemmed | Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) |
| title_short | Balance and Gait Improvements of Postoperative Rehabilitation in Patients with Parkinson’s Disease Treated with Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) |
| title_sort | balance and gait improvements of postoperative rehabilitation in patients with parkinson s disease treated with subthalamic nucleus deep brain stimulation stn dbs |
| url | http://dx.doi.org/10.1155/2019/7104071 |
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