JFSF Vol 9, No 4, December 2024, p.267-280
doi: 10.22540/JFSF-09-267
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Original Article
Post-Physical Therapy 4-Month In-Home Dynamic Standing Protocol Maintains Physical Therapy Gains and Improves Mobility, Balance Confidence, Fear of Falling and Quality of Life in Parkinson’s Disease: A Randomized Controlled Examiner-Blinded Feasibility Clinical Trial
Miriam van Emde Boas1,2,3, Chatkaew Pongmala1,2,3, Abigail M. Biddix1,2,3, Alexis Griggs1,2,3, Austin T. Luker1,2,3, Giulia Carli1,2,4, Uros Marusic5,6, Nicolaas I. Bohnen1,2,3,7
- Functional Neuroimaging, Cognitive & Mobility Laboratory, University of M ichigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence in Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia
- Neurology Service and GRECC, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA
Keywords: Parkinson’s Disease, Physical Therapy, Sedentarism, Sarcopenia, Quality of Life
Abstract
Objective: Parkinson’s patients will experience mobility disturbances with disease progression. Beneficial effects of physical therapy are short-lasting. Novel interventions are needed to maintain these benefits.
Methods: Fourteen Parkinson’s patients (71±4.08 years) participated in a randomized controlled examiner-blinded feasibility clinical trial. After 12 physical therapy sessions, the intervention group received a height-adjustable desk that facilitates stepping while standing, for 4 months. Explorative outcome measures included MDS-UPDRS II, III, TUG, 8.5m walking test, PDQ-39, sABC, sFES, DEXA scans, and lower extremity strength.
Results: Post-physical-therapy, everyone significantly improved on the MDS-UPDRS II, III, TUG, and 8.5m walking test, and PDQ-39. (p<0.05) After 4 months, the control group regressed towards pre-physical-therapy values. In the intervention group, sedentary behavior decreased beyond desk use, indicating a carry-over effect. MDS-UPDRS II, PDQ-39, sFES, sABC, TUG, 8.5m walking test, activity time, sitting time, hip strength all improved with clinically relevant effect sizes.
Conclusion: Post-physical therapy in-home reduction of sedentary behavior was associated with maintenance of physical benefits and additional improvements in mobility, activity time, balance and quality of life.
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