Can sensory training improve the primary motor impairments of Parkinson's disease?


PD SAFEx is a sensory training rehabilitation therapy which has been proven to significantly improve the PD-specific motor symptoms in individuals with Parkinson's disease (PD), using the gold standard assessment tool known as the Unified Parkinson's disease Rating Scale (UPDRS-III). However, overall UPDRS scores don't give a true depiction an individual's degree of disability, or improvements of specific motor symptoms. For example, people with identical overall UPDRS-III may vary widely and hence present with a very different symptom phenotype. Therefore, to truly assess the specific motor benefits of an exercise program, sub-sections of UPDRS-III were retrospectively analyzed (speech, facial expression, total resting tremor, total action tremor, total rigidity, total bradykinesia, total hand grip, leg agility, arise from chair and balance (posture+gait+postural instability), in those who have participated in SAFEx. UPDRS-III scores for anyone who has ever participated in a SAFEx (12-week) program was identified in the MDRC database (n=299) and the sub-sections were summed. Data was analysed in SPSS using paired t-test and the Wilcoxon matched pairs singed-rank test to compare symptom improvement. Overall, results revealed that UPDRS scores decreased significantly from pre-test (correlation 0.728) to post-test (correlation 0.726) (p=0.0001). The subsets of scores further indicated significant improvements to speech (p=0.0001), total resting tremor (p=0.0001), total action tremor (p=0.0001), total neck and body rigidity (p=0.0001), bradykinesia (p=0.004), total hand grip (p=0.001), total leg agility (p=0.001) and balance (p=0.001). These findings suggest that SAFEx is a very promising program that significantly improves the main PD-specific symptoms, especially resting tremor and bradykinesia.

Acknowledgments: Movement Disorders Research and Rehabilitation Centre and Wilfrid Laurier University