Evaluating specific motor symptom improvements with PD safex exercise rehabilitation

Abstract

The cardinal motor symptoms of Parkinson's Disease (PD) include, postural instability, bradykinesia, tremor and rigidity. The overall Unified Parkinson's Disease Rating Scale(UPDRS-III) indicates, the gold-standard treatment for PD (dopaminergic-therapy) is very effective in improving these symptoms. However, recent research indicated that 2 of the 4 cardinal symptoms of PD (balance and tremor) remain unimproved by dopaminergic-therapy. This prompts the investigation of other alternative and adjunct treatments such as exercise rehabilitation. Unfortunately, like drug studies, exercise studies often focus on overall symptom-improvement yet fail to monitor changes to specific symptoms. This may be problematic for individuals with different symptomatic phenotypes. If tremor/balance were the main concern, then adjunct therapies may be critically important when these symptoms may be dopa-resistant. Thus, it is important for all therapies to examine individual symptomatic-improvement. Interestingly, recent studies show PDSAFEx™(a sensory integration therapy) to have a significantly improve motor symptoms in comparison to traditional exercise(Sage et al.,2012). Yet, the effects of PDSAFEx™ on individual PD symptoms is unknown. Thus, the purpose of this study was to explore the effects of PD SAFEx™ on PD symptoms in adjunct to medications. UPDRS-III scores of 229 cases were retrospectively examined and analysed in SPSS using Wilcoxon pairs singed-rank test to evaluate specific symptom-improvements. PDSAFEx™ was confirmed to improve overall motor symptoms(p=0.0001), but more importantly a significant improvement to tremor(p<0.00001) and balance(p<0.00001) were also identified. These findings suggest that PDSAFEx™ is an important adjunct to medications, since it is able to address all four cardinal symptoms of PD.

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