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The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait

Background: The sequence effect (SE), defined as a reduction in amplitude of repetitive movements, is a common clinical feature of Parkinson's disease (PD) and is supposed to be a major contributor to freezing of gait (FOG). During walking, SE manifests as a step-by-step reduction in step lengt...

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Autores principales: Putortì, Alessia, Corrado, Michele, Avenali, Micol, Martinelli, Daniele, Allena, Marta, Cristina, Silvano, Grillo, Valentina, Martinis, Luca, Tamburin, Stefano, Serrao, Mariano, Pisani, Antonio, Tassorelli, Cristina, De Icco, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453149/
https://www.ncbi.nlm.nih.gov/pubmed/34557151
http://dx.doi.org/10.3389/fneur.2021.723468
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author Putortì, Alessia
Corrado, Michele
Avenali, Micol
Martinelli, Daniele
Allena, Marta
Cristina, Silvano
Grillo, Valentina
Martinis, Luca
Tamburin, Stefano
Serrao, Mariano
Pisani, Antonio
Tassorelli, Cristina
De Icco, Roberto
author_facet Putortì, Alessia
Corrado, Michele
Avenali, Micol
Martinelli, Daniele
Allena, Marta
Cristina, Silvano
Grillo, Valentina
Martinis, Luca
Tamburin, Stefano
Serrao, Mariano
Pisani, Antonio
Tassorelli, Cristina
De Icco, Roberto
author_sort Putortì, Alessia
collection PubMed
description Background: The sequence effect (SE), defined as a reduction in amplitude of repetitive movements, is a common clinical feature of Parkinson's disease (PD) and is supposed to be a major contributor to freezing of gait (FOG). During walking, SE manifests as a step-by-step reduction in step length when approaching a turning point or gait destination, resulting in the so-called destination sequence effect (dSE). Previous studies explored the therapeutic effects of several strategies on SE, but none of them evaluated the role of an intensive rehabilitative program. Objectives: Here we aim to study the effects of a 4-week rehabilitative program on dSE in patients with PD with and without FOG. Methods: Forty-three patients (30 males, 70.6 ± 7.5 years old) with idiopathic PD were enrolled. The subjects were divided into two groups: patients with (PD + FOG, n = 23) and without FOG (PD – FOG, n = 20). All patients underwent a standardized 4-week intensive rehabilitation in-hospital program. At hospital admission (T0) and discharge (T1), all subjects were evaluated with an inertial gait analysis for dSE recording. Results: At T0, the dSE was more negative in the PD + FOG group (−0.80 ± 0.6) when compared to the PD – FOG group (−0.39 ± 0.3) (p = 0.007), even when controlling for several clinical and demographic features. At T1, the dSE was reduced in the overall study population (p = 0.001), with a more pronounced improvement in the PD + FOG group (T0: −0.80 ± 0.6; T1: −0.23 ± 0.4) when compared to the PD – FOG group (T0: −0.39 ± 0.3; T1: −0.22 ± 0.5) (p = 0.012). At T1, we described in the overall study population an improvement in speed, cadence, stride duration, and stride length (p = 0.001 for all variables). Conclusions: dSE is a core feature of PD gait dysfunction, specifically in patients with FOG. A 4-week intensive rehabilitative program improved dSE in PD patients, exerting a more notable beneficial effect in the PD + FOG group.
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spelling pubmed-84531492021-09-22 The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait Putortì, Alessia Corrado, Michele Avenali, Micol Martinelli, Daniele Allena, Marta Cristina, Silvano Grillo, Valentina Martinis, Luca Tamburin, Stefano Serrao, Mariano Pisani, Antonio Tassorelli, Cristina De Icco, Roberto Front Neurol Neurology Background: The sequence effect (SE), defined as a reduction in amplitude of repetitive movements, is a common clinical feature of Parkinson's disease (PD) and is supposed to be a major contributor to freezing of gait (FOG). During walking, SE manifests as a step-by-step reduction in step length when approaching a turning point or gait destination, resulting in the so-called destination sequence effect (dSE). Previous studies explored the therapeutic effects of several strategies on SE, but none of them evaluated the role of an intensive rehabilitative program. Objectives: Here we aim to study the effects of a 4-week rehabilitative program on dSE in patients with PD with and without FOG. Methods: Forty-three patients (30 males, 70.6 ± 7.5 years old) with idiopathic PD were enrolled. The subjects were divided into two groups: patients with (PD + FOG, n = 23) and without FOG (PD – FOG, n = 20). All patients underwent a standardized 4-week intensive rehabilitation in-hospital program. At hospital admission (T0) and discharge (T1), all subjects were evaluated with an inertial gait analysis for dSE recording. Results: At T0, the dSE was more negative in the PD + FOG group (−0.80 ± 0.6) when compared to the PD – FOG group (−0.39 ± 0.3) (p = 0.007), even when controlling for several clinical and demographic features. At T1, the dSE was reduced in the overall study population (p = 0.001), with a more pronounced improvement in the PD + FOG group (T0: −0.80 ± 0.6; T1: −0.23 ± 0.4) when compared to the PD – FOG group (T0: −0.39 ± 0.3; T1: −0.22 ± 0.5) (p = 0.012). At T1, we described in the overall study population an improvement in speed, cadence, stride duration, and stride length (p = 0.001 for all variables). Conclusions: dSE is a core feature of PD gait dysfunction, specifically in patients with FOG. A 4-week intensive rehabilitative program improved dSE in PD patients, exerting a more notable beneficial effect in the PD + FOG group. Frontiers Media S.A. 2021-09-07 /pmc/articles/PMC8453149/ /pubmed/34557151 http://dx.doi.org/10.3389/fneur.2021.723468 Text en Copyright © 2021 Putortì, Corrado, Avenali, Martinelli, Allena, Cristina, Grillo, Martinis, Tamburin, Serrao, Pisani, Tassorelli and De Icco. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Putortì, Alessia
Corrado, Michele
Avenali, Micol
Martinelli, Daniele
Allena, Marta
Cristina, Silvano
Grillo, Valentina
Martinis, Luca
Tamburin, Stefano
Serrao, Mariano
Pisani, Antonio
Tassorelli, Cristina
De Icco, Roberto
The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title_full The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title_fullStr The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title_full_unstemmed The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title_short The Effects of Intensive Neurorehabilitation on Sequence Effect in Parkinson's Disease Patients With and Without Freezing of Gait
title_sort effects of intensive neurorehabilitation on sequence effect in parkinson's disease patients with and without freezing of gait
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453149/
https://www.ncbi.nlm.nih.gov/pubmed/34557151
http://dx.doi.org/10.3389/fneur.2021.723468
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