title: Effectiveness of intensive inpatient rehabilitation treatment on disease progression in parkinsonian patients: a randomized controlled trial with 1-year follow-up.
abstract: BACKGROUND
  Rehabilitation treatments have acute beneficial effects in Parkinson's disease (PD) patients, but whether the effects persist over time is unclear.
  
  
  OBJECTIVE
  To assess whether an intensive rehabilitation treatment (IRT) is effective in improving motor performance compared with a control group in a 12-month follow-up, to investigate whether a second cycle administered after 1 year has the same efficacy as the first treatment, and to determine whether IRT reduces the need for increasing levodopa dosage.
  
  
  METHODS
  A total of 50 PD patients were randomly assigned to 2 groups; 25 participants had 4 weeks of inpatient physical therapy that included treadmill and stabilometric platform training. At discharge, these patients were invited to continue doing the learned exercises. After 12 months, the same treatment was repeated. The control group of 25 patients received only pharmacological treatment and was invited to practice generic physical exercise at home. The rating scales used for the clinical evaluation were the Unified Parkinson's Disease Rating Scale Sections II and III (UPDRS II and III) and total (UPDRS tot).
  
  
  RESULTS
  The authors found that the beneficial effects of IRT persisted over time. A second rehabilitation cycle administered after 1 year was as effective as the first treatment. At the end of the study, daily medication dosage was reduced in treated patients, whereas it was significantly increased in control patients.
  
  
  CONCLUSIONS
  These findings suggest that the natural worsening of symptoms associated with PD can be effectively counteracted by a properly designed IRT.
authors.affiliation: Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy. giuseppe.frazzitta@fsm.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
authors.forename: Gabriella
authors.initials: G
authors.lastname: Bertotti
authors.forename: Giulio
authors.initials: G
authors.lastname: Riboldazzi
authors.forename: Marinella
authors.initials: M
authors.lastname: Turla
authors.forename: Davide
authors.initials: D
authors.lastname: Uccellini
authors.forename: Natalia
authors.initials: N
authors.lastname: Boveri
authors.forename: Gabriele
authors.initials: G
authors.lastname: Guaglio
authors.forename: Michele
authors.initials: M
authors.lastname: Perini
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Comi
authors.forename: Pietro
authors.initials: P
authors.lastname: Balbi
authors.forename: Roberto
authors.initials: R
authors.lastname: Maestri
mesh_terms: D000161:Acoustic Stimulation; D000203:Activities of Daily Living; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D003463:Cues; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000534:rehabilitation*; D010775:Photic Stimulation; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa