Effectiveness of an intensive rehabilitation treatment on different Parkinson's disease subtypes.
Parkinsonian patients can be classified in two main subgroups: tremor dominant and akinetic-rigid. The aim of this study was to evaluate whether intensive rehabilitation treatment has the same efficacy in the two subtypes.


METHODS
Patients were classified according to tremor: 65 patients with absence of tremor in "on" and "off" state were assigned to Group_1 and 65 patients with tremor were assigned to Group_2. All patients underwent a 4-week intensive multidisciplinary rehabilitation treatment. The primary outcome measures were: the Unified Parkinson's Disease Rating Scale (UPDRS) II, III, UPDRS akinetic-rigid score and UPDRS tremor score. The secondary outcome measures were: the Berg Balance Scale, 6-minute walking test, self-assessment Parkinson's Disease Disability Scale, Abnormal Involuntary Movement Scale, Freezing of Gait Questionnaire.


RESULTS
Patients in Group_1 tended to be more affected than patients in Group_2 by dyskinesias (45% vs 29% p = 0.069) and freezing (46% vs 29%, p = 0.046). Levodopa-equivalent dosages were higher in Group_1 (802 vs 670 mg/day, p = 0.008). Considering the effect of rehabilitation, an homogeneous improvement was observed in all variables in both groups of patients (p < 0.0001).


CONCLUSIONS
Intensive rehabilitation treatment is effective in improving motor performance in both groups. The anatomical and biochemical differences existing between the two subgroups appear to not determine different clinical outcomes.
Department of Neurorehabilitation, Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy.
Giuseppe
G
Frazzitta
Giovanni
G
Abbruzzese
Gabriella
G
Bertotti
Natalia
N
Boveri
Gianni
G
Pezzoli
Roberto
R
Maestri
D000368:Aged; D005081:Exercise Therapy; D006801:Humans; D010300:Parkinson Disease / Q000145:classification* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016896:Treatment Outcome
Parkinson's disease; akinetic-rigid; rehabilitation; tremor