title: Randomized cross-over trial to investigate the efficacy of a two-week physiotherapy programme with repetitive exercises of cueing to reduce the severity of freezing of gait in patients with Parkinson's disease.
abstract: OBJECTIVE
  To investigate the efficacy of a two-week programme of repetitive exercise with cueing and movement strategies upon freezing of gait in people with Parkinson's disease.
  
  
  METHODS
  Randomized cross-over trial.
  
  
  METHODS
  Specialist clinic for Parkinson's disease.
  
  
  METHODS
  A total of 22 patients with Parkinson's disease and freezing while other symptoms had favorably responded to dopaminergic treatment.
  
  
  METHODS
  Patients were randomized into a four-week cross-over trial, and received either treatment (Group 1) or no treatment (Group 2) during Period 1, and switched during Period 2. Treatment consisted of a two-week programme during which the patients exercised cueing, and movement strategies together with a physiotherapist.
  
  
  METHODS
  The primary outcome measure was a freezing score assessed from blinded and random ratings of video recordings. The secondary outcome measure was a patient-reported freezing questionnaire. Mean differences between the treatment periods (treatment arms) were evaluated for treatment (period) effects. Sums of treatment periods were evaluated for carry-over effects.
  
  
  RESULTS
  The programme led to a significant treatment effect in the freezing score of 3.0 improvement (95% confidence interval 0.9-5.0; p < 0.01). No carry-over or period effects were detected. The questionnaire revealed a period effect, so groups were compared after Period 1, where a significant difference was found (15.0 vs. 11.7; p < 0.05).
  
  
  CONCLUSIONS
  The two-week physiotherapy programme reduced the severity of freezing in patients with Parkinson's disease.
authors.affiliation: Schön Klinik München Schwabing, Munich, Germany.
authors.forename: Urban M
authors.initials: UM
authors.lastname: Fietzek
authors.affiliation: Schön Klinik München Schwabing, Munich, Germany.
authors.forename: Frauke E
authors.initials: FE
authors.lastname: Schroeteler
authors.affiliation: Schön Klinik München Schwabing, Munich, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Ziegler
authors.affiliation: Schön Klinik München Schwabing, Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Zwosta
authors.affiliation: Schön Klinik München Schwabing, Munich, Germany ACeballos-Baumann@schoen-kliniken.de.
authors.forename: Andres O
authors.initials: AO
authors.lastname: Ceballos-Baumann
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D003463:Cues; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D005858:Germany; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000534:rehabilitation*; D012720:Severity of Illness Index
chemical_list: D007980:Levodopa
keywords: Parkinson’s disease; Randomized cross-over trial; freezing; gait; physiotherapy