title: Overground robot assisted gait trainer for the treatment of drug-resistant freezing of gait in Parkinson disease.
abstract: Freezing of Gait (FOG) is a frequent and disabling feature of Parkinson disease (PD). Gait rehabilitation assisted by electromechanical devices, such as training on treadmill associated with sensory cues or assisted by gait orthosis have been shown to improve FOG. Overground robot assisted gait training (RGT) has been recently tested in patients with PD with improvement of several gait parameters. We here evaluated the effectiveness of RGT on FOG severity and gait abnormalities in PD patients. Eighteen patients with FOG resistant to dopaminergic medications were treated with 15 sessions of RGT and underwent an extensive clinical evaluation before and after treatment. The main outcome measures were FOG questionnaire (FOGQ) global score and specific tasks for gait assessment, namely 10 meter walking test (10 MWT), Timed Up and Go test (TUG) and 360° narrow turns (360 NT). Balance was also evaluated through Fear of Falling Efficacy Scale (FFES), assessing self perceived stability and Berg Balance Scale (BBS), for objective examination. After treatment, FOGQ score was significantly reduced (P=0.023). We also found a significant reduction of time needed to complete TUG, 10 MWT, and 360 NT (P=0.009, 0.004 and 0.04, respectively). By contrast the number of steps and the number of freezing episodes recorded at each gait task did not change. FFES and BBS scores also improved, with positive repercussions on performance on daily activity and quality of life. Our results indicate that RGT is a useful strategy for the treatment of drug refractory FOG.
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy. Electronic address: manupill@yahoo.it.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pilleri
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Weis
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Zabeo
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Koutsikos
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Biundo
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Facchini
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Rehabilitation Unit, Department of Neurosciences, University of Padova, via Giustiniani 1, 35128 Padova, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: Department of Parkinson disease, IRCCS San Camillo, Via Alberoni 70, Venice-Lido, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D012371:Robotics; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents
keywords: Balance; Freezing of gait; Gait; Parkinson disease; Rehabilitation; Robot assisted gait trainer