title: Long-term effects of automated mechanical peripheral stimulation on gait patterns of patients with Parkinson's disease.
abstract: New treatments based on peripheral stimulation of the sensory-motor system have been inspiring new rehabilitation approaches in Parkinson's disease (PD), especially to reduce gait impairment, levodopa washout effects, and the incidence of falls. The aim of this study was to evaluate the change in gait and the clinical status of PD patients after six sessions of a treatment based on automated mechanical peripheral stimulation (AMPS). Eighteen patients with PD and 15 age-matched healthy individuals (control group) participated in this study. A dedicated medical device delivered the AMPS. PD patients were treated with AMPS six times once every 4 days. All PD patients were treated in the off-levodopa phase and were evaluated with gait analysis before and after the first intervention (acute phase), after the sixth intervention, 48 h after the sixth intervention, and 10 days after the end of the treatment. To compare the differences among the AMPS interventions (pre, 6 AMPS, and 10 days) in terms of clinical scales, a t-test was used (α≤0.05). In addition, to compare the differences among the AMPS interventions (pre, post, 6 AMPS, 48 h and 10 days), the gait spatiotemporal parameters were analyzed using the Friedman test and the Bonferroni post-hoc test (α≤0.05). Also, for comparisons between the PD group and the control group, the gait spatiotemporal parameters were analyzed using the Mann-Whitney test and the Bonferroni post-hoc test (α≤0.05). The results of the study indicate that the AMPS treatment has a positive effect on bradykinesia because it improves walking velocity, has a positive effect on the step and stride length, and has a positive effect on walking stability, measured by the increase in stride length. These results are consistent with the improvements measured with clinical scales. These findings indicate that AMPS treatment seems to generate a more stable walking pattern in PD patients, reducing the well-known gait impairment that is typical of PD; regular repetition every 4 days of AMPS treatment appears to be able to improve gait parameters, to restore rhythmicity, and to reduce the risk of falls, with benefits maintained up to 10 days after the last treatment. The trial was registered online at ClinicalTrials.gov (number identifier: NCT0181528).
authors.affiliation: aDepartment of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome bDepartment of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy cMovement Analysis and Neuroscience-Neurological Rehabilitation Laboratories, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil dSan Raffaele Cassino Hospital, Tosinvest Sanità, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stocchi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Sale
authors.forename: Ana F R
authors.initials: AF
authors.lastname: Kleiner
authors.forename: Miriam
authors.initials: M
authors.lastname: Casali
authors.forename: Veronica
authors.initials: V
authors.lastname: Cimolin
authors.forename: Francesca
authors.initials: F
authors.lastname: de Pandis
authors.forename: Giorgio
authors.initials: G
authors.lastname: Albertini
authors.forename: Manuela
authors.initials: M
authors.lastname: Galli
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D004599:Electric Stimulation Therapy; D005260:Female; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000534:rehabilitation*