title: Multidisciplinary intensive rehabilitation treatment improves sleep quality in Parkinson's disease.
abstract: BACKGROUND
  Sleep disturbances are among the most common non-motor symptoms of Parkinson's disease (PD), greatly interfering with daily activities and diminishing life quality. Pharmacological treatments have not been satisfactory because of side effects and interactions with anti-parkinsonian drugs. While studies have shown that regular exercise improves sleep quality in normal aging, there is no definitive evidence in PD.
  
  
  METHODS
  In a retrospective study, we determined whether an intense physical and multidisciplinary exercise program improves sleep quality in a large group of patients with PD. We analyzed the scores of PD Sleep Scale (PDSS), which was administered twice, 28 days apart, to two groups of patients with PD of comparable age, gender, disease duration and pharmacological treatment. The control group (49 patients) did not receive rehabilitation, The treated group (89 patients) underwent a 28-day multidisciplinary intensive rehabilitation program (three one-hour daily sessions comprising cardiovascular warm-up, relaxation, muscle-stretching, balance and gait training, occupational therapy to improve daily living activities).
  
  
  RESULTS
  At enrolment, control and treated groups had similar UPDRS and PDSS scores. At re-test, 28 days later, UPDRS and total PDSS scores improved in the treated (p < 0.0001) but not in the control group. In particular, the treated group showed significant improvement in PDSS scores for sleep quality, motor symptoms and daytime somnolence. The control group did not show improvement for any item.
  
  
  CONCLUSIONS
  These results suggest that multidisciplinary intensive rehabilitation treatment may have a positive impact on many aspects of sleep in PD.
authors.affiliation: Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy ; Department of Parkinson Rehabilitation, Ospedale Moriggia Pelascini, Via Pelascini 3, Gravedona ed Uniti, Como, 22015 Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
authors.affiliation: Department of Biomedical Engineering, Scientific Institute of Montescano, S. Maugeri Foundation IRCCS, Montescano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Maestri
authors.affiliation: Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Ferrazzoli
authors.affiliation: Center for Parkinson's Disease, Macchi Foundation, Varese and Department of Rehabilitation, "Le Terrazze" Hospital, Cunardo, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Riboldazzi
authors.affiliation: Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica FERB, "S.Isidoro" Hospital, Trescore Balneario, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Bera
authors.affiliation: Department of Physiol. Pharmacol. & Neuroscience, CUNY Medical School, Harris Hall 08, CCNY, 160 Convent Ave, New York, NY 10031 USA ; The Graduate Center, Biology - Neuroscience PhD Program, CUNY, New York, NY USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Fontanesi
authors.affiliation: Department of Physical Medicine & Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ USA ; NYU Movement Disorder Center, New York University, New York, NY USA.
authors.forename: Roger P
authors.initials: RP
authors.lastname: Rossi
authors.affiliation: Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.affiliation: Department of Physiol. Pharmacol. & Neuroscience, CUNY Medical School, Harris Hall 08, CCNY, 160 Convent Ave, New York, NY 10031 USA ; Department of Physical Medicine & Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ USA.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Ghilardi
keywords: PDSS; Plasticity; Rehabilitation; Sleep quality