• 제목/요약/키워드: Hoehn and Yahr scale

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The Effects of Walking and Turning and Treadmill Training on Postural Balance and Walking in People with Parkinson's Disease

  • Bang, Dae-Hyouk;Jeong, Wang-Mo
    • PNF and Movement
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    • 제17권2호
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    • pp.189-197
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    • 2019
  • Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson's disease (PD). Methods: Twenty-four participants with Stage 1 to 3 ($2.13{\pm}0.64$) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson's disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081-6.519), BBS (p = 0.042; 95% CI, 1.375-4.541), TUG (p = 0.034; 95% CI, -3.315--0.143), 10MWT (p = 0.011; 95% CI, -2.032--0.289), and 6MWT (p = 0.002; 95% CI, 24.39-91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

동적탄력튜빙 보행훈련 프로그램이 만성 파킨슨병 환자의 자세정렬과 보행능력과 삶의 질에 미치는 영향 : 사례연구 (Effects of Dynamic Tubing Gait Training on Postural Alignment, Gait, and Quality of Life in Chronic Patients with Parkinson's Disease : Case Study)

  • 이동률
    • 한국엔터테인먼트산업학회논문지
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    • 제15권8호
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    • pp.363-377
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    • 2021
  • 본 연구에서는 만성 파킨슨병 환자의 동적탄력튜빙 보행 훈련 (I, II)이 자세정렬, 보행, 삶의 질에 미치는 영향을 조사하였다. 총 3명의 만성 파킨슨병 환자를 모집하여 사례 연구를 시행하였다(Hoehn 및 Yahr 1-3단계 각 1명). 동적탄력튜빙 보행 훈련 (I 및 II)은 파킨슨병 환자에게 하루 30분, 주 5일, 5주 동안 25세션 적용되었다. 본 연구의 효과를 알아보기 위해, 자세정렬검사, 근 활성도검사, 보행분석 및 파킨슨병 환자의 삶의 질을 평가하였다. Dynamic tubing 보행 훈련(I, II) 중재 후 몸통 굽힘은 감소되었다. 또한 초기 접촉기(IC)에서 중간 디딤기(Mst)까지 보행 시 넙다리네갈래근, 뒤넙다리근, 앞정강근(TA)의 근 활성도가 증가하고 장딴지근의 근활성도가 감소하였다. 척추세움근(ES T12, L3)의 근활성도는 H&Y I, III 단계에서 증가하고 H&Y II 단계에서 감소하였다. 압력 중심(COP) 매개변수인 보행선의 길이, 한 발 지지선, 앞/뒤 위치, 좌우대칭 값이 개선되었다. 시공간 보행 매개변수인 보폭, 보폭, 의 속도는 증가하고 분당걸음수는 감소되었다. 나아가 파킨슨 병 환자의 삶의 질도 개선되었다. 이러한 연구 결과를 바탕으로 동적탄력튜빙 보행 훈련 (I 및 II)은 약물 내성이 절반으로 감소된 5년 이상된 만성 파킨슨병 환자의 자세, 보행, 삶의 질을 개선하기 위한 새로운 접근 방식으로 적용될 수 있을 것이다.

파킨슨씨병 환자에서 편측 담창구파괴술의 효과 (Efficacy of Unilateral Pallidotomy for Parkinson's Diesease)

  • 조우진;이경진;지철;박성찬;박해관;조정기;조경근;나형균;강준기;최창락
    • Journal of Korean Neurosurgical Society
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    • 제30권8호
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    • pp.976-980
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    • 2001
  • Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.

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특발성 파킨슨 환자에서 경혈(經穴)에 따른 침(鍼) 치료 효과의 비교 연구 (The Study on the Effect of Acupuncture Treatment in Patients with Idiopathic Parkinson's Disease)

  • 박연철;장대일;이윤호;박동석
    • Journal of Acupuncture Research
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    • 제24권4호
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    • pp.43-54
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    • 2007
  • Objectives : This study was designed to evaluate the effect of acupuncture with various scales on symptoms of Idiopathic Parkinson's disease. Methods: Subjects were voluntarily recruited through newspapers and internet advertisement. All the subjects were confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 4 weeks by oriental medical doctor at Kyung-hee University hospital. Patients were randomly assigned to three groups : sham acupuncture group, acupuncture treatment group and Sasang-Constitution acupuncture treatment group. Acupun cture points used in acupuncture treatment group were $GB_{34}$, $LR_3$, and $ST_{36}$, which were proven to be effective in rat Parkinson's disease study. Acupuncture points used in sham treatment were non-acupoints near $GB_{34}$, $LR_3$, and $ST_{36}$. In Sasang-Constitution acupuncture treatment, we classfied Sasang constitution of patients by QSCCII. Acupuncture was applied based on theory of Korean medicine. The patient's symptoms were assessed at baseline and after 4 weeks of treatment by one evaluator with Unified Kingdom Parkinson's Disease Rating Scale (UPDRS), modified Hoehn-Yahr(H-Y) stage, and Schwab & England activ ity of daily living and freezing of gait questionnaire (FOGQ). Results : The results were as follows ; 1. UPDRS IV score differences between sham group and Sasang-Constitution acupuncture treatment were statistically significant(p=0.001). 2. UPDRS total score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.041, p=0.014). 5. FOGQ score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.001, p=0.001). Conclusion : The results suggest Sasang-Constitution acupuncture treatment can be applicable to improve symptoms in patients with idiopathic Parkinson's disease.

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파킨슨병 환자의 골밀도 영향요인 (Factors Affecting Bone Mineral Density of the Femur in Parkinson's Disease Patients)

  • 김상희;이은남;박은영;김재우
    • 근관절건강학회지
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    • 제19권3호
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    • pp.350-361
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    • 2012
  • Purpose: The purpose of this study is to explore the level of bone mineral densities of the femur neck and to identify factors affecting bone mineral density of the femur in Parkinson's disease (PD) patients. Methods: Participants were 121 PD patients visiting the outpatient clinic of D University Hospital in B City. Bone mineral density was measured at the femur neck by using a dual-energy x-ray absorptiometry. The serum vitamin D level, the amounts of milk intake, caffeine intake, cigaret smoking, and alcohol consumption, and the number of steps taken daily were measured. Past and present disease history, the medication history, and duration of the disease were also collected. The level of disability was obtained by neurologists using the Hoehn and Yahr stage and the Unified Parkinson's Disease Rating Scale. Results: Among PD patients, 57% had osteopenia and 15.7% had osteoporosis. The bone mineral density of the femur was associated with weight, serum vitamin D level, age, and working status. Conclusion: The identification of weight and serum vitamin D level as important predictive factors emphasizes the importance of balanced nutrition for PD patients.

파킨슨병 환자의 삶의 질과 가족지지 관련요인 분석 (An Analytical Study on Quality of Life and family Support of Patients with Parkinson's Disease)

  • 송경애;이광수;최동원
    • 기본간호학회지
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    • 제12권2호
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    • pp.231-239
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    • 2005
  • Purpose: Investigation of the quality of life (QoL), family support and associated variables in patients with Parkinson's disease. Methods: The data were collected from 102 patients registered in the neurology department of C University Hospital. QoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39) and Family Support Scale. Modified Hoehn and Yahr (H & Y) stages were obtained from an interview and clinical examination by a neurologist. Collected data were analyzed using the SAS program. Results: The participants' PDQ-39 average score was 34.34. The scores were significantly higher for participants who were older, who had a job and who were over 2.5 on the H & Y stage. The average for Family support scores was 41.6. Participants who had a living spouse, religion and a job scored higher than those who did not. PDQ-39 score had a positive correlation with age, job, and H & Y stage. Family support and PDQ-39 score were also positively correlated. Conclusion: It is recommended a program involving family that improves family support and be developed and that it be varied according to different H & Y stages, in order to improve QoL.

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조등산(Diaoteng-san, Choto-san, 釣藤散)과 GB34(陽陵泉) 전침치료를 활용한 약인성파킨슨증후군 환자의 증례 1례 (A Case Report of Drug-Induced Parkinsonism Treated with Jodeung-san and Electro-acupuncture at GB34)

  • 김은지;송호준;김현호;한양희;임정태
    • 대한한방내과학회지
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    • 제38권5호
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    • pp.600-609
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    • 2017
  • Drug-induced Parkinsonism is the most frequently observed type among the cases of secondary Parkinsonism. Besides typical parkinsonian symptoms, such as tremor, rigidity and bradykinesia, drug-induced Parkinsonism manifests with additional simultaneous symptoms like orobuccolingual dyskinesia, mixed type of tremor (resting, action), and symmetry of expressions. We present a case of drug-induced Parkinsonism, affected by taking the antiulcer drug cimetidine. Jodeung-san extract (Choto-san, Tsumura Co. 10) was administered for 7 days and acupuncture (electronic, auricular, pharmacopuncture) was conducted 3 times. The clinical outcomes were then evaluated through the patient's global impression of change, visual analogue scale, and Hoehn and Yahr stage. After the treatment, the clinical features, such as tremor and orobuccolingual dyskinesia, disappeared. The combination of Jodeung-san and electro-acupuncture at GB34 could therefore be a remedy for the patients with drug-induced Parkinsonism.

Evaluation of Gait Assistive Devices in Patients with Parkinson's Disease

  • Kim, Mi-Young;Lim, Bee-Oh
    • 한국운동역학회지
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    • 제26권3호
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    • pp.309-314
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    • 2016
  • Objective: There are no guidelines for choosing appropriate gait assistive devices. The aim of this study was to evaluate gait assistive devices in patients with Parkinson's disease. Method: We evaluated 15 individuals with Parkinson's disease who did or did not use one of two different devices including canes and two-wheeled walkers. Data were collected using the GAITRite system. Results: Participants in the group using canes and two-wheeled walkers had significantly increased double support time and decreased gait velocity, normalized gait velocity, and stride length compared with those who did not. Participants who used a two-wheeled walker had significantly decreased gait velocity, normalized gait velocity, and stride length compared with those who used a cane. Furthermore, participants who used a two-wheeled walker had significantly decreased coefficients of variation for step time, stride length, and swing time compared with those who used a cane. Conclusion: Our results indicated that the two-wheeled walker offered the most consistent advantages for decreasing the risk of falling.

The phenomenology of pain in Parkinson's disease

  • Camacho-Conde, Jose Antonio;Campos-Arillo, Victor Manuel
    • The Korean Journal of Pain
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    • 제33권1호
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    • pp.90-96
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    • 2020
  • Background: Parkinson's disease (PD) is a neurodegenerative disorder that is the second most common disorder after Alzheimer's disease. PD includes both "motor" and "non-motor" symptoms, one of which is pain. The aim of this study was to investigate the clinical characteristics of pain in patients with PD. Methods: This cross-sectional study included 250 patients diagnosed with PD, 70% of which had mild to moderate PD (stages 2/3 of Hoehn and Yahr scale). The average age was 67.4 years, and the average duration since PD diagnosis was 7.1 years. Relevant data collected from PD patients were obtained from their personal medical history. Results: The prevalence of pain was found to be high (82%), with most patients (79.2%) relating their pain to PD. Disease duration was correlated with the frequency of intense pain (R: 0.393; P < 0.05). PD pain is most frequently perceived as an electrical current (64%), and two pain varieties were most prevalent (2.60 ± 0.63). Our findings confirm links between pain, its evolution over time, its multi-modal character, the wide variety of symptoms of PD, and the female sex. Conclusions: Our results demonstrated that the pain felt by PD patients is mainly felt as an electrical current, which contrasts with other studies where the pain is described as burning and itching. Our classification is innovative because it is based on anatomy, whereas those of other authors were based on syndromes.

파킨슨병 환자의 진전이 한의학적 치료로 호전된 치험 1례 (A Case of Tremor in Parkinson's Disease Treated with Korean Medicine)

  • 김은지;황동규;최기훈;홍은기
    • 대한한방내과학회지
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    • 제38권2호
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    • pp.103-109
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    • 2017
  • Objective: To describe the effects of traditional Korean medicine (TKM) on a patient diagnosed with Parkinson's disease. Methods: The patient was treated with Korean medicine, including pharmacopuncture, acupuncture, and Chungpajunsin-bang. The Unified Parkinson's Disease Rating Scale (UPDRS) and modified Hoehn and Yahr staging (H-Y stage) were used to measure changes in amplitude and improvements in the patient's symptoms. Results: After treatment with the Korean medicine, according to the UPDRS and H-Y stage assessments, the patient's tremor improved, with the tremor amplitude decreasing from 30 cm to 5 cm. Conclusions: We suggest that TKM could be effective in reducing tremor in Parkinson's disease.