• Title/Summary/Keyword: Hoehn-Yahr stage

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

  • Kim, Eun-ji;Song, Ho-joon;Kim, Hyun-ho;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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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.

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

  • Kim, Sang Hee;Lee, Eun Nam;Park, Eun Young;Kim, Jae Woo
    • Journal of muscle and joint health
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    • v.19 no.3
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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.

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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    • v.17 no.2
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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.

Effects of the Team Approach Rehabilitation Program on Balance, Gait, and Muscle Strength of Lower Extremities for Elderly Patients with Parkinson's Disease (팀 접근 재활프로그램이 노인 파킨슨병 환자의 균형, 보행 및 하지근력에 미치는 효과)

  • Choi, Jin-Young;Jo, Hyun Sook
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.199-206
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    • 2019
  • Purpose: The purpose of this paper was to verify effects of the team approach rehabilitation program on balance, gait, and muscle strength of lower extremities of elderly people with Parkinson's disease. Method: Subjects of this paper were 40 elderly people with Parkinson's disease, 20 control and experimental groups respectively, who could walk independently and were less than the 2.5 Hoehn &Yahr stage. The team approach rehabilitation program was applied to the experimental group for 12 weeks. Results: There was significant decrease in second at timed up &go test (p= .008), but no significant difference in reach length at functional reach test (p= .201) with partial improvement of balance. There was no significant difference in second at 10-meter walk test (p= .070), but showed tendency of improvement of gait. And number of times at 30s-chair stand test, indicating muscle strength on lower extremities, increased significantly (p= .029), Conclusion: The team approach rehabilitation program has demonstrated its effectiveness on improving balance, and muscle strength of lower extremities for the elderly with Parkinson's disease.

The Study on the Characteristics of Yangdorak in the Patients with Idiopathic Parkinson's Disease (특발성 파킨슨병 환자의 양도락 특성에 관한 연구)

  • Bang, Jun-Kyu;Park, Yeon-Cheol;Lee, Sang-Hoon;Chang, Dae-Il;Lee, Yun-Ho
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.153-164
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    • 2006
  • Introduction : The Aim of the Study Is to Investigate the Characteristics of Yangdorak m the Patients with Idiopathic Parkinson's Disease. Methods : Subjects Were Voluntarily Recruited by Newspapers And Internet. All the Subjects Were Confirmed as Idiopathic Parkinson's Disease by a Neurologist. The Patient's Symptoms Were Assessed by Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn-Yahr (H-Y) Stage, Schwab & England Activity of Daily Living And Freezing of Gait Questionnaire(FOGQ). Sasang Constitution Was Differentiated by QSCCII. Yangdorak Was Measured after 15 minutes' Bed Rest Results : The Results Were as Follows; 1. The Average Value of Yangdorak m 50 Patients with Parkinson's Disease Was $39.01{\pm}17.97$. 2. The Mean Values of Fl, F2, F3, F4, F5 and F6 were under 40. 3. The Number of Pyesaek Was Significantly Increased According to H-Y Stage. 4. The Yangdorak Value Had No Significant Correlation between UPDRS, H-Y Stage and Duration. 5. There Was No Significant Difference in the Value of Yangdorak among Sasang Constitutions. Conclusion : This Study Suggests that Yangdorak Can Be Used as a Assistant Tool to Investigate the Patients of Parkinson's Disease. Further Study on the Yangdorak And Parkinson's Disease Is Recommended.

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Correlations among Respiratory Function, UPDRS and Senior Fitness in Parkinson's Disease Patients (파킨슨병환자의 호흡기능, UPDRS 및 Senior Fitness의 관련성)

  • Kang, Dong-Yeon;Cheon, Sang-Myung;Cheon, Sang-Myung;Lee, Kyung-Soon;Kim, Kyoung
    • The Journal of Korean Physical Therapy
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    • v.26 no.2
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    • pp.48-55
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    • 2014
  • Purpose: The purpose of this study was to examine correlations among UPDRS, respiratory function, and senior fitness and to investigate the effects of restrictive respiratory function on these factors in Parkinson's disease patients. Methods: Subjects (n=25, Hoehn & Yahr (H&Y) stage: 2-3, $69.3{\pm}5.9$ yrs) from D Hospital Parkinson's Disease Center at Busan metropolitan area in the Republic of Korea volunteered for this study. They performed the pulmonary function test, UPDRS, and the senior fitness test. SPSS 18.0 was used for analysis of data, and the collected data were analyzed using Pearson's correlation coefficient (n=25). In addition, Independent t-test was used for determination of differences between two groups (between the normal pulmonary function group (n=10) and the restrictive pulmonary function group (n=10)). Results: Forced vital capacity (FVC (L)) showed significant negative correlation (r=-0.44, p<0.05) with H&Y stage in Parkinson's disease patients, and chair stand showed significant negative correlations (r=0.41, 0.43, 0.42, p<0.05) with FVC (L), FVC (%), and FEV1 (L). FVC (%) showed significant positive correlations (r=0.44, r=0.44, p<0.05) with right and left back scratch. In addition, the restrictive respiratory function group showed significantly lower FVC (%) (p<0.01) and was significantly slower (p<0.05) in the 8-foot up-and-go test than the normal respiratory function group. Conclusion: In conclusion, these results suggest that restrictive respiratory function in PD was related to H&Y stage. In addition, agility of PD patients was lower in the restrictive respiratory function group than in the normal function group.

Sleep Disturbances in Patients with Parkinson's Disease according to Disease Severity (파킨슨병의 중증도에 따른 수면 장애)

  • Lee, Su-Yun;Cheon, Sang-Myung;Kim, Jae Woo
    • Annals of Clinical Neurophysiology
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    • v.17 no.1
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    • pp.17-23
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    • 2015
  • Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

A case of tremor in Parkinson's disease treated with Korean medicine (파킨슨병으로 유발된 진전이 한약 치료를 통하여 호전된 치험 1례)

  • Kim, Jin-Won;Kim, Byung-Chul;Woo, Sung-Ho;Na, Yu-Jin;Shim, Hyo-Ju;Lee, Won-Hui;Lee, Ji-Young;Seo, Ho-Seok;Kim, Yong-Ho;Jeong, Byeong-Ju
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.954-961
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    • 2006
  • As society ages, the seriousness of Parkinson's disease in the elderly increases. This study was performed in order to evaluate the effect of Korean medical treatments on Parkinson's symptoms. An elderly patient was diagnosed with Parkinson's disease by clinical symptoms, which were resting tremor, pill-rolling tremor and mild bradykinesia. We treated her disease with Korean medical treatment, including herbal medicine and acupuncture therapy and excluding western medication. For the herbal medicine, Insamyangyeong-tang (人參養榮湯), Bobi-tang (補脾湯), Dokhwaljihwang-tang (獨活地黃湯) and Sipimijihwang-tang (十二味地黃湯) were primarily used. In result, the clinical symptoms, measured by unified Parkinson's disease rating scale (UPDRS) and modified Hoehn and Yahr stage (H-Y stage), of Parkinson's disease in this patient had improved after the Korean medical treatment. This study suggests that Korean medical treatments can be applicable to improve symptoms in patients with Parkinson's disease.

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Effects of Sagittal Spinopelvic Alignment on Motor Symptom and Respiratory Function in Mild to Moderate Parkinson's disease

  • Kang, DongYeon;Cheon, SangMyung;Son, MinJi;Sung, HyeRyun;Lee, HyeYoung
    • The Journal of Korean Physical Therapy
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    • v.31 no.2
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    • pp.122-128
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    • 2019
  • Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.

Predicting Factors on Fatigue in Patients with Parkinson's Disease (파킨슨병 환자의 피로와 영향요인)

  • Kim, Sung-Reul;Chung, Sun-Ju;Yu, Soo-Yeon;Kim, Mi-Sun;Park, En-Ok;Shin, Nah-Mee;Lee, Sook-Ja
    • Korean Journal of Adult Nursing
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    • v.23 no.4
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    • pp.363-373
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    • 2011
  • Purpose: Fatigue is a common problem in Parkinson's disease (PD), affecting 30~65% of patients with that diagnosis. Only recently has fatigue been recognized as an important clinical feature of PD. The aim of this study was to investigate the level of fatigue and related factors in patients with PD. Methods: Between March 1, and September, 30, 2010, a sample of 181 PD patients agreed to be interviewed. Results: The female patients' PFS (Parkinson Fatigue Scale) score was higher than those of the male patients. Household income and having a Job were significantly correlated with the PFS scores. Among the disease characteristics, motor fluctuations, dyskinesia and modified Hoehn and Yahr stage were significantly correlated with the PFS scores. On stepwise regression analysis, the most important factors related to the PFS scores were depression and sleep disturbance. Conclusion: Fatigue in patients with PD was associated with many factors and strongly associated with depression and sleep disturbance. Fatigue is a multidimensional construct; therefore, multidimensional strategies for relieving specific aspects of fatigue are needed.