• Annals of Clinical Neurophysiology
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• v.11 no.1
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• pp.9-15
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• 2009

Background: To investigate the differences of locomotor dynamics between Parkinson's disease (PD) patients with tremor dominant symptom and patients with postural instability dominant symptom. Methods: 66 subjects with PD were classified into two subgroups, tremor-dominant group and postural instability and gait disorder group by Unified Parkinson's disease rating scale (UPDRS). The spatial, temporal and electrodynamic gait parameters were recorded automatically using computerized 3-D motion analysis system with electrogoniometer. Results: There was no significant difference in cadence, pelvic tilt range, hip flexion range, knee flexion range and ankle dorsiflexion range. Postural instability and gait disorder group showed decreased gait velocity, short stride length, decreased range of motion in pelvic obliquity, pelvic rotation and ankle plantar flexion. Conclusions: There was meaningful difference in locomotor dynamics between Parkinson's disease(PD) patients with tremor dominant symptom and patients with postural instability dominant symptom.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

• 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.

• Journal of Sasang Constitutional Medicine
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• v.29 no.2
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• pp.182-201
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• 2017

Objectives Gait disorders are incapacitating symptoms of Parkinson's disease(PD). Here, we report improvements of patients diagnosed with PD treated by Sasang Constitutional Medicine, focused on gait and balance analysis. Methods The patients diagnosed with PD were treated on the basis of Sasang Constitutional Medicine, and their stance and gait status were analyzed by zebris Medical GmbH. To evaluate other general symptoms related with PD, GAS scale, NRS scale, H&Y scale and UPDRS were used. Results Stride length, velocity, stance phase, lateral symmetry were improved in all 6 patients. Other symptoms related to Parkinson's disease were reduced, along with the improvements in GAS scale, NRS scale, H&Y scale and UPDRS score. Conclusion This case study showed Sasang Constitutional Medicine is effective in various symptoms of Parkinson's disease. Especially in regard to the stance and gait status, the improvements were assessed accurately with Gait analysis.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.96-102
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• 2013

Purpose: The purpose of the study was to investigate the effect of a training program using virtual reality on the balance and lower muscular strength of Parkinson's disease patients. Methods: The study included 22 patients with Parkinson's disease who were arbitrarily classified into 2 groups: 11 patients in the experimental group and 11 patients in the control group. Balance was measured with the Berg balance scale (BBS), the functional reach test (FRT), one-leg stance test (OLST), and the timed up and go test (TUG); whereas, lower muscular strength was measured with the sit-to-stand test (STS). Ping-Pong, bowling, and tennis were selected for virtual reality training for the experimental group, and were performed for 30 minutes 3 times a week for 8 weeks. The control group did not undergo any of the virtual reality training programs. Results: A significant difference was observed in the BBS, FRT, OLST, TUG, and STS results within the experimental group that underwent the virtual reality training program. On the other hand, no significant difference was observed in the BBS, FRT, OLST, TUG, and STS values within the control groups. Conclusion: In conclusion, the virtual reality training program positively affects the balance and lower muscular strength in Parkinson's disease patients. This result indicates the possibility of application of the virtual reality training program to the management for Parkinson's disease patients, and highlights the need for the development and application of more efficient virtual reality training programs in the future.

• Research in Community and Public Health Nursing
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• v.27 no.2
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• pp.153-162
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• 2016

Purpose: Music therapy is a non-pharmacological treatment of the behavioral and psychological symptoms. This study was conducted to contribute to the rehabilitation of patients with idiopathic Parkinson's disease in the areas of functionality, emotionality and sociability. Methods: The study included 35 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression, chronic illness anticipated stigma, and worrying about quality of life. The patients were recruited from the department of outpatient neurology at School of Medicine, D University in B Metropolitan City. Group music therapy was performed for nine weeks. The results were analyzed by repeated measures ANOVA. Results: In terms of stigma, there were significant differences between two groups and time (p<.05). Analysis of the interaction between time and service method revealed significant differences (p<.05). Between time, and the interaction between time and service method revealed significant differences in terms of quality of life (p<.05). Conclusion: The results suggest that group music therapy will be effective on the psychosocial well-being of patients with Parkinson's disease living in assisted and independent living communities.

• Korean Journal of Adult Nursing
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• v.27 no.3
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• pp.283-293
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• 2015

Purpose: Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD). Methods: The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. Results: All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. Conclusion: Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.441-451
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• 2015

Objective : The purpose of the study was to investigate and compare the differences between Parkinson's disease rating, balance, fall and gait scales. Results : Parkinson's disease rating scales include the Hoehn-Yahr Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). The Hoehn-Yahr Scale can measure disease rates easily; however it is not sensitive enough to evaluate the disease's process and management. UPDRS's advantage is in it's higher inter-reliability score; however it is more complicated to use. Parkinson's balance scales are comprised of the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence Scale (ABC). BBS has the advantage in that it is cheaper to measure and simple in use. ABC's advantage is especially in it's ability to measure higher functional levels; however it is more difficult measure responses due to scores appearing in both extremes. The Fall Efficacy Scale (FES) and The Survey of Activities and Fear of Falling in the Elderly (SAFE) are Parkinson's fall scales. FES's leverage over SAFE is that it is simpler to measure; however it does not coincide with responses which proves disadvantageous in measuring balance loss in high-level Parkinson's patients. SAFE's advantage is in it's simpler use and ability to be utilized without encountering the fear of fall; however it's at a disadvantage in regards to its use with multilateral aspects providing insufficient inspection. Lastly, the Dynamic Gait Index (DGI) and the Functional Gait Assessment (FGA) are Parkinson's gait scales. DGI is advantageous in its ability to test gait ability when exposed to a variety of external environments; however it is disadvantageous in that it registers higher scores with activities. FGA's advantage is in it's dynamic balance test; however it at a disadvantage with those unable to walk. Conclusion : A researcher of Parkinson's patients must choose each scale while considering their positive and negative characteristics.

• PNF and Movement
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• v.14 no.3
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• pp.219-229
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• 2016

Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.

• The Journal of Korean Physical Therapy
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• v.19 no.5
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• pp.21-28
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• 2007

Purpose: The aims of this study was to evaluate the effects of shoulder lateral rotation and trunk extension exercises on standing posture improvement exercises using turning round in the patients with Parkinson's disease. Methods: For twenty-one patients with Parkinson's disease, shoulder lateral rotation and trunk extension exercises were performed for a total of three sets, ten times a set, three days a week for twelve weeks. To measure turning round, ink foot-print method was used. The number of steps and time were measured every week for before and after study (twelve weeks). Results: The results are as follows: Changes in steps and time on each week during twelve weeks showed significant differences, compared with before test(p<0.05). Conclusion: Standing posture improvement exercises can help perform turning round in the patients with Parkinson's disease.