Authors (including presenting author) :
Lau MY(1), Tsang NW(1), Chung HT(1), Yeung HM(2), Chan WL(2), Lau WK(1), Chan PY(1)
Affiliation :
(1)Physiotherapy Department, Alice Ho Miu Ling Nethersole Hospital
(2)Department of Neurology, Alice Ho Miu Ling Nethersole Hospital
Introduction :
PD is a neurodegenerative disease with motor manifestations. Despite optimal medical treatment, patients experience deterioration of body function. Physiotherapy is prescribed as non-pharmacological management. A systematic review recommended that physiotherapy should address the disorder through six specific cores (gait, transfer, balance, posture, reaching and grasping, and physical capacity), which are impractical in outpatient setting. Owing to training complexity and specificity, a PD specific CTP was designed.
Objectives :
1. To evaluate if CTP could improve gait speed and gait endurance, and reduce fall risk in PD patients.
Methodology :
CTP comprised of different stations tackling specific motor problems in PD patients, including high-intensity gait training and dual-tasking training to improve gait; cognitive movement strategies, limbs-truncal strengthening exercise to improve transfer, posture and physical capacity; obstacle course with different elements to improve balance, reaching and grasping.
A prospective, pretest-posttest interventional study was employed. Patients were referred from neurologists of Alice Ho Miu Ling Nethersole Hospital. The duration of study was 6 months, including baseline evaluation, eight weeks of CTP, evaluation immediately after CTP and evaluation 6 months after CTP. A two-tailed paired t-test was conducted for statistical analysis.
Result & Outcome :
25 PD patients were recruited with 2 drop out from 2017 to 2019. There were significant increase in self-selected speed of 10-metre Walk Test (10MWT) by 18.7%(1.05m/s, p=0.0001) immediately after CTP and 25.6%(1.11m/s, p=0.0002) 6months after CTP. There were also significant increase in fast speed of 10MWT by 22.7%(1.38m/s, p< 0.0001) immediately after CTP and 31.4%(1.48m/s, p< 0.0001) 6months after CTP. The Timed Up And Go Test (TUGT) were reduced by 22.7%(18.9s, p=0.005) immediately after CTP and 30.8%(16.9s, p=0.116) 6months after CTP. The Five Times Sit-to-Stand Test (5XSST) were reduced by 28.5%(20.2s, p=0.08) immediately after CTP and 30.0%(19.9s, p=0.017) 6months after CTP. The 6-minute Walk Test were significantly increased by 48.1%(418m, p< 0.0001) immediately after CTP and 42.2%(401m, p< 0.0001) 6months after CTP.
