The effects of combined glucosamine sulfate and chondroitin sulfate supplements on condylar cartilage remodeling during functional appliance therapy. A Micro-CT study.

Glucosamine and chondroitin sulphate supplementation is used to prevent the degeneration of articular surfaces and also to enhance repair and regeneration of cartilage. The ability for adaptation of condylar cartilage to mandibular forward positioning is what constitutes the fundamental rationale for orthodontic functional therapy, which partially contributes to the correction of jaw discrepancies in growing Skeletal II mandibular retrusive patients. The purpose of this study was to qualitatively and quantitatively analyse the effect of Glucosamine sulphate (GS) and Chondroitin sulphate (CS) supplementation on condylar remodeling with functional appliance therapy in rats. One hundred and forty 3-week-old female Sprague-Dawley rats were randomly divided into 4 groups consisting of; baseline controls, supplementation only, functional appliances only and those receiving both supplements and functional appliances. Supplements were preloaded for a period of 2 weeks prior to the placement of functional appliances at five weeks of age. The animals were sacrificed at days 0, 7 and 21 after appliance placement. The appliances were removed in the remaining experimental animals on day 21 with sacrifice on day 28 to analyse post growth modification changes. Condylar samples were then soaked in 0.2 M Gadolinium Chloride (GdCl3) (aq) for 6 days and analyzed using micro-computed tomography (μCT) for morphological characteristics and linear and volumetric measurements of the mandibular condyle. The results demonstrated supplement therapy increased the volume of cartilage with and without functional appliance therapy. Functional appliance therapy alone resulted in increases in cartilage volume over untreated animals, with peak volume increases occurring by day 7 of appliance wear followed with decreases as endochondral ossification ensued. Supplement therapy was found to enhance the normal biological response to functional appliance therapy in the rat model

Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson's Disease

Dual-task training is gaining ground as a physical therapy intervention in people with Parkinson's disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of dual-task measures in patients with PD remains largely unknown.status: publishe

Dual tasking in Parkinson's disease: should we train hazardous behavior?

Dual-task (DT) circumstances aggravate gait disorders in Parkinson's disease (PD) and are associated with an increased risk of falling and reduced functional mobility. Clinical rehabilitation guidelines for PD consider DT interventions as potentially hazardous and recommend avoiding them in daily life. The current article challenges this notion and addresses the necessity of implementing DT training in PD. First, underlying reasons for DT interference in PD and current theoretical models are discussed. Subsequently, different training approaches to tackle DT difficulties are put forward. Finally, the effectiveness and limitations of DT training in PD are reviewed. We conclude that there is a need for DT interventions in PD and recommend randomized, power-based studies to further test their efficacy.peerreview_statement: The publishing and review policy for this title is described in its Aims & Scope. aims_and_scope_url: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=iern20status: publishe

Are factors related to dual-task performance in people with Parkinson's disease dependent on the type of dual task?

Impaired dual-task performance significantly impacts upon functional mobility in people with Parkinson's disease (PD). The aim of this study was to identify determinants of dual-task performance in people with PD in three different dual tasks to assess their possible task-dependency.publisher: Elsevier articletitle: Are factors related to dual-task performance in people with Parkinson's disease dependent on the type of dual task? journaltitle: Parkinsonism & Related Disorders articlelink: http://dx.doi.org/10.1016/j.parkreldis.2015.11.020 content_type: article copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.status: publishe

Training dual tasks together or apart in Parkinson's disease: Results from the DUALITY trial

Many controversies surround the usefulness of dual-task training in Parkinson's disease (PD). This study (1) compared the efficacy of two different dual-task training programs for improving dual-task gait and (2) assessed the possible fall risk of such training.status: publishe

Efficacy of community-based physiotherapy networks for patients with Parkinson's disease: a cluster-randomised trial.

Contains fulltext : 88714.pdf (publisher's version ) (Closed access)BACKGROUND: Many patients with Parkinson's disease are treated with physiotherapy. We have developed a community-based professional network (ParkinsonNet) that involves training of a selected number of expert physiotherapists to work according to evidence-based recommendations, and structured referrals to these trained physiotherapists to increase the numbers of patients they treat. We aimed to assess the efficacy of this approach for improving health-care outcomes. METHODS: Between February, 2005, and August, 2007, we did a cluster-randomised trial with 16 clusters (defined as community hospitals and their catchment area). Clusters were randomly allocated by use of a variance minimisation algorithm to ParkinsonNet care (n=8) or usual care (n=8). Patients were assessed at baseline and at 8, 16, and 24 weeks of follow-up. The primary outcome was a patient preference disability score, the patient-specific index score, at 16 weeks. Health secondary outcomes were functional mobility, mobility-related quality of life, and total societal costs over 24 weeks. Analysis was by intention to treat. This trial is registered, number NCT00330694. FINDINGS: We included 699 patients. Baseline characteristics of the patients were comparable between the ParkinsonNet clusters (n=358) and usual-care clusters (n=341). The primary endpoint was similar for patients within the ParkinsonNet clusters (mean 47.7, SD 21.9) and control clusters (48.3, 22.4). Health secondary endpoints were also similar for patients in both study groups. Total costs over 24 weeks were lower in ParkinsonNet clusters compared with usual-care clusters (difference euro727; 95% CI 56-1399). INTERPRETATION: Implementation of ParkinsonNet networks did not change health outcomes for patients living in ParkinsonNet clusters. However, health-care costs were reduced in ParkinsonNet clusters compared with usual-care clusters. FUNDING: ZonMw; Netherlands Organisation for Scientific Research; Dutch Parkinson's Disease Society; National Parkinson Foundation; Stichting Robuust.1 januari 201