THE INFLUENCE OF THE AQUATIC EXERCISES PROGRAM ON THE POSTURAL BALANCE AND GAIT IN PEOPLE WITH PARKINSON’S DISEASE

Parkinson’s disease is a debilitating disease that leads to loss of balance and postural control because of neuronal deterioration. Aquatic therapy is a more recent form of therapy for PD patients and has been shown to benefit postural stability. The aim of the study is to assess the effects of aquatic exercise program on postural balance and gait in people with Parkinson’s disease. Methods: 7 PD patients were included, aged between 50 and 70, who in II and III stages of the disease. The subjects underwent 40 sessions of aquatic therapy during 4 months, lasting 60 minutes, in a heated therapy pool. The participants were evaluated in the start and end of the interventions phase using the Berg Balance Scale (PBS), Time Up and Go (TUG), Tandem stance, and 10m walk and 3600 turn. Results: the results of this study showed an important improvement in static and dynamic balance and gait outcomes in comparison with the baseline results. Conclusion: Balance training in the aquatic environment promoted improvement on balance and gait of patients with Parkinson´s disease

Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study

The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors

Group-based cardiac rehabilitation interventions. A challenge for physical and rehabilitation medicine physicians: a randomized controlled trial

BACKGROUND: In recent decades, many studies are focused on different training modalities comparison in patients with cardiac diseases. High intensity aerobic interval training (HIAIT) has been considered as an alternative approach to moderate-intensity continuous training (MICT) in rehabilitation of patients with chronic heart failure (CHF). AIM: To highlight the superiority of the modified group-based HIAIT intervention (m-Ullevaal) compared to the moderate-intensity continuous training (MICT), also to encourage physical and rehabilitation medicine (PRM) physicians to apply the m-Ullevaal intervention in routine cardiac rehabilitation (CR) practice. DESIGN:. single-blind, prospective randomized controlled trial. SETTING: Medical Center of Rehabilitation and Sports Medicine, Plovdiv, Bulgaria outpatients were enrolled. LATIO N: One hundred and twenty subjects of both genders, mean age of 63.73 +/- 6.68 years, with stable CHF, NYHA classes II to IIIB, were randomly assigned to m-Ullevaal group (N.=60) or to MICT (N.=60) group. Both CR protocols were conducted throughout a 12-week period. METHODS: Functional exercise capacity (FEC), assessed with six-minute walk test, and peak oxygen uptake (VO2peak), left ventricular ejection fraction (LVEF), m-Borg's perceived exertion scale (mBPES), and quality of life (QoL) were outcome measures evaluated. RESULTS: Significant improvement in FEC (P<0.001), LVEF (P<0.001), mBPES and QoL (P<0.001), was observed 12 weeks after both CR interventions (T2). However, the participants performed m-Ullevaal protocol achieved a greater improvement compared to those performed MICT (P<0.001). CONCLUSIONS: The m-Ullevaal protocol seems to be more beneficial and more effective compared to MICT. PRM physicians can efficiently apply the m-Ullevaal protocol in CHF patients rehabilitation. CLINICAL REHABILITATIO N IMPACT : Group-based HIAIT interventions can be widely applied by PRM physicians in CHF patients rehabilitation

White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 3. A primary medical specialty: the fundamentals of PRM

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper deals with the core concepts at the base of the PRM specialty. These are the essential constituents that make PRM a primary medical specialty, different from all the other medical specialties, and PRM physician the primary medical specialist among the rehabilitation professionals. The core concepts that will be discussed in this Section include:- PRM is a person/functioning oriented specialty, and this makes the specialty different from the organ/disease oriented, or treatment/age specific medical specialties- PRM physicians have medical responsibilities, like all the other medical specialists, but with an additional specificity of making a functional assessment- Like the other specialists, PRM physicians provide direct treatments, but they also work leading the multi-professional rehabilitation team, that works in a collaborative way with other professionals and medical specialists- Due to its function oriented approach, PRM has a multimodal approach including a wide variety of treatment tools (frequently provided by other rehabilitation professionals) and manages all persons' morbidities (health conditions), since it focuses on decreasing impairments and activity limitations to allow the best possible participation of patients- As PRM bases its work on functioning, it has a transversal role to other specialties: it overlaps with several of them, sharing part of their knowledge, but it is also totally independent front all of them, since it is based on a different and transversal body of knowledge-PRM is focused on the person and neither on the disease nor on the setting; in fact, PRM is not only transversal to specialties, but also to the settings of care, and PRM physicians should know these different realities: persons with disabilities and those with long-term health conditions in fact move inside the national health systems between various facilities to obtain the best possible functioning and participation through an appropriate rehabilitation process

White Book on Physical and Rehabilitation Medicine in Europe Introductions, Executive Summary, and Methodology

The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies (European Academy of Rehabilitation Medicine - EARM, European Society of PRM - ESPRM, European Union of Medical Specialists - PRM Section, European College of PRM-ECPRM served by the European Union of Medical Specialists-PRM Board) and constitutes the reference book for PRM physicians in Europe. It has now reached its third edition; the first was published in 1989 and the second in 2006/2007. The WB has multiple purposes, including providing a unifying framework for European countries, to inform decision-makers on European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public