Four-week trunk-specific exercise program decreases forward trunk flexion in Parkinson's disease: A single-blinded, randomized controlled trial

INTRODUCTION: Pathological forward trunk flexion is a disabling and drug-refractory motor complication of Parkinson's disease (PD) leading to imbalance, pain, and fall-related injuries. Since it might be reversible, early and multidisciplinary management is emphasised. The primary aim was to compare the effects of a four-week trunk-specific rehabilitation program on the severity of the forward trunk flexion. The secondary aim was to compare the training effects on the motor impairments, dynamic and static balance, pain, falls, and quality of life. METHODS: 37 patients with PD (H&Y\u202f 64\u202f4) and forward trunk flexion were randomized in the experimental (n\u202f=\u202f19) or control group (n\u202f=\u202f18). The former consisted of active self-correction exercises with visual and proprioceptive feedback, passive and active trunk stabilization exercises and functional tasks. The latter consisted of joint mobilization, muscle strengthening and stretching, gait and balance exercises. Protocols lasted 4 weeks (60\u202fmin/day, 5 days/week). Before, after, and at 1-month follow-up, a blinded examiner evaluated patients using primary and secondary outcomes. The primary outcome was the forward trunk flexion severity (degree). Secondary outcomes were the UPDRS III, dynamic and static balance, pain falls, and quality of life assessment. RESULTS: The experimental group reported a significantly greater reduction in forward trunk flexion than the control group from T0 to both T1 (p\u202f=\u202f0.003) and T2 (p\u202f=\u202f0.004). The improvements in dynamic and static balance were significantly greater for the experimental group than the control group from T0 to T2 (p\u202f=\u202f0.017 and 0.004, respectively). Comparable effects were reported on the other outcomes. Pre-treatment forward trunk flexion values were highly correlated to post-treatment trunk deviation changes. CONCLUSION: The four-week trunk-specific rehabilitation training decreased the forward trunk flexion severity and increased postural control in patients with PD. NCT03741959

From DYMUS to DYPARK: validation of a screening questionnaire for dysphagia in Parkinson's disease

Dysphagia is a common debilitating symptom in people with Parkinson's Disease (PD), adequate screening of swallowing disorders is fundamental. The DYMUS questionnaire has shown very good characteristics for the screening of dysphagia in Multiple Sclerosis, and it might also prove useful for screening dysphagia in PD. The primary aim was to test and validate the DYMUS questionnaire in PD patients. This is an observational multicentric study involving 103 patients affected by PD. All subjects filled in the DYMUS and the Eating Assessment Tool (EAT-10) questionnaires. A subgroup of patients (n = 53) underwent a fiber-optic endoscopic evaluation of swallowing (FEES) and their dysphagia was scored by means of the Dysphagia Outcome Severity Scale (DOSS). DYMUS showed a relatively high level of internal consistency (Cronbach's alpha 0.79). A significant positive correlation was found between the DYMUS and the EAT-10 scores (p < 0.001), while a negative correlation was found between the DYMUS and the DOSS scores (p < 0.001). DYMUS showed a good sensitivity and specificity compared to FEES for detecting dysphagia (area under the curve: 0.82, p < 0.001). The ROC curve analysis showed that a DYMUS score >= 6 represents a reliable cut-off for the risk of dysphagia. The DYMUS questionnaire proved to be a reliable screening tool to detect dysphagia in patients suffering from PD. It is easy to understand, it can be self-administered and therefore adequate for adoption in the clinical practice with the more convenient name of DYPARK

Performance of NbSi transition-edge sensors readout with a 128 MUX factor for the QUBIC experiment

QUBIC (the Q&U Bolometric Interferometer for Cosmology) is a ground-based experiment which seeks to improve the current constraints on the amplitude of primordial gravitational waves. It exploits the unique technique, among Cosmic Microwave Background experiments, of bolometric interferometry, combining together the sensitivity of bolometric detectors with the control of systematic effects typical of interferometers. QUBIC will perform sky observations in polarization, in two frequency bands centered at 150 and 220 GHz, with two kilopixel focal plane arrays of NbSi Transition-Edge Sensors (TES) cooled down to 350 mK. A subset of the QUBIC instrument, the so called QUBIC Technological Demonstrator (TD), with a reduced number of detectors with respect to the full instrument, will be deployed and commissioned before the end of 2018. The voltage-biased TES are read out with Time Domain Multiplexing and an unprecedented multiplexing (MUX) factor equal to 128. This MUX factor is reached with two-stage multiplexing: a traditional one exploiting Superconducting QUantum Interference Devices (SQUIDs) at 1 K and a novel SiGe Application-Specific Integrated Circuit (ASIC) at 60 K. The former provides a MUX factor of 32, while the latter provides a further 4. Each TES array is composed of 256 detectors and read out with four modules of 32 SQUIDs and two ASICs. A custom software synchronizes and manages the readout and detector operation, while the TES are sampled at 780 Hz (100kHz/128 MUX rate). In this work we present the experimental characterization of the QUBIC TES arrays and their multiplexing readout chain, including time constant, critical temperature, and noise properties