Parkinson's disease is a major source of handicap, for which physical treatments are often underutilized with respect to chemical or surgical treatments. Yet, dopaminergic treatments alone prove unable to stop or control the gradual worsening of motor disability after a few years. The training program that this study sets out to evaluate aims to restore balance between agonist extensors and antagonist flexors in Parkinson's disease. There is indeed in Parkinson's disease an imbalance between weak flexors and weaker extensors, with excessive predominance of the flexors. The hypothesis of the study is that a motor strengthening program targeting extensor muscles specifically will improve body posture and restore motor function better than a conventional physical therapy program, in mild to moderate Parkinson's disease. This is a parallel-group, single blind, randomized trial (investigators will be kept unaware of the physical treatment followed by study subjects). The duration of patient participation is 5 months: 2-month intervention and 3-month follow-up following the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
39
In the Asymmetric Motor Strengthening program, the principle is to concomitantly reinforce the "body openers" and stretch the "body closers". One alternates two types of practice during a session. Active exercises consist of fatiguing series of rapid alternating movements against light weights working on movements of extension/abduction/external rotation/supination. Stretch postures consists of short 1-2 minutes bouts of flexor/internal rotator/adductor/pronator stretch. The duration of rehabilitation program is 8 weeks.
Conventional therapy will include general stretch, strengthening and balance exercises, respiratory exercises and relaxation methods.
Henri Mondor Hospital
Créteil, France
Change in UPDRS (Unified Parkinson's Disease Rating Scale) III score in the " OFF " medication state, between baseline (D1) and Day 60
Time frame: Baseline (D1) and Day 60
UPDRS III score in " ON " medication state
Time frame: Baseline (Day 1), Day 60 and Day 150
UPDRS III score in " OFF " medication state
Time frame: Day 150
Speed and step length over 20 meters (with 2 turn around, 2 Stand up-Sit down and 2 Sit down-Stand up) at maximal speed in " OFF " medication state
Time frame: Day 1, Day 60 and Day 150
Motor power of neck, elbow and knee extensors, measured using a portable dynamometer at Day 1, Day 60 and Day 150
Time frame: Day 1, Day 60 and Day 150
Kinematic measurements of trunk inclination
Time frame: Day 1 and Day 60
Balance measurement on posturography
Time frame: Day 1 and Day 60
Quantitative testing of large vs small rapid alternating movement in the upper limbs (Hand Tapper)
Time frame: Day 1, Day 60 and Day 150
Mount Sinai Parkinson Impairment Rating Scale
Time frame: Day 1, Day 60 and Day 150
Global Mobility Task (GMT)
Time frame: Day 1, Day 60 and Day 150
Geriatric Depression Scale - 15 items
Time frame: Day 1, Day 60 and Day 150
Quality of life measured by PDQ-39
Time frame: Day 1, Day 60 and Day 150
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