Influence of various physical therapy programs on the quality of life, balance, kinematics of speed and accuracy movements of the hand in patients with Parkinson’s disease

Problem of study: Parkinson's disease - one of the most common progressive, degenerative, incurable diseases that affect the human nervous system (Tomlison et al., 2012). With the changing rate of reproduction of the population, as well as fertility and mortality ratios, population age structure changes. The number of elderly people increases as a result(Daugėlienė ir Tamošiūnas, 2007). Parkinson's disease is the disease of the elderly and therefore the probability of getting the disease increases. Worldwide Parkinson's disease affects 6.3 million people. According to Lithuanian Hygiene Institute of Health Information Centre, 10,757 people were ill with Parkinson's disease in Lithuania in 2010. This is a relevant health problem in the way that the disease limits human movement to a great extent as well as degrades the quality of life and overall communication capabilities. Object of the study: changes in the quality of life, balance, kinematics of speed and accuracy movements of the hand. Hypothesis of the study: We believe that by accelerating the pace of workouts on the treadmill in the gym, we will achieve better results than using physical therapy at home. Aim of the study: to determine the influence of various physical therapy programs on the quality of life, balance and kinematics of speed and accuracy movements of the handin patients with Parkinson’s disease. Objectives of the study: 1. To evaluate the quality of life, static and dynamic balance and control of speed and accuracy movements of the hand in patients with Parkinson’s disease before and after the physical therapy at home. 2. To evaluate the quality of life, static and dynamic balance and control of speed and accuracy movements of the hand in patients with Parkinson’s disease before and after the physical therapy in the gym before the accelerating pace workout on the treadmill. 3. To compare the impact of different physical therapy programs on the quality of life, static and dynamic balance and control of speed and accuracy movements of the hand in patients with Parkinson’s disease. Methods and organization of the study: The study was carried out in Lithuanian Sports University in November 2012 - January 2013, which was attended by 16 individuals diagnosed with idiopathic Parkinson’s disease. Subjects were randomly divided into two groups (n = 8). For the first group individual physical therapy took place in the weightlifting gymof Lithuanian Sports University. The second group had individual physical therapy at home. Subjects were tested two times: before physical therapy procedures (2012-12-08) and after physiotherapy (2013-01-07). Each subject got 16 physiotherapy procedures. For the assessment of the quality of life, we selected questionnaire PDQ-39 (Parkinson’s Disease Questionaire-39), and the subjects filled it in independently. For the assessment of static and dynamic balance, Berg Balance Scale and balance confidence scale were applied. Walking speed was assessed using “Up and go” test. The original device developed by Lithuanian Sports University researchers and UAB Katra specialists - the dynamic parameter analyser of human arm and leg movements DPA-1 – was used to evaluate the characteristics of the kinematics of the dominant arm movement. Subjects had to perform three tasks (2 easy and 1 difficult task): 1.the reaction task (simple task) – to react to the audible signal and push the handle of the device. 2. the speed task (simple task) – to perform the movement toward the target as quickly as possible. 3. the accuracy task (a difficult task) – the subjects had to react as quickly as possible to the target device as it appeared on the screen and push the handle so that the symbol of the circle on the screen could reach the target circle with exact trajectory as quickly as possible and stop in it. Conclusions: 1.After physical therapy, subjects who received physical therapy at home experienced a statistically significant improvement in their quality of life, static and dynamic balance and control of speedand accuracy movements of the hand. 2.After physical therapy, subjects who received physical therapy in accelerating pace workouts on the treadmill in thegym experienced a statistically significant improvement in their quality of life, static and dynamic balance and control of speed and accuracy movements of the hand. 3.Subjects who received physical therapy by accelerating the pace of workouts on the treadmill in the gym assessed their quality of life better, experienced improvement of the control of speed and accuracy movements of the hand and balance after physical therapy