LSVT-BIG ®'in Parkinson hastalığında fonksiyonel hareketlilik, yürüme, el becerisi ve yaşam kalitesi üzerine etkisi

Year 2022, Volume: 47 Issue: 4, 1738 - 1745, 28.12.2022

Türkan Turgay Yasemin Ekmekyapar Fırat Seval Selver Soğan Pınar Günel

https://doi.org/10.17826/cumj.1172689

Abstract

Amaç: Bu çalışmanın amacı, Parkinson hastalığında (PH) LSVT-BIG ® (Lee Silverman Voice Treatment Big) tekniğinin fonksiyonel hareketlilik, el becerisi ve yaşam kalitesi üzerindeki etkisini değerlendirmekti.
Gereç ve Yöntem: Parkinson hastalığı olan 15 hasta (9 erkek ve 6 kadın, yaşları 40-75; Hoehn & Yahr Evre I-III), haftada 4 seans, 1 saat/seans olmak üzere 4 haftalık bir LSVT-BIG eğitim programını tamamladı. Hastaların rehabilitasyon programının başında (t0) ve sonunda (t1) yaşam kalitelerinin ölçülmesinde Parkinson Hastalığı Yaşam Kalitesi Anketi-39 (PDQ-39) kullanıldı. El becerisi için Dokuz Delikli Çivi Testi (NHPT) kullanıldı. Fonksiyonel mobilitenin değerlendirilmesinde 10 Metre Yürüme Testi (10MWT), Zamanlı Kalk ve Yürü Testi (TUG) ve Beş Kez Oturup Kalkma Testi (5XSST) kullanıldı. 4 hafta sonra, tüm katılımcılar yeniden test edildi.
Bulgular: 4 haftalık LSVT-BIG tedavisinden sonra, PDQ-39 mobilite, günlük yaşam aktiviteleri, duygusal durum, stigma, kognisyon, iletişim, bedensel rahatsızlık ve genel skorlarda egzersiz sonrası öncesine kıyasla istatistiksel olarak anlamlı bir iyileşme bulundu. Egzersiz sonrası bakılan PDQ-39 sosyal destek puanında öncesine göre istatistiksel olarak anlamlı bir değişiklik olmadı. Ayrıca TUG testi, 5XSST, 10MWT’de ve sol el için NHPT ile bakılan beceri testinde iyileşme gelişti.
Sonuç: LSVT-BIG eğitimi, PH'da daha iyi yürüme, fonksiyonel hareketlilikve el becerisi performansı ile yaşam kalitesini arttıran yeni bir tedavi seçeneği olabilir. LSVT-BIG rehabilitasyon programının Parkinson hastalarında motor ve motor olmayan bozuklukları azaltma üzerindeki etkisini değerlendirmek için daha büyük boyutlarda randomize kontrollü çalışmalara ihtiyaç vardır.

Keywords

LSVT-BIG, Parkinson hastalığı, telerehabilitasyon, yaşam kalitesi

Impact of LSVT-BIG ® on functional mobility, walking, dexterity, and quality of life in Parkinson's disease

Abstract

Purpose: The aim of this study was to evaluate the impact of the LSVT-BIG ® (Lee Silverman Voice Treatment Big) technique on functional mobility, dexterity, and quality of life in Parkinson's disease (PD).
Materials and Methods: Fifteen patients with Parkinson's disease (9 males, and 6 females, aged 40-75 years; Hoehn & Yahr Stages I-III) completed a 4-week LSVT-BIG training program for 1 hour/session, 4 sessions per week. Parkinson's Disease Quality of Life Questionnaire-39 (PDQ-39) was used in measuring patients' quality of life at the beginning (t0) and at the end (t1) of the rehabilitation program. Nine-Hole Peg Test (NHPT) was used for dexterity. 10 Meter Walking Test (10MWT), Timed-Up-and-Go Test (TUG), and Five-Times Sit-to-Stand Test (5XSST) were used for assessing functional mobility. After 4 weeks, all participants were retested.
Results: After 4 weeks of LSVT-BIG therapy, a statistically significant improvement was found in PDQ-39 mobility, activities of daily living, emotional state, stigma, cognition, communication, physical discomfort, and general scores after exercise compared to before. There was no statistically significant change in the PDQ-39 social support score after exercise compared to before. In addition, functional mobility improved as indicated by the TUG test, 5XSST, 10MWT (and dexterity by NHPT on the left.
Conclusion: LSVT-BIG training may be a new therapeutic option for better walking, functional mobility, and manual capability performance and for enhancing the quality of life in PD. Randomized controlled trials with bigger sizes are needed to evaluate the effect of the LSVT-BIG rehabilitation program on reducing motor and non-motor impairments in patients with PD.

Keywords

LSVT-BIG therapy, Parkinson's disase, telerehabilitation, quality of life

References

• 1. Tysnes OB, Storstein A. Epidemiology of Parkinson’s disease. J Neural Transm. 2017;124(8):901-905. doi:10.1007/s00702-017-1686-y
• 2. Fahn S. Description of Parkinson’s Disease as a Clinical Syndrome. New York Acad Sci. 2003;991:1–14.
• 3. Bloem BR, Okun MS, Klein C. Parkinson’s disease. Lancet. 2021;397(10291):2284-2303. doi:10.1016/S0140-6736(21)00218-X
• 4. In M. Bernardo-Filho, D. u. de Sá-Caputo & RT (Eds. . Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives. In: Physical Therapy Effectiveness. ; 2019.
• 5. Yaliman A, Sen EI. Parkinson hastaliǧi ve rehabilitasyonu. Turkiye Fiz Tip ve Rehabil Derg. 2011;57(1):38-44. doi:10.4274/tftr.57.07
• 6. Ramig LO, Fox CM SS. Speech and voice disorders in Parkinson’s disease. In: Olanow CW, Stocchi F, Lang AE eds., ed. Parkinson’s Disease: Non‐Motor and Non‐Dopaminergic Features. Oxford: Wiley–Blackwell; 2011:348–362.
• 7. Farley BG, Koshland GF. Training BIG to move faster: the application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp Brain Res. 2005;167(3):462-467. doi:10.1007/s00221-005-0179-7
• 8. Ebersbach G, Ebersbach A, Edler D, et al. Comparing exercise in Parkinson’s disease - The Berlin LSVT®BIG study. Mov Disord. 2010;25(12):1902-1908. doi:10.1002/mds.23212
• 9. McDonnell MN, Rischbieth B, Schammer TT, Seaforth C, Shaw AJ PA. Lee Silverman Voice Treatment (LSVT)-BIG to improve motor function in people with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil. 2018;32(5):607-618.
• 10. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-184. doi:10.1136/jnnp.55.3.181
• 11. Neff C, Wang MC, Martel H. Using the PDQ-39 in routine care for Parkinson’s disease. Park Relat Disord. 2018;53(February):105-107. doi:10.1016/j.parkreldis.2018.05.019
• 12. Opara JA, Małecki A, Małecka E, Socha T. Motor assessment in parkinson’s disease. Ann Agric Environ Med. 2017;24(3):411-415. doi:10.5604/12321966.1232774
• 13. Combs-Miller SA ME. Predictors of outcomes in exercisers with Parkinson disease: A two-year longitudinal cohort study. NeuroRehabilitation. 2019;44(3):425-432.
• 14. Da Silva BA, Faria CDCM, Santos MP, Swarowsky A. Assessing timed up and go in Parkinson’s disease: Reliability and validity of timed up and go assessment of biomechanical strategies. J Rehabil Med. 2017;49(9):723-731. doi:10.2340/16501977-2254
• 15. Duncan RP, Leddy AL, Earhart GM. Five times sit-to-stand test performance in Parkinson’s disease. Arch Phys Med Rehabil. 2011;92(9):1431-1436. doi:10.1016/j.apmr.2011.04.008
• 16. Janssens J, Malfroid K, Nyffeler T, Bohlhalter S, Vanbellingen T. Application of LSVT BIG intervention to address gait, balance, bed mobility, and dexterity in people with Parkinson disease: A case series. Phys Ther. 2014;94(7):1014-1023. doi:10.2522/ptj.20130232
• 17. Millage B, Vesey E, Finkelstein M, Anheluk M. Effect on Gait Speed, Balance, Motor Symptom Rating, and Quality of Life in Those with Stage I Parkinson’s Disease Utilizing LSVT BIG®. Rehabil Res Pract. 2017;2017:1-8. doi:10.1155/2017/9871070
• 18. Ueno T, Sasaki M, Nishijima H, et al. LSVT-BIG improves UPDRS III scores at 4 weeks in Parkinson’s disease patients with wearing off: A prospective, open-label study. Parkinsons Dis. 2017;2017(May 2013):10-13. doi:10.1155/2017/8130140
• 19. Vanbellingen T, Kersten B, Bellion M, et al. Impaired finger dexterity in Parkinson’s disease is associated with praxis function. Brain Cogn. 2011;77(1):48-52. doi:10.1016/j.bandc.2011.06.003
• 20. Nocera JR, Stegemöller EL, Malaty IA, Okun MS, Marsiske M HC. Using the Timed Up & Go Test in a Clinical Setting to Predict Falling in Parkinson’s Disease. Arch Phys Med Rehabil. 2013;94(7):1300-1305. doi:10.1016/j.apmr.2013.02.020.Using
• 21. Fox C, Ebersbach G, Ramig L, Sapir S. LSVT LOUD and LSVT BIG: Behavioral treatment programs for speech and body movement in Parkinson disease. Parkinsons Dis. 2012;2012. doi:10.1155/2012/391946
• 22. Ramig LO, Sapir S, Countryman S, et al. Intensive voice treatment (LSVT®) for patients with Parkinson’s disease: A 2 year follow up. J Neurol Neurosurg Psychiatry. 2001;71(4):493-498. doi:10.1136/jnnp.71.4.493
• 23. Ebersbach G, Grust U, Ebersbach A, Wegner B, Gandor F, Kühn AA. Amplitude-oriented exercise in Parkinson’s disease: a randomized study comparing LSVT-BIG and a short training protocol. J Neural Transm. 2015;122(2):253-256. doi:10.1007/s00702-014-1245-8
• 24. Isaacson S, O’Brien A, Lazaro JD, Ray A, Fluet G. The JFK BIG study: the impact of LSVT BIG® on dual task walking and mobility in persons with Parkinson’s disease. J Phys Ther Sci. 2018;30(4):636-641. doi:10.1589/jpts.30.636
• 25. Hirakawa Y, Koyama S, Takeda K et al. Short-term effect and its retention of LSVT® BIG on QOL improvement: 1-year follow-up in a patient with Parkinson’s disease. NeuroRehabilitation. 2021;49(3):501-509.
• 26. Muñoz-Bermejo L, Adsuar JC, Mendoza-Muñoz M, et al. Test-retest reliability of five times sit to stand test (Ftsst) in adults: A systematic review and meta-analysis. Biology (Basel). 2021;10(6):1-10. doi:10.3390/biology10060510
• 27. Flood MW, O’Callaghan BPF, Diamond P, Liegey J, Hughes G, Lowery MM. Quantitative clinical assessment of motor function during and following LSVT-BIG® therapy. J Neuroeng Rehabil. 2020;17(1):1-19. doi:10.1186/s12984-020-00729-8
• 28. Prakash KM, Nadkarni N V, Lye W, Yong M, Tan E. The impact of non-motor symptoms on the quality of life of Parkinson ’ s disease patients : a longitudinal study. Eur J Neurol. 2016:854-861. doi:10.1111/ene.12950
• 29. Cusso ME, Donald KJ, Khoo TK. The impact of physical activity on non-motor symptoms in Parkinson’s disease: A systematic review. Front Med. 2016;3(AUG):1-9. doi:10.3389/fmed.2016.00035
• 30. Schaible F, Maier F, Buchwitz TM, et al. Effects of Lee Silverman Voice Treatment BIG and conventional physiotherapy on non-motor and motor symptoms in Parkinson’s disease: a randomized controlled study comparing three exercise models. Ther Adv Neurol Disord. 2021;14:1-18. doi:10.1177/1756286420986744