Prior TBI Diagnosis Increases Risk of Parkinson’s Disease

Recently, there has been attention on the association of traumatic brain injury (TBI) with progressive neurodegenerative diseases; such as, Parkinson’s disease. However, the association between mild TBI and Parkinson’s remains unclear. Therefore, the authors used 3 nationwide Veterans Health Administration databases (Comprehensive TBI Evaluation, National Patient Care Databases, Vital Status File Database) of inpatients and outpatients seen between 2002-2014 to determine the risk of developing Parkinson’s disease following a TBI. Authors age-matched 162,935 patients (~48 years of age) with TBI diagnosis without dementia, Parkinson’s disease, or secondary parkinsonism at baseline to a random sample of patients without any of the aforementioned conditions. The authors defined TBI exposure as a diagnosis of TBI after a comprehensive neurological assessment or by at least one inpatient or outpatient TBI diagnosis from a list of ICD-9 codes. Parkinson’s disease was defined as any inpatient or outpatient diagnosis of ICD-9 332.0 at least 1 year after TBI. The average follow-up was ~5 years. The authors found that a veteran with a prior TBI (0.6%) is >56% more likely to develop Parkinson’s disease than a veteran without a prior TBI (0.3%). This finding was consistent even after accounting for factors such as medical comorbidities (diabetes, hypertension, cerebrovascular disease) and psychiatric disorders (anxiety, post-traumatic stress, drug/alcohol use). Furthermore, this finding was consistent among people with mild or moderate-severe TBI.

Full story at Sports Medicine Research

Scrutinizing Medicare coverage for physical, occupational and speech therapy

For years, confusion has surrounded the conditions under which older adults can receive physical, occupational and speech therapy covered by Medicare.

Services have been terminated for some seniors, such as those with severe cases of multiple sclerosis or Parkinson’s disease, because therapists said they weren’t making sufficient progress. Others, including individuals recovering from strokes or traumatic brain injuries, have been told that they reached an annual limit on services and didn’t qualify for further care.

Neither explanation stands up to scrutiny. Medicare does not require that older adults demonstrate improvement in order to receive ongoing therapy. Nor does it limit the amount of medically necessary therapy, for the most part.

Full story at news-medical.net

High-intensity exercise decreases worsening of motor symptoms in Parkinson’s patients

High-intensity exercise three times a week is safe for individuals with early-stage Parkinson’s disease and decreases worsening of motor symptoms, according to a new phase 2, multi-site trial led by University of Colorado Anschutz Medical Campus and Northwestern Medicine scientists.

This is the first time scientists have tested the effects of high-intensity exercise on patients with Parkinson’s disease, the second most common neurodegenerative disorder and the most common movement disorder affecting more than 1 million people in the United States.

“If you have Parkinson’s disease and you want to delay the progression of your symptoms, just a stroll isn’t sufficient. You should exercise three times a week with your heart rate between 80 to 85 percent maximum. It is that simple,” said lead author Margaret Schenkman, Associate Dean for Physical Therapy Education and PT Program Director at the CU School of Medicine at the Anschutz Medical Campus.

Full story at News-Medical.net

Transcranial stimulation and/or physical therapy improves walking speed in Parkinson’s disease

Noninvasive brain stimulation and physical therapy – alone or in combination – improve some measures of walking ability in patients with Parkinson’s disease (PD), concludes a clinical trial in the American Journal of Physical Medicine & Rehabilitation, the official journal of the Association of Academic Physiatrists. The journal is published by Wolters Kluwer.

Transcranial direct current stimulation and physical therapy “could be used alone or together as a combination treatment protocol to improve walking speed and step length among patients with PD,” according to the study by Krisna Piravej, MD, and colleagues of King Chulalongkorn Memorial Hospital, Bangkok, Thailand. In addition to showing a benefit of brain stimulation, the results suggest that physical therapy has benefits beyond symptom relief for patients with PD.

Full story of PT improving walking in Parkinson’s disease at Medical News Today

Microsoft shows off watch that quiets Parkinson’s tremors

Tech company developer conferences always feature a wacky demo or three.

But at Build 2017 in Seattle Wednesday, Microsoft went for the waterworks at the conclusion of CEO Satya Nadella’s keynote address: it showcased a prototype watch that temporarily eliminated the arm shaking that often plagues those suffering from the neurological disease Parkinson’s.

After a speech that both heralded and warned about coming leaps in technological power, Nadella screened a video that told the story of two British Microsoft Research employees, Haiyan Zhang and Nicolas Villa, who developed the tremor-interrupting device for a BBC documentary, The Big Life Fix.

Full story of prototype watch for Parkinson’s Disease at USA Today

2-Year Study: Informal Exercise Could Play a Role in Slowing QoL, Mobility Losses Associated with PD

Plenty of research supports the idea that formal, supervised exercise interventions can slow and even improve mobility and health-related quality-of-life (HRQL) among individuals with Parkinson disease (PD), but a new study asserts that informal home-based exercise can also produce positive effects that are long-lasting, especially when individuals get in at least 2.5 hours a week—and particularly for those with more advanced stages of the disease.

The study, published in the March 28 issue of the Journal of Parkinson’s Disease, analyzed data from 3,408 individuals participating in the National Parkinson Foundation Quality Improvement Initiative (NPF-QII), a 3-country program that tracks functional mobility, HRQL, and lifestyle data among individuals with PD through a series of annual visits. Researchers looked at data spanning a 2-year period, hoping to see if there was any correlation between participants who reported at least 2.5 hours of exercise weekly and scores on HRQL and mobility measures over time. HQRL was measured by way of the Parkinson Disease Questionnaire; mobility was measured through the timed up-and-go test (TUG).

Full story of exercise and mobility loss in Parkinson’s Disease at APTA

Parkinson’s disease patients benefit from physical activity

A comprehensive review published in the Journal of Parkinson’s Disease confirms that people living with Parkinson’s disease (PD) can benefit from being physically active, especially when it comes to improving gait and balance, and reducing risks of falls. It concludes that health professionals should be confident about prescribing physical activity to improve the health and quality of life of PD patients.

“Exercise should be a life-long commitment to avoid physical and cognitive decline, and our research shows that this is also true for individuals with PD,” explained Christian Duval, PhD, Professor, Département des sciences de l’activité physique, Université du Québec á Montréal, Montréal, Québec, Canada. Despite the progressive nature of the disease, people living with PD can expect to improve their physical condition by being more physically active.

Full story of physical activity and Parkinson’s disease at Science Daily

Flex CEUs: New CEU Courses

SHOE MODIFICATIONS FOR ADULTS WITH KNEE OSTEOARTHRITIS

Knee osteoarthritis (OA) is the most common form of OA and is the leading cause of pain and disability in older adults.  The goal of this CEU course is to determine the difference between different shoes and lateral wedge insoles on external knee adduction moment (EKAM), knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA.

PARKINSON’S DISEASE EXERCISE MODE COMPARISON

Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease.  Physical rehabilitation is commonly used in patients with PD to improve their health and alleviate the symptoms.  The goal of this CEU course is to determine the overall effect of resistance training (RT) on measures of muscular strength in people with PD and identify effective RT interventions to increase strength in people with PD in order to provide evidence-based guidelines.  Further, this course compares resistance training with balance training for the improvement of postural control in people with PD.  Lastly, this course explores a technology-assisted exercise protocol that is specifically aimed at reducing bradykinesia.

For more on these new ceu courses and many more, visit Flex CEUs

Does Physical Therapy Help With Early Parkinson’s?

Physical therapy might not benefit people with mild-to-moderate Parkinson’s disease, a new study suggests.

Parkinson’s disease is a movement disorder that interferes with the ability to do daily tasks. Typically, physical therapy is used in the later stages of the disease, but this study assessed its effectiveness in earlier stages.

Researchers randomly assigned 762 patients with mild-to-moderate Parkinson’s to either physical therapy and occupational therapy, or a “control” group with no therapy. Over eight weeks, the patients in the therapy group did about four 58-minute sessions.

After three months, there was no difference between the therapy group and the control group in the ability to do daily tasks, the study found.

Full story on PT and early Parkinson’s disease at WebMD

Physical Therapy ‘Ineffective’ for PD? Headlines Overstate Study’s Conclusions

A recent study from England involving physical therapy, occupational therapy, and individuals with Parkinson Disease (PD) has generated plenty of dramatic headlines about physical therapy’s supposed “ineffectiveness.” But as is often the case with dramatic headlines, there’s more to the story.

The study in question, published in JAMA Neurology, aimed to evaluate the clinical effectiveness of individualized physical and occupational therapy for individuals with PD by comparing outcomes at baseline and 3 months among 381 participants who received treatment with an equally sized control group that didn’t.

Researchers found little to no difference in outcomes primarily based on the Nottingham Extended Activities of Daily Living (NEADL) scale, and secondarily based on the Parkinson Disease Questionnaire-39 and the EruoQol-5D, writing that “physiotherapy and occupational therapy were not associated with immediate or medium-term clinical improvements in [activities of daily living] or quality of life in mild to moderate PD.”

Full story PT ineffective for Parkinson Disease at APTA