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Improving motor performance in Parkinson's disease: a preliminary study on the promising use of the computer assisted virtual reality environment (CAREN).
Neurol Sci. 2020 Apr; 41(4):933-941.NS

Abstract

BACKGROUND

Parkinson's disease (PD) is a neurodegenerative disorder characterized by various motor symptoms including balance and gait impairment. Several studies have shown that physiotherapy, cueing techniques, treadmill training, and cognitive movement strategies are useful in improving balance and gait in patients with PD. Devices employing virtual reality (VR) have been shown to be promising in neurorehabilitation as they can provide the patients with multisensory stimulation creating a realistic environment and improve the motivation and the adhesion of patients to the rehabilitation program. This preliminary study is aimed at testing the efficacy and feasibility of gait training based on the computer-assisted virtual reality environment (CAREN) in a sample of PD.

METHODS

In this preliminary study, 22 outpatients affected by PD who attended the Behavioral and Robotic Neurorehab Laboratory of the IRCCS Neurolesi between August 2017 and October 2018 were enrolled. All PD patients underwent 20 conventional physiotherapy sessions followed by 3-month of rest. Then, the patients were provided with 20 sessions of CAREN training. Gait and balance performances were rated before, after each training protocol, and 3 months later. Gait analysis was also performed before and after CAREN training.

RESULTS

All patients completed both of the rehabilitation trainings without any adverse event. All considered scales improved significantly at the end of both rehabilitation treatments. However, patients presented with a greater clinical improvement after the CAREN training, compared with conventional physiotherapy. In particular, patients walked faster and with more stability, with wider, longer steps.

CONCLUSIONS

Even though further neurophysiological details are required to identify the patients who may benefit from CAREN training, our findings suggest that this innovative device is an effective and feasible tool to train balance and gait in patients with PD.

Authors+Show Affiliations

IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy. salbro77@tiscali.it.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, S.S. 113, C.da Casazza, 98124, Messina, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31858331

Citation

Calabrò, Rocco Salvatore, et al. "Improving Motor Performance in Parkinson's Disease: a Preliminary Study On the Promising Use of the Computer Assisted Virtual Reality Environment (CAREN)." Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, vol. 41, no. 4, 2020, pp. 933-941.
Calabrò RS, Naro A, Cimino V, et al. Improving motor performance in Parkinson's disease: a preliminary study on the promising use of the computer assisted virtual reality environment (CAREN). Neurol Sci. 2020;41(4):933-941.
Calabrò, R. S., Naro, A., Cimino, V., Buda, A., Paladina, G., Di Lorenzo, G., Manuli, A., Milardi, D., Bramanti, P., & Bramanti, A. (2020). Improving motor performance in Parkinson's disease: a preliminary study on the promising use of the computer assisted virtual reality environment (CAREN). Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 41(4), 933-941. https://doi.org/10.1007/s10072-019-04194-7
Calabrò RS, et al. Improving Motor Performance in Parkinson's Disease: a Preliminary Study On the Promising Use of the Computer Assisted Virtual Reality Environment (CAREN). Neurol Sci. 2020;41(4):933-941. PubMed PMID: 31858331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving motor performance in Parkinson's disease: a preliminary study on the promising use of the computer assisted virtual reality environment (CAREN). AU - Calabrò,Rocco Salvatore, AU - Naro,Antonino, AU - Cimino,Vincenzo, AU - Buda,Antonio, AU - Paladina,Giuseppe, AU - Di Lorenzo,Giuseppe, AU - Manuli,Alfredo, AU - Milardi,Demetrio, AU - Bramanti,Placido, AU - Bramanti,Alessia, Y1 - 2019/12/19/ PY - 2019/06/10/received PY - 2019/12/10/accepted PY - 2019/12/21/pubmed PY - 2019/12/21/medline PY - 2019/12/21/entrez KW - CAREN KW - Gait rehabilitation KW - Parkinson's Disease KW - Risk of falls KW - Virtual reality SP - 933 EP - 941 JF - Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology JO - Neurol Sci VL - 41 IS - 4 N2 - BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder characterized by various motor symptoms including balance and gait impairment. Several studies have shown that physiotherapy, cueing techniques, treadmill training, and cognitive movement strategies are useful in improving balance and gait in patients with PD. Devices employing virtual reality (VR) have been shown to be promising in neurorehabilitation as they can provide the patients with multisensory stimulation creating a realistic environment and improve the motivation and the adhesion of patients to the rehabilitation program. This preliminary study is aimed at testing the efficacy and feasibility of gait training based on the computer-assisted virtual reality environment (CAREN) in a sample of PD. METHODS: In this preliminary study, 22 outpatients affected by PD who attended the Behavioral and Robotic Neurorehab Laboratory of the IRCCS Neurolesi between August 2017 and October 2018 were enrolled. All PD patients underwent 20 conventional physiotherapy sessions followed by 3-month of rest. Then, the patients were provided with 20 sessions of CAREN training. Gait and balance performances were rated before, after each training protocol, and 3 months later. Gait analysis was also performed before and after CAREN training. RESULTS: All patients completed both of the rehabilitation trainings without any adverse event. All considered scales improved significantly at the end of both rehabilitation treatments. However, patients presented with a greater clinical improvement after the CAREN training, compared with conventional physiotherapy. In particular, patients walked faster and with more stability, with wider, longer steps. CONCLUSIONS: Even though further neurophysiological details are required to identify the patients who may benefit from CAREN training, our findings suggest that this innovative device is an effective and feasible tool to train balance and gait in patients with PD. SN - 1590-3478 UR - https://www.unboundmedicine.com/medline/citation/31858331/Improving_motor_performance_in_Parkinson's_disease:_a_preliminary_study_on_the_promising_use_of_the_computer_assisted_virtual_reality_environment__CAREN__ L2 - https://link.springer.com/10.1007/s10072-019-04194-7 DB - PRIME DP - Unbound Medicine ER -