The link between vertigo and anxiety is well known. The aim of this study is to compare anxiety disorders in 3 groups: patients with vestibular migraine (VM), patients with migraine but without ...vertigo (MO) and healthy controls (HC).We performed cross-sectional analysis of following tests: (a) Hamilton Anxiety Rating Scale (HAMA); (b) State-Trait Anxiety Inventory (STAI-X1 and STAI-X2); (c) Beck Depression Inventory (BDI); (d) Panic–Agoraphobic Scale and (e) Penn State Worry Questionnaire (PSWQ). ANOVA, Kruskal–Wallis and Chi-square tests were used for comparisons and least significant difference was used for further post-hoc analysis. There were 35 definite VM patients, 31 MO patients and 32 volunteer HC. There were no significant differences between three groups in age, total years of education or duration of headaches in VM and MO patients. On the other hand, vertigo severity was moderately and positively correlated with headache severity and with headache duration. There were significant differences in scores of HARS, BDI, PSWQ, and various PAS-R sub-scales between the three groups. Our study shows that VM patients are significantly more anxious and agoraphobic than MO patients and HC, displaying higher sensitivity to separation and being more prone to seeking medical reassurance.
A longitudinal study of balance in migraineurs Akdal, Gülden; Balci, Birgül Dönmez; Angin, Salih ...
Acta oto-laryngologica,
2012-January, 1/1/2012, 2012, 2012-Jan, 2012-01-00, 20120101, Letnik:
132, Številka:
1
Journal Article
Recenzirano
Abstract
Conclusion: Balance in migraineurs, even in those without vestibular symptoms, deteriorates slightly over 1 year in the most challenging test conditions, when measured with posturography. ...Objective: To discover by a longitudinal study of a group of migraineurs and their controls, whether the well-known, mild imbalance found on posturography in migraineurs is static or progressive. Methods: Posturographic measures of sway under incrementally more challenging conditions (up to eyes closed standing on a foam surface with the head extended) using the modified clinical test of sensory interaction on balance, limits of stability test, and tandem gait tests in a group of 19 migraineurs and 19 age- and gender-matched controls, all of whom who had been tested over 1 year before. Results: After 1 year migraineurs showed a slight but statistically significant deterioration: in postural sway especially, when measured with eyes closed standing on a foam surface with the head extended backwards; in reaction time; and in maximal excursion on the limits of the stability test; and perhaps in walk speed and step width on the tandem walk test.
To investigate the effects of two different rehabilitation programs in acute central vestibulopathy secondary to posterior circulation stroke.
A prospective randomized controlled study was conducted ...on 25 patients with posterior circulation stroke. Patients were instructed in routine balance and mobility exercises during the acute hospitalization period. At discharge, patients were assigned to either a rehabilitation or home exercise group. The home exercise group was instructed to perform the same exercise program provided in the course of hospitalization period. The rehabilitation group was randomized into the visual feedback posturography training or vestibular rehabilitation group. The balance and gait performance were assessed with clinical and objective measurements before and after 6 weeks of training.
The balance and gait scores were significantly improved in both rehabilitation groups and in the home exercise group (p< 0.05), but no significant difference was found between the groups in terms of post-treatment values (p> 0.05).
The improvements of balance and gait function in rehabilitation groups did not differ from the home exercise group. Rehabilitation programs were equally effective to improve the recovery in acute central vestibulopathy.
Objective: The aim of our study is to investigate the effects of home exercise program on balance, postural control, coordination and functional strengthening in parkinsonian patients. Methods: The ...study was consisted of idiopathic Parkinson's disease patients, who were not given any exercise training previously. The program including stretching, strengthening, coordination and balance exercises was structured according to the severity of disease. The patients were taught the exercises by a physiotherapist and in addition, were given an illustrated annotated leaflet for home program. Patients were asked to perform the exercises 2 times a day, with 10 times repetitions, for 12 weeks. The static and dynamic balance capacities (Berg Balance Scale-BBS, functional reach test), timed performance capacity (timed up&go test, sit to stand test) of the patients were evaluated before the exercise training. The stage of the disease was evaluated using Modified Hoehn-Yahr Parkinson's Disease Staging, also the severity of the disease was assessed using the United Parkinson's Disease Rating Scale (UPDRS) motor score and the activities of daily living were measured using the Schwab and England Activities of Daily Living Scale. All assessments were repeated following the 12-week exercise program. Results: The mean age of the parkinsonian patients, who completed the exercise program, was 68.34 + or - 8.92 year (51-88) and the mean duration of disease was 4.94 + or - 4.25 (1-20) year. A significant increase in the scores of BBS, functional reach test (both forward and backward), and a significant decrease in the score of single timed chair-rise test were observed following the home exercise program. A significant improvement was observed in the scores of the Schwab England Activities of Daily Living Scale (p<0.05). Conclusion: Home exercises enhance the balance abilities and provide improvement on activities of daily living of Parkinson's disease patients. Therefore, besides the medical treatment, exercise programs should be included in the treatment of Parkinson's patients. (Archives of Neuropsychiatry 2010; 47:53-7) Key words: Parkinson's disease, exercise, physiotherapy Amac: Calismamizin amaci Parkinson hastalarinda ev programi olarak verilen denge, postural kontrol, koordinasyon ve kuvvetlendirmeye yonelik egzersiz programinin hastalarin denge yetenekleri ve fonksiyonel kapasiteleri uzerine olan etkilerini incelemektir. Yontemler: Calismaya daha once egzersiz egitimi verilmemis idyopatik Parkinson hastalari alindi. Egzersiz programi, hastaligin siddetine uygun olarak secilmis germe, kuvvetlendirme, koordinasyon ve denge egzersizlerini icermekteydi. Egzersizler fizyoterapist tarafindan hastalara ogretildi ve ayrica resimli ve aciklamali olarak ev programi seklinde verildi. Hastalardan egzersizleri gunde 2 kez, 10 tekrarli olarak ve 12 hafta boyunca yapmalari istendi. Hastalarin egzersiz egitimi oncesi statik-dinamik dengeleri (Berg Denge Olcegi, Fonksiyonel uzanma testi) ve sureli yurume, sandalyeye oturma, oturmadan ayaga kalkma aktivitele-riyle sureli performanslari degerlendirildi. Hastalik evresi modifiye Hoehn-Yahr evrelemesi, hastalik siddeti Birlesik Parkinson Hastaligi Degerlendirme Olcegi (BPHDO) motor skoru, gunluk yasam aktiviteleri Schwab England Gunluk Yasam Etkinlikleri Olcegi ile degerlendirildi. Tum degerlendirmeler 12 haftalik egzersiz programindan sonra tekrarlandi. Bulgular: Egzersiz programini tamamlayan 29 Parkinson hastasinin yas ortalamasi 68.34 + or - 8.92 yil (51-88) ve hastalik baslangic suresi 4.94 + or - 4.25 (1-20) yil idi. Hastalarin ev egzersiz programi sonrasinda Berg Denge Olcegi (BDO) skorlarinda, one ve arkaya fonksiyonel uzanma testinde anlamli artis ve sureli performans testlerinden olan sandalyeden bir kez ayaga kalkma testinde anlamli azalma saptandi. Schwab England Gunluk Yasam Aktiviteleri Olcegi skorlarinda anlamli duzelme gozlendi (p<0.05). Sonuc: Parkinson hastaliginda ev egzersizleri hastalarin denge yeteneklerini duzeltmekte ve gunluk yasam aktivitelerinde iyilesme saglamaktadir. Bu nedenle Parkinson hastalarinin tedavisinde medikal tedavilerin yani sira egzersiz programlari da mutlaka yer almalidir. (Noropsikiyatri Arsivi2010; 47:53-7) Anahtar kelimeler: Parkinson hastaligi, egzersiz, fizyoterapi
Amaç: Çalışmamızın amacı Parkinson hastalarında ev programı olarak verilen denge, postural kontrol, koordinasyon ve kuvvetlendirmeye yönelik egzersiz programının hastaların denge yetenekleri ve ...fonksiyonel kapasiteleri üzerine olan etkilerini incelemektir.
Yöntemler: Çalışmaya daha önce egzersiz eğitimi verilmemiş idyopatik Parkinson hastaları alındı. Egzersiz programı, hastalığın şiddetine uygun olarak seçilmiş germe, kuvvetlendirme, koordinasyon ve denge egzersizlerini içermekteydi. Egzersizler fizyoterapist tarafından hastalara öğretildi ve ayrıca resimli ve açıklamalı olarak ev programı şeklinde verildi. Hastalardan egzersizleri günde 2 kez, 10 tekrarlı olarak ve 12 hafta boyunca yapmaları istendi. Hastaların egzersiz eğitimi öncesi statik-dinamik dengeleri (Berg Denge Ölçeği, Fonksiyonel uzanma testi) ve süreli yürüme, sandalyeye oturma, oturmadan ayağa kalkma aktiviteleriyle süreli performansları değerlendirildi. Hastalık evresi modifiye Hoehn-Yahr evrelemesi, hastalık şiddeti Birleşik Parkinson Hastalığı Değerlendirme Ölçeği (BPHDÖ) motor skoru, günlük yaşam aktiviteleri Schwab England Günlük Yaşam Etkinlikleri Ölçeği ile değerlendirildi. Tüm değerlendirmeler 12 haftalık egzersiz programından sonra tekrarlandı.
Bulgular: Egzersiz programını tamamlayan 29 Parkinson hastasının yaş ortalaması 68.34±8.92 yıl (51-88) ve hastalık başlangıç süresi 4.94±4.25 (1-20) yıl idi. Hastaların ev egzersiz programı sonrasında Berg Denge Ölçeği (BDÖ) skorlarında, öne ve arkaya fonksiyonel uzanma testinde anlamlı artış ve süreli performans testlerinden olan sandalyeden bir kez ayağa kalkma testinde anlamlı azalma saptandı. Schwab England Günlük Yaşam Aktiviteleri Ölçeği skorlarında anlamlı düzelme gözlendi (p<0.05).
Sonuç: Parkinson hastalığında ev egzersizleri hastaların denge yeteneklerini düzeltmekte ve günlük yaşam aktivitelerinde iyileşme sağlamaktadır. Bu nedenle Parkinson hastalarının tedavisinde medikal tedavilerin yanı sıra egzersiz programları da mutlaka yer almalıdır.
Objective: The aim of our study is to investigate the effects of home exercise program on balance, postural control, coordination and functional strengthening in parkinsonian patients.
Methods: The study was consisted of idiopathic Parkinson's disease patients, who were not given any exercise training previously. The program including stretching, strengthening, coordination and balance exercises was structured according to the severity of disease. The patients were taught the exercises by a physiotherapist and in addition, were given an illustrated annotated leaflet for home program. Patients were asked to perform the exercises 2 times a day, with 10 times repetitions, for 12 weeks. The static and dynamic balance capacities (Berg Balance Scale-BBS, functional reach test), timed performance capacity (timed up&go test, sit to stand test) of the patients were evaluated before the exercise training. The stage of the disease was evaluated using Modified Hoehn-Yahr Parkinson's Disease Staging, also the severity of the disease was assessed using the United Parkinson's Disease Rating Scale (UPDRS) motor score and the activities of daily living were measured using the Schwab and England Activities of Daily Living Scale. All assessments were repeated following the 12-week exercise program.
Results: The mean age of the parkinsonian patients, who completed the exercise program, was 68.34±8.92 year (51-88) and the mean duration of disease was 4.94±4.25 (1-20) year. A significant increase in the scores of BBS, functional reach test (both forward and backward), and a significant decrease in the score of single timed chair-rise test were observed following the home exercise program. A significant improvement was observed in the scores of the Schwab England Activities of Daily Living Scale (p<0.05).
Conclusion: Home exercises enhance the balance abilities and provide improvement on activities of daily living of Parkinson's disease patients. Therefore, besides the medical treatment, exercise programs should be included in the treatment of Parkinson's patients.
Amaç:Beynin arka dolaşım sistemini etkileyen serebrovasküler olay (SVO) sonrası, santral vestibüler işlev bozukluğu olan akut dönem hastalarında farklı iki denge rehabilitasyon programının denge, ...yürüme, özürlülük seviyesi, düşme riski ve işlevsel bağımsızlık üzerine etkilerinin belirlenmesidir.Yöntem:Çalışmaya beyin sapı ve serebellar enfarkt geçirmiş 25 hasta dahil edildi. Tüm hastalar hastane içi dönemde çalışma ve kontrol grubuna randomize edildikten sonra çalışma grubu hastalarından kart çekme yöntemiyle iki farklı rehabilitasyon grubu oluşturuldu. Kontrol grubu, hastanede öğretilen egzersizleri 6 hafta boyunca evde uygulamaya devam etti.Çalışma grubu ise 6 hafta süreyle bireye özgü egzersizlerden oluşan rehabilitasyon programlarına alındı. Tedavi yöntemlerinden bir tanesi bilgisayarlı denge sisteminde uygulanan (NeuroCom System Version 8.1 Balance Master) rehabilitasyon programı idi. Sistemde görsel geri bildirim ile hastaya uygun özel denge egzersizleri oluşturuldu. Diğer tedavi yöntemi olan gözetimli ev programı grubunda ise hastalar, haftada bir kez kontrole gelerek vestibüler rehabilitasyon egzersizlerini evde uyguladı. Altı haftanın sonunda tüm hastalara tedavi öncesinde uygulanan değerlendirmeler tekrar edildi. Değerlendirmede Berg Denge Ölçeği, Ataksi Değerlendirme ve Derecelendirme Ölçeği, Başdönmesi Engellilik Envanteri, Aktiviteye Özgü Denge Güvenlilik Ölçeği, Düşme Etki Ölçeği, Dinamik Yürüme İndeksi, Süreli Kalk Yürü Testi, Enstrümental Günlük Yaşam Aktiviteleri Ölçeği ile Balance Master denge ve performans test cihazının statik ve dinamik denge testleri kullanıldı.Bulgular:Tüm gruplarda denge ölçeklerinin sonuçları, anlamlı iyileşme göstermiş (p<0.05) fakat gruplar arasında tedavi sonu değerleri açısından anlamlı farklılık görülmemiştir (p>0.05). Balans Master sisteminde dengenin kliniğe uyarlanmış duyusal etkileşim testine (DKUDET) göre yerçekimi merkezi salınım hızı, tüm gruplarda anlamlı iyileşirken (p<0.05) gruplar arasında tedavi sonu değerleri açısından anlamlı farklılık saptanmadı (p>0.05).Dinamik denge yeteneklerini yansıtan kararlılık sınırları testi sonuçlarında postürografi eğitim grubu hastalarında tedavi sonrasında anlamlı iyileşme saptandı (p<0.05).Topuk-parmak ucu yürüme testinde ev programı grubunun, normal yürüme testinde ise kontrol grubu hastalarının anlamlı iyileşme gösterdiği tespit edildi (p<0.05).Sonuç:Elde edilen sonuçlar, üç grubun denge işlevleri tedavi sonrası iyileşme göstermiştir fakat iyileşme miktarları açısından gruplar arasında anlamlı görülememiştir. Sonuçlara göre erken dönemde rutin programlara ek olarak uygulanan tedavilerin iyileşme üzerine ek katkı sağlamadığı düşünülmektedir. Dolayısıyla hastaların akut dönemi geçirdikten sonra devam eden dengesizlik şikayetleri mevcutsa uygun rehabilitasyon programlarına katılmasının daha başarılı sonuçlar doğuracağı yorumu yapılmıştır.
•Sedentary PD patients had worse scores in postural control and walking performance.•However, deteriorated dynamic stability might not lead to sedentary lifestyle.•Balance training may not be ...adequate to improve activity level in PD.•Behavioral and motivational strategies should be integrated into PD rehabilitation.
The International Classification of Functioning, Disability and Health (ICF) is a framework providing information on disability and health. Physical activity’s behavior is complex and affected by various factors. We aimed to examine the ICF domains in Parkinson’s disease (PD) patients; to compare them in sedentary and non-sedentary PD patients and their association with activity level.
Sixty PD patients (25 sedentary PD group, 35 non-sedentary PD group) were included in this retrospective study. Functional disability was evaluated using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale. The physical activity level was measured by the SenseWear Arm Band activity monitor. Patients’ cognitive function, severity of depression and anxiety, the functional impact of fatigue, balance performance (NeuroCom Balance Master System), functional mobility (Timed Up and Go Test, TUG), walking capacity (Six-Minute Walk Test, 6MWT), fear of falling, health-related quality of life are also analyzed.
Sedentary PD patients had worse scores in NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in activities domains of the ICF model as a guide than non-sedentary group (p < 0.05). No statistically significant differences were found in the body structures and function, participation, personal and environmental domains of the ICF model between sedentary and non-sedentary PD groups (p > 0.05). There was no correlation between steps taken per day and NeuroCom Balance Master System parameters, TUG score, and 6MWT distance in both groups (p > 0.05).
Patients with sedentary lifestyle had worse scores in postural control/balance, sit-to-stand and walking performance. However, deteriorated dynamic balance may not lead to sedentary lifestyle. Physiotherapy programs should be including the behavior change interventions and motivational strategies to promote activity level in PD.
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