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FUNCTIONAL PROGNOSIS IN PARKINSON'S DISEASE
Fita I, Tutu-Pata V, Prada G, Prada S
Walking and self-care can be improved in Parkinson's disease patients by ameliorating mobility and coordination. Success of functional re-education is connected to the commencement of rehabilitation program since, if it is started during the first stage, it can demonstrate a clear "prophylactic" effect for functional deficit. Thus one can avoid abnormal movement patterns or, at least, they can be postponed. A total of 187 patients with Parkinson's disease have been investigated and divided into two groups: study group with 104 subjects (who have followed all the stages of rehabilitation protocol, with a progressive increase of up to 45% of the maximum resistance) and control group of 83 subjects (who could not increase the intensity of the exercise beyond 10% of the maximum resistance). Authors noticed a much better and persistent improvement of motor performance (63%) in early stages of disease. Exercise has a greater benefit if it is started early and if it is continued at home (77%), because it can maintain aerobic capacity and prevents stiffness. Several parameters connected to continuity, accessibility and comprehension on behalf of family have important place in reeducation of patients with Parkinson's disease. Flexed posture affects concomitantly mobility, digestion and breathing, increasing risk of aspiration or pneumonia. Postural instability and falls, orientation, perception disorders (illusions, hallucinations) and motor patterns (agitation) represented negative factors for the disease progress. In conclusion, a careful follow-up of the functional prognostic factors can improve the progress of the patients with Parkinson's disease and maintain their mobility and self-care.
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