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How   to   cite   this   Article:    Sarala   Khangare,   Maneesha   Deshpande .   ASSESSMENT   OF   GAIT   AS   OUTCOME   MEASURE   FOLLOWING   SENSORY- ENHANCED   THERAPY   IN   PARKINSON’S   DISEASE   USING   UNIFIED   PARKINSON’S   DISEASE   RATING   SCALE   (PART   III).    Int   J   Physiother   Res 2016;4(6):1757-1761. DOI: 10.16965/ijpr.2016.184.
Type of Article: Original Research DOI: http://dx.doi.org/10.16965/ijpr.2016.184 Page No.:  1757-1761
ASSESSMENT   OF   GAIT   AS   OUTCOME   MEASURE   FOLLOWING    SENSORY-ENHANCED   THERAPY   IN   PARKINSON’S   DISEASE   USING   UNIFIED   PARKINSON’S DISEASE RATING SCALE (PART III). Sarala Khangare  * 1   , Maneesha Deshpande   2 . *1 Senior Physiotherapist, Physiotherapy School & Centre, Government Medical College & Hospital, Nagpur. (M.S), India. Ph. D scholar, Seth G.S Medical College and KEM Hopsital, Parel, Mumbai.(M.S), India. 2 Principal and Professor, VSPM’s College of Physiotherapy, Hingna Road, Nagpur, India. Address   for   correspondence:   Dr.   Sarala   Khangare   (PT),   Senior   Physiotherapist,   Physiotherapy   School   and   Centre,   Government   Medical   College   and   Hospital, Medical square, Nagpur-440009, Maharashtra, India . E-Mail:   saral.machhirke@gmail.com                    Abstract: Background   of   the   study:   Gait   and   mobility   problems   causes   disability   in   patients   with   Parkinson’s   Disease   (PD)   which   can   result   in   loss   of   independence, falls   and   hospitalisation.   Cueing   is   defined   as   using   external   temporal   or   spatial   stimuli   to   facilitate   gait.   The   purpose   of   the   study   was   to   assess   the   effects of   4   weeks   of   gait   training   with   sensory-enhanced   therapy   by   using   visual   and   auditory   cue   on   gait   score   on   tool   Unified   Parkinson’s   Disease   Rating   Scale (UPDRS), step length, gait speed and cadence in patients with PD. Materials   and   Methods:   Study   Design   was   experimental   study   with   total   sample   size   of   30   patients   with   confirmed   diagnosis   of   PD.   Patients   were   divided into   experimental   group   (n=15)   and   age   and   disease   severity   matched   control   group(n=15).   Conventional   gait   training   was   commonly   administered   in   both the   groups,   whereas   sensory-enhanced   therapy   (visual   and   auditory   cue)   was   given   along   with   gait   training   in   experimental   group   for   4   weeks.   The outcome measures were recorded at the 1 st  day & at the end of 4 th  week in both experimental and control group. Results:    The   data   collected   was   subjected   to   analysis   using   Statistical   Package   for   the   Social   Sciences   (SPSS).   All   data   were   expressed   in   mean±sd,   paired   t- test   was   used   to   analyze   the   variables   within   the   experimental   and   control   group.   Unpaired   t-test   was   used   for   analyzing   the   variables   between   the experimental   and   control   group.   A   significance   level   of   0.05   was   set   for   all   comparisons.   There   was   a   significant   decrease   in   gait   score   on   tool   UPDRS (p=0.0002)   increase   in   step   length   (p<0.001),   gait   speed   (p<0.001)   and   cadence   (p=0.005)   in   experimental   group   following   4-weeks   of   sensory-enhanced gait training as compared with the patients in the control group. Conclusion   and   Clinical   Significance:    Sensory-enhanced   gait   training   can   be   a   useful   rehabilitation   strategy   for   the   improvement   of   gait   in   PD   patients   and may prove to be valuable adjunct to traditional pharmacologic treatment of Parkinsonian gait. KEY WORDS: Parkinson’s Disease, Gait Training, UPDRS, Visual Cue, Auditory Cue, Sensory-Enhanced Therapy, Basal Ganglia. References 1 . Parkinson J. An essay on the shaking palsy. J Neuropsychiatry Clin Neurosci. Spring 2002;14(2):223-236. 2 . Columbia  Encyclopedia. The Columbia Electronic Encyclopedia, 2003, 6 th  edition, Columbia University Press. [ www.cc.columbia.edu/cu/cup ] 3 . Schenkman   M,   Cutson   T,   Kuchibatla   M   et   al.   Reliability   of   impairments   and   physical   performance   measures   of   persons   with   Parkinson’s   Disease. Journal  of  Physical Therapy, Jan 1997;77;1:19-27. 4 . 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Brain, Oct 2000;123(10):2077-2090. 9 . Rubinstein   T,   Giladi   N,   Hausdorff   J.   The   power   of   cueing   to   circumvent   dopamine   deficits:   A   review   of   physical   therapy   treatment   of   gait   disturbances in Parkinson’s Disease. Movement Disorders,2002;17(6):1148-1160. 1 0 . Coutts F. Peripheral joints. In: Beeton K, Manual therapy Masterclasses. 2003, Elsevier Health Sciences, page 103 1 1 . Perry Jacquelin. Stride analysis In: Gait Analysis: Normal and Pathological function, 1992, SLACK Incorporated. page 431 1 2 . Richards   C,   Malouin   F,   Bedard   P,   Ciono   M.   Changes   induced   by   L-dopa   and   sensory   cues   on   the   gait   of   Parkinsonian   patients.   In:   Woollacott   M,   Horak F, eds. Posture and gait: control mechanisms, Vol 2, Eugene OR: University of Oregan Books 1992;126-129 1 3 . Jiang Y, Norman K. Effects of visual and auditory cues on gait initiation in people with Parkinson’s Disease. 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International Journal of Physiotherapy and Research ISSN (O): 2321-1822  ISSN (P): 2321-8975 Volume 4 |Issue 6 |  2016 Date of Publication:  11 December 2016 http://ijmhr.org/ijpr.html editor_physiotherapy@hotmail.com HOME ABOUT US EDITORIAL BOARD AUTHOR GUIDELINES SPECIAL SERVICES CONTACT US