Post-Physical Therapy 4-Month In-Home Dynamic Standing Protocol Maintains Physical Therapy Gains and Improves Mobility, Balance Confidence, Fear of Falling and Quality of Life in Parkinson's Disease: A Randomized Controlled Examiner-Blinded Feasibility Clinical Trial

Miriam van Emde Boas; Chatkaew Pongmala; Abigail M Biddix; Alexis Griggs; Austin T Luker; Giulia Carli; Uros Marusic; Nicolaas I Bohnen

doi:10.22540/JFSF-09-267

Post-Physical Therapy 4-Month In-Home Dynamic Standing Protocol Maintains Physical Therapy Gains and Improves Mobility, Balance Confidence, Fear of Falling and Quality of Life in Parkinson's Disease: A Randomized Controlled Examiner-Blinded Feasibility Clinical Trial

J Frailty Sarcopenia Falls. 2024 Dec 1;9(4):267-280. doi: 10.22540/JFSF-09-267. eCollection 2024 Dec.

Authors

Miriam van Emde Boas^{1

2

3}, Chatkaew Pongmala^{1

2

3}, Abigail M Biddix^{1

2

3}, Alexis Griggs^{1

2

3}, Austin T Luker^{1

2

3}, Giulia Carli^{1

2

4}, Uros Marusic^{5

6}, Nicolaas I Bohnen^{1

2

3

7}

Affiliations

¹ Functional Neuroimaging, Cognitive & Mobility Laboratory, University of M ichigan, Ann Arbor, MI, USA.
² Morris K. Udall Center of Excellence in Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA.
³ Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
⁴ Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
⁵ Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.
⁶ Department of Health Sciences, Alma Mater Europaea University, Maribor, Slovenia.
⁷ Neurology Service and GRECC, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA.

Abstract

Objective: Parkinson's patients will experience mobility disturbances with disease progression. Beneficial effects of physical therapy are short-lasting. Novel interventions are needed to maintain these benefits.

Methods: Fourteen Parkinson's patients (71±4.08 years) participated in a randomized controlled examiner-blinded feasibility clinical trial. After 12 physical therapy sessions, the intervention group received a height-adjustable desk that facilitates stepping while standing, for 4 months. Explorative outcome measures included MDS-UPDRS II, III, TUG, 8.5m walking test, PDQ-39, sABC, sFES, DEXA scans, and lower extremity strength.

Results: Post-physical-therapy, everyone significantly improved on the MDS-UPDRS II, III, TUG, and 8.5m walking test, and PDQ-39. (p<0.05) After 4 months, the control group regressed towards pre-physical-therapy values. In the intervention group, sedentary behavior decreased beyond desk use, indicating a carry-over effect. MDS-UPDRS II, PDQ-39, sFES, sABC, TUG, 8.5m walking test, activity time, sitting time, hip strength all improved with clinically relevant effect sizes.

Conclusion: Post-physical therapy in-home reduction of sedentary behavior was associated with maintenance of physical benefits and additional improvements in mobility, activity time, balance and quality of life.

Keywords: Parkinson’s Disease; Physical Therapy; Quality of Life; Sarcopenia; Sedentarism.