The role of rehabilitation in deep brain stimulation of the subthalamic nucleus for Parkinson's disease: A pilot study

Tassorelli, Cristina; Buscone, Simona; Sandrini, Giorgio; Pacchetti, Claudio; Furnari, Anna; Zangaglia, Roberta; Bartolo, Michelangelo; Nappi, Giuseppe; Martignoni, Emilia

doi:10.1016/j.parkreldis.2009.03.006

« Previous Next »Parkinsonism & Related Disorders
Volume 15, Issue 9 , Pages 675-681, 5 November 2009

The role of rehabilitation in deep brain stimulation of the subthalamic nucleus for Parkinson's disease: A pilot study

Cristina Tassorelli
- Neurorehabilitation Unit, Department of Neurological Sciences, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
- Corresponding author. Tel.: +39 (0)382 380425; fax: +39 (0)382 380448.
Simona Buscone
- Neurorehabilitation Unit, Department of Neurological Sciences, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
Giorgio Sandrini
- Neurorehabilitation Unit, Department of Neurological Sciences, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
Claudio Pacchetti
- Parkinson's Disease and Movement Disorders Unit, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy
Anna Furnari
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
Roberta Zangaglia
- Parkinson's Disease and Movement Disorders Unit, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy
Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Neurological Sciences, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
Giuseppe Nappi
- Neurorehabilitation Unit, Department of Neurological Sciences, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy
- Parkinson's Disease and Movement Disorders Unit, Interdepartmental Centre of Research on Parkinson's Disease (ICRPD), IRCCS “C. Mondino Institute of Neurology” Foundation, Pavia, Italy
- University “La Sapienza”, Chair of Neurology, Rome, Italy
Emilia Martignoni
- Unit of Neurorehabilitation and Movement Disorders, IRCCS S. Maugeri Foundation, Scientific Institute of Veruno, Italy
- Department of Medical Sciences, University of Insubria, Varese, Italy

Received 22 February 2008; received in revised form 1 March 2009; accepted 25 March 2009.

Abstract

Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an efficacious therapeutic option in the treatment of advanced Parkinson's disease (PD). The procedure may be however associated with functional impairment of different types and intensity. In this paper we describe the functional impairments detected in a group of 34 subjects with PD who were submitted to DBS. These patients belonged to a cohort of 75 consecutive PD patients who underwent the surgical procedure. The rehabilitation program included physiotherapy exercises for recovery/maintenance of the range of motion, active exercises, exercises for coordination and proprioception, and walking training based on the use of sensory cues, with daily sessions for a period of 4–8 weeks. The motor examination section of unified Parkinson's disease rating scale (UPDRS-ME) and the functional independence measure (FIM) scores showed a consistent and significant improvement in the patients' motor performances.

The reported findings suggest that rehabilitation may play an important role in the correction of specific functional impairments caused by or associated with DBS in PD.

Keywords: Deep brain stimulation, Parkinson’s disease, Physical therapy, Neurorehabilitation