P-2-06-05
MUSCLE STRENGTH IN PARKINSON'S DISEASE (THE SECOND REPORT)
Hiroshi Nogaki, Mitsunori Morimatsu (Yamaguchi University, Ube, Japan)
Purpose: Patients with Parkinson's disease often complain of muscle weakness in their daily lives. However, there are few reports in which the muscle strength of patients with Parkinson's disease has been measured quantitatively. In the present study, we assessed the isokinetic muscle strength of the lower extremities in patients with Parkinson's disease revealing a marked laterality of symptoms and signs.
Methods: Twenty-two patients with Parkinson's disease who demonstrated a marked laterality of symptoms and signs were examined. Their mean age was 61.2 years. Twelve patients were classified as Hoehn and Yahr stage I, six patients as stage II and the remaining four patients as stage III. The mean duration of their symptoms was 61.7 months. Isokinetic muscle strength of the knee was measured bilateraly using a Cybex II+ isokinetic dynamometer set at five revolutions per minute (RPM) and 15 RPM. Patients performed five consecutive repetitions of knee extension and flexion movements under maximum efforts, with continual verbal encouragement from the examiner. A maximum peak torque value (foot- pound) was derived, and was compared between the affected and the less affected sides.
Results: In all the 22 patients or 12 patients belonging to Hoehn and Yahr stage I, both at 5 RPM and 15 RPM, muscle strength on the affected side was significantly below that of the less affected side for both extension and flexion, especially at 15 RPM. In 10 patients belonging to Hoehn and Yahr stage II and III, at five RPM, there was no statistical difference in muscle strength between the affected and the less affected sides. Alternatively, at 15 RPM, muscle strength on the affected side was significantly below that of the less affected side for both extension and flexion.
Conclusion: These results suggest that muscle weakness in patients with Parkinson's disease may depend on the velocity of the performed movement as the severity of the disease progresses.
P-2-06-06
REHABILITATION OUTCOME OF VASCULAR PARKINSONISM WITH OR WITHOUT LEUKOARAIOSIS
Tadatoshi Komiya (Amakusa Rehabilitation Hospital, Saitama, JAPAN.)
Vascular parkinsonism show a disturbance of mentality and/or ADL, and the drug therapy for parkinsonian symptoms is not so effective. In the present study, the rehabilitation effects of vascular parkinsonism with or without leukoaraiosis on CT is discussed.
Thirty-three patients with vascular parkinsonism (mean age: 73) were enrolled in this study, and divided into two groups (18 patients without leukoaraiosis on CT, 15 patients with leukoaraiosis). Only cases which showed evident leukoaraiosis were classified as leukoaraiosis and other cases without leukoaraiosis. Assessments of mentality and ADL were made using MMS and Barthel Index (BI).
In the patient group without leukoaraiosis (mean age: 70), the mean MMS and BI scores before rehabilitation therapy was 21±2.4 (mean±SD) and 62±20, and after 3-month therapy, 23±2.8 and 88±12. In the patient group with leukoaraiosis (mean age: 75), the mean MMS and BI before rehabilitation therapy was 15±5.4 and 49±33, and after 3-month therapy, 17±5.0 and 67±28.
Rehabilitation therapy for the vascular parkinsonism without leukoaraiosis on CT appears to be more effective than that with evident leukoaraiosis. These results indicate that it is important to take the evident leukoaraiosis into account in formulating rehabilitation program and in research for vascular parkinsonism.
