The effect of rehabilitation after the deep brain stimulation of subthalamic nucleus on the axial symptom in Parkinson’s disease

抄録

【Background/Purpose】

 The deep brain stimulation of subthalamic nucleus (STN-DBS) is a surgical treatment for Parkinson's disease (PD) to reduce off-state. There have been scarce reports that indicate the effectiveness of postoperative rehabilitation on the axial symptoms. The purpose of this study is to examine the effectiveness of postoperative rehabilitation in PD patients.

【Methods or Cases】

 The data of 31 postoperative PD patients who received 2 week physical therapy from May 2017 to May 2018 were extracted from a prospectively maintained database, and were analyzed retrospectively.

 Outcome measures were the Mini-Balance Evaluation Systems Test (Mini-BESTest), Trunk impairment scale (TIS), Leg extension torque, 10 times toe tapping (10TTT) and Treadmill gait analysis. The patients were evaluated at pre-operation, post-operation and discharge period. One-way repeated measures analysis of variance (ANOVA) and post-hoc Paired t-tests with Bonferroni adjustment for multiple comparison were used to analyze the data (P < 0.05).

【Results】

 The ANOVA showed that all clinical data had the significant differences among three periods. The post hoc test revealed that there were significant differences between pre-operation and discharge periods in the Mini-BESTest (P < 0.0001), TIS (P < 0.0001), Step length on the Treadmill (P=0.004) and 10TTT (P=0.009), but the lower limb extension torque (P=0.11).

 There was only significantly different between pre-operation and post-operation in the Step length on the Treadmill (P=0.032).

 【Discussion/Conclusion】

 The results showed that postoperative rehabilitation has a positive effect on the balance ability, trunk function, gait function and limb akinesia of the PD patients. These facts might indicate that STN-DBS and postoperative rehabilitation provide different effects on the PD patients.

【Ethical consideration】

This study was conducted with the declaration of Helsinki.

 This study was approved by the institutional ethics review board (JHS 18-007).