PB2. Beneficial Effects of intensive speech-language therapy or virtual dance training on mobility deficits in patients with Parkinsons disease (PD)

Abstract

Literature Parkinson’s disease comprises postural instability, problems with gait, balance and mobility. Such deficits may lead to falls, which may further decrease quality of life, morbidity of PD and mortality in PD patients ( Muslimovic et al., 2008 ). PD patients suffer from 3 times the risk of falls and 5 times the injuries when compared to age-matched healthy controls (Horak, 2005). Although DBS improves motor skills, a trend towards more falls has been reported after STN-DBS (Weaver, 2009; Lai, 2013). Dancing therapies have been reported to improve balance ( Earhart, 2009 ). However, whether a virtual dance training (VDT) may reduce problems with balance and mobility compared to an intensive speech-language therapy (SLT) and compared to no therapy (NT) remains uninvestigated so far. Method This study is laid out as a cross-over design with 26 PD Patients ( N = 13 DBS; N = 13 non-DBS; Education Mdn 16 yrs. [12–20 yrs.]; gender: 16 m/10f; PD-Onset Mdn 7 yrs. [3–10 yrs.]; L-Dopa Mdn 350 mg. [80–450 mg]), who – so far – participated in SLT ( N = 19), or a VDT ( N = 9) or NT ( N = 17). Their neurophysiological abilities were tested using POMA (Tinetti, 1990), TUG (Podsiadlo and Richardson, 1991) and the Tandem-Test (Murphay, 2003). Participants were tested at baseline, directly after the intensive training (4 weeks) and again after 6 months. These preliminary results are based on raw data. Independent t - tests were performed and if results reached p > . 05 or below, results were seen as significant. Result Both SLT and VDT groups showed a significant improvement on the TUG ( p . 05 ), the Tandem ( p . 01 ), and the POMA test ( p . 05 ) comparing their performance at baseline and after 4 weeks of intensive training. Improvements were more pronounced in the VDT compared to the SLT ( p . 05 ). Whilst the NT group had highest performance levels at baseline compared to VDT ( p . 001 ) and SLT ( p . 01 ), the NT group showed a non significant decrease in performance over time. At 6 months, results were similar to baseline ( p > . 92 ) for each group and across groups ( p > .42). Conclusions VDT may reduce problems with balance and mobility on a short-term basis. SLT may have beneficial ‘transfer-effects’ due to empathy and due to the fact that (self-)perception is a main focus in therapy. After 6 months, therapeutic effects are erased and require a refresher intervention.