17 Rehabilitation improves dyskinesias in Parkinsonian patients: A pilot study comparing two different rehabilitative treatments

Background The present study was devised: (a) to test whether an intensive multidisciplinary rehabilitation treatment (60 h) for Parkinsonian patients is effective in improving dyskinesia and motor performance compared to a control group undergoing a non-intensive non multidisciplinary rehabilitation treatment (30 h) and (b) to verify whether rehabilitation may lead to a reduction in levodopa dosage. Methods Forty Parkinsonian patients suffering from dyskinesias were admitted to study: 20 for an intensive (group-1) and 20 for a standard treatment (group-2). The rating scales used for the clinical evaluation were: Unified Parkinson’s Disease Rating Scales (UPDRS) II, III, IV, Parkinson’s disease disability scale (PDDS), Abnormal Involuntary Movement Scale (AIMS). Results All outcome measurements improved in both groups of patients, but patients group-1 presented better results: UPDRS II was reduced by 33% in group-1 and by 22% in group-2, UPDRS III 29% vs. 22%, UPDRS IV 74% vs. 10%, PDDS 18% vs. 12%, and AIMS 71% vs. 8%. A different behaviour was observed for levodopa dosage at baseline and after treatment: dosage decreased by an average value of 210 mg ( p p  = 0.08) in group-2. Conclusion Our findings suggest that a rehabilitation protocol should be considered as a valid non-invasive therapeutic support for patients who show dyskinesias and that there are better results when the treatment is intensive.