Intensive Care Unit delirium, insomnia, anxiety, and frontal/dysexecutive disorders have been described following COVID-19 infection. The aim of this case study was to re-evaluate the neuropsychological pattern in a series of patients with COVID-19 outcomes. We retrospectively evaluated 294 patients admitted to the Istituti Clinici Scientifici Maugeri of Lumezzane (Brescia) (May–September 2020). Neuropsychological assessment was available for 12 patients. We extracted clinical, functional data (FIM and Barthel Index score) and neuropsychological tests (MMSE, Trail making a-b, verbal fluency test, digit span, prose memory test, Frontal Assessment Battery, clock drawing test, Rey–Osterrieth complex figure, Tower of London test). The results were analyzed by Spearman (rho) correlation. Six patients presented dysexecutive alterations even in the presence of normal overall cognitive functioning. Forward digit span score was directly correlated to FIM value at admission (p = 0.015) and inversely correlated to delta FIM (p = 0.030) and delta Barthel Index (p = 0.025). In our experience, subclinical cognitive alterations were present in 4% of patients recovering from COVID-19 pneumonia. The possible correlation between verbal memory and frontal functions, and the degree of functional impairment at admission and its subsequent improvement, underscores the importance of an adequate cognitive evaluation and rehabilitation.

Purpose: Almost 90% of people with Parkinson's disease (PD) develop voice and speech disorders during the course of the disease. Ventilatory dysfunction is one of the main causes. We aimed to evaluate relationships between respiratory impairments and speech/voice changes in PD.Method: At Day 15 from admission, in consecutive clinically stable PD patients in a neurorehabilitation unit, we collected clinical data as follows: comorbidities, PD severity, motor function and balance, respiratory function at rest (including muscle strength and cough ability), during exercise-induced desaturation and at night, voice function (Voice Handicap Index [VHI] and acoustic analysis [Praat]), speech disorders (Robertson Dysarthria Profile [RDP]), and postural abnormalities. Based on an arbitrary RDP cutoff, two groups with different dysarthria degree were identified—moderate–severe versus no–mild dysarthria—and compared.Results: Of 55 patients analyzed (median value Unified Parkinson's Disease Rating Scale Part II 9 and Part III 17), we found significant impairments in inspiratory and expiratory muscle pressure (> 90%, both), exercise tolerance at 6-min walking distance (96%), nocturnal (12.7%) and exercise-induced (21.8%) desaturation, VHI (34%), and Praat Shimmer% (89%). Patients with moderate–severe dysarthria (16% of total sample) had more comorbidities/disabilities and worse respiratory pattern and postural abnormalities (camptocormia) than those with no–mild dysarthria. Moreover, the risk of presenting nocturnal desaturation, reduced peak expiratory flow, and cough ability was about 11, 13, and 8 times higher in the moderate–severe group.Conclusions: Dysarthria and respiratory dysfunction are closely associated in PD patients, particularly nocturnal desaturation and reduced cough ability. In addition, postural condition could be at the base of both respiratory and voice impairments.Supplemental Material: https://doi.org/10.23641/asha.21210944

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder that impairs mobility. Treadmill training (TT) is a common rehabilitation strategy for improving gait parameters in individuals with PD. This systematic review evaluated the effectiveness of TT in improving motor function, walking ability, and overall functional mobility in PD patients. Methods: We compared TT to other forms of gait and motor rehabilitation, including conventional and robotic gait training. Trials that compared a treadmill training group with a non-intervention group were excluded from this review. We searched multiple databases for RCTs involving Parkinson’s patients until January 2025. The primary outcomes were motor function (UPDRS-III) and walking ability (6 MWT and TUG test). Results: We identified 285 articles; 199 were excluded after screening. We assessed the full text of 86 articles for eligibility, and 13 RCTs met the inclusion criteria. Some of them were included in the meta-analysis. The TT group showed a significant improvement in UPDRS-III scores [mean difference (MD): −1.36 (95% CI: −2.60 to −0.11)] and greater improvement in TUG performance [MD, −1.75 (95% CI: −2.69 to −0.81)]. No significant difference in walking capacity as assessed through the 6 MWT was observed [MD: 26.03 (95% CI: −6.72 to 58.77). Conclusions: The current study suggests that TT is effective in improving the motor symptoms and functional mobility associated with PD. Further studies are needed to develop protocols that consider the patients’ clinical characteristics, disease stage, exercise tolerance, and respiratory function.

Article: Patients recovering from COVID-19 pneumonia at a sub-acute admissions unit exhibit profound muscular weakness - European Journal of Physical and Rehabilitation Medicine 2021 April;57(2):310-2 - Minerva Medica - Journals

Background: Surface electromyography is emerging as a noninvasive tool to examine neurogenic dysphagia in Parkinson’s disease (PD). This pilot study evaluated the feasibility of surface electromyography (sEMG) (acceptability, resource use, and safety), and explored changes in swallowing-related sEMG parameters following rehabilitation. Methods: Ten patients with mild to moderate PD (Hoehn Yahr 1–3) underwent clinical, respiratory, and swallowing assessments, including sEMG recordings of perioral (orbicularis oris), masticatory (masseter) and cervical muscles (submental/mylohyoid and infrahyoid group). Feasibility outcomes included recruitment, protocol completion, and adverse events. Exploratory sEMG measures comprised amplitude indices (root-mean-square, RMS; peak-to-peak, P2P range; area under curve, AUC) and activation time during saliva swallowing and continuous drinking tasks. Results: Nine out of 10 participants completed the protocol, and no adverse events were reported, indicating good acceptability and safety. Exploratory pre–post analyses showed reduced sEMG amplitude during saliva swallowing of orbicularis oris [median ΔP2P Range = −0.273 (p = 0.020), median ΔAUC = −0.145 (p = 0.027); RMS (median Δ = −0.427) (p = 0.074)] and a generalized prolongation of activation time during continuous sipping across recorded muscles. Conclusions: Multichannel sEMG assessment of swallowing muscles during speech therapy is feasible and safe in patients with PD. Exploratory signal changes warrant cautious interpretation and should be validated in larger rehabilitation-oriented studies.