Background: Stroke (S), multiple sclerosis (MS), Parkinson’s disease (PD) are chronic neurological diseases that are a challange for public health and represent a real social problem. Physical activity (PA) improves functional performance, reduces various symptoms in PD and MS, in stroke- reduced neurological impairment of patients and provides a chance for independence. One of the main obstacles in successful rehabilitation is patients’ movement passivity. The reason might be the psychological aspects, in particular fear of movement—kinesiophobia. Aim: To determine how many patients with S, MS, and PD suffer from kinsiophobia and what factors influence this process. Methods: Fifty patients after stroke, eighty one MS patients and sixty one PD patients were consecutively recruited from hospital and outpatients clinics. The sociodemographic data, self- assesment of fitness, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK) and The Modified Baecke Questionnarie for Older Adults for physical activity were collected. A score >37 was considered to indicate a high level of kinesiophobia according to the TSK. Results: High level of kinesiophobia was shown in 66.67% of the subjects. TSK medians in particular illnesses were above the cut-off score and amounted: S—42.50 points; MS—38 points; PD—42.00 points. Regression showed 15% of fluctuation of variance (R2 = 0.1498; p < 0.0001), where regression factor showed: for mobility self-assessment: b = −0.2137 and for the age b = 0.0065. Conclusions: Kinesiophobia among the patients suffering from S, MS and PD concerns most of the subjects. Predictors of kinesiophobia are: limitations connected with functioning and age. The meaning of kinesiophobia in neurological disorders requires further research.
Background and objectives: Motor rehabilitation improves physical mobility and quality of life in Parkinson’s disease (PD). As specialized rehabilitation is expensive and resource-consuming, there is a need for simpler, cost-effective methods. The purpose of the study was to determine whether Nordic Walking (NW) training may support the management of motor disability in PD. Materials and Methods: Forty patients (median age 64.0 years, range 50–75 years) with idiopathic PD, Hoehn and Yahr stages II–III, were randomly assigned to NW or standard rehabilitation (SR) programs, comprising twelve rehabilitation sessions conducted bi-weekly throughout the 6-week study period. Results: Median Unified Parkinson’s Disease Rating Scale part III scores were significantly reduced with NW, by 8.5, and with SR, by 6.0 points (both p < 0.001), with significantly greater improvement with NW than with SR (p = 0.047). Gait quality and balance control, measured using the Dynamic Gait Index, improved with NW by a median of 8.0 and with SR by 5.5 points (both p < 0.001), with slightly greater improvement with NW, compared to the SR group (p = 0.064). Quality of life, assessed using the Parkinson’s Disease Questionnaire (PDQ-39), improved with NW by a median of 15 and with SR by 12 points, p = 0.001 and p = 0.008, respectively. Conclusions: The 6-week Nordic Walking program improves functional performance, quality of gait, and quality of life in patients with PD and has comparable effectiveness to standard rehabilitation.
Background and Objectives: Multiple sclerosis (MS) is the most common chronic demyelinating disease. Factors that reduce the occurrence of symptoms include physical activity (PA). However, the data indicate that PA levels among people with MS are lower than those of healthy peers. The cause may be kinesiophobia. The aim of the study was to determine the level of kinesiophobia among people with MS and its relationship with age, disease duration, functional status, PA, and degree of acceptance of the disease. Materials and Methods: Eighty people aged 35–69 were examined: 60 women (75%) and 20 men (25%). The Expanded Disability Status Scale (EDSS) was used to determine the level of disability (median: 3.50; min–max: 1–6). The research questionnaire consisted of a metric section, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK), Acceptance of Illness Scale (AIS), and Modified Baecke Questionnaire for Older Adults for physical activity. Results: Of the respondents, 52.50% were characterized by a high level of kinesiophobia (>37 points). Correlation analysis: TSK and PA showed the following: r = −0.363 (p = 0.001). Regression explains kinesiophobia in 44% (R2 = 0.4364; p < 0.0000). The predictors of TSK were as follows: disability level: p < 0.01, ß = 0.33; disease acceptance: p < 0.01, ß = −0.34; PA: p < 0.05, ß < −0.05. Conclusions: The problem of kinesiophobia is significant in MS patients, and its predictors are the functional status of the patients, low degree of acceptance of the disease, and low level of physical activity. The age and duration of the disease do not determine the problem of fear of movement.
Background: Staying at home for long periods and limiting various types of activities and social contacts due to the COVID-19 pandemic may have negative consequences for health. This is especially true for people suffering from chronic diseases, in whom an appropriate level of activity and social contacts delay the progress of the disease. This group includes people diagnosed with Parkinson’s disease—PD. Aim: It was decided to investigate the effect of COVID-19 isolation related to self-assessment of physical fitness, physical activity, and the level of anxiety and depression in people with PD. Methods: The study included 30 patients diagnosed with Parkinson’s disease. We compared the results of the pre-pandemic questionnaire and the telephone interview with the same questions—after the period of isolation due to COVID-19. The questionnaire included questions about physical activity and fitness self-assessment. The level of affective disorders was tested using HADS. Results: There was a statistically significant decrease in the physical activity of the respondents after isolation related to COVID-19 (p < 0.05). Self-assessment of physical fitness also decreased, but the differences were not statistically significant. In the post-isolation study, only 50% of the respondents had normative values for anxiety and only 40% for depression. The analysis showed that the level of physical activity—the independent variable, explains anxiety in 30% and depression in 27%. Conclusions: Pandemic isolation has significantly reduced physical activity in PD patients. There was a certain drop in the self-esteem of physical fitness in these people. Physical fitness is an important predictor of preventing the affective disorders of anxiety and depression. The effects of isolation due to COVID-19 require further research.
Due to the increasing number of people requiring rehabilitation and an aging society, the need to streamline, improve, and, above all, increase the availability of rehabilitation has been identified. In the present study, research was conducted to evaluate the feasibility of adapting an industrial robot to assist in the rehabilitation process. The study included four measurement series, which consisted of ten repetitions of Proprioception Neuromuscular Facilitation (PNF) movements. The first two series were performed with the assistance of a physiotherapist, the next two with the support of the Cobot UR10e. The lower limb movement was analyzed using the Noraxon Ultium Motion system using inertial sensors (IMU). The study analyzed the following parameters: hip flexion and abduction angles; knee flexion and rotation angles; ankle dorsiflexion angle; and motion cycle. Based on the results, it can be seen that the robot reproduces physiotherapeutic movements more precisely and with greater repeatability. The robot reproduced the movements in the hip and knee joints very well. From the analysis, it can be concluded that with proper adaptation, the robot could be used in the rehabilitation process.
Background/Objectives: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that typically affects adults aged 20–50. Its early stages can be difficult to diagnose due to the variable clinical course, although subtle impairments often appear in balance and motor control. The Timed Up and Go (TUG) test is commonly used to assess functional mobility; however, traditional evaluation based solely on total test duration may not be sensitive to early gait alterations. The use of inertial measurement units enables instrumented analysis of individual TUG subphases (iTUG). The aim of this study was determine whether iTUG parameters can help detect balance and movement difficulties indicative of early-stage MS. Methods: A total of 30 healthy people and 30 people in the early stages of MS with an expanded disability status score between 1 and 2 were included. The iTUG was performed using three Noraxon inertial sensors placed on the feet and upper spine. Results: No significant differences were observed in total iTUG duration between the MS and control groups (p = 0.888). In contrast, individuals with MS demonstrated significant differences in spatiotemporal gait parameters, trunk flexion range of motion (p = 0.003), number of steps during gait (p = 0.004), and turning velocity compared with healthy controls (p = 0.008). Conclusions: Analysis of iTUG duration is not enough to identify subtle gait and balance impairments in individuals with early-stage MS. Parameters that should be considered when performing an iTUG for the assessment of early stages of MS are spatiotemporal parameters, number of steps, and speed of rotation and subphase times.