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JKM > Volume 38(3); 2017 > Article
Yang, Kim, Lee, Lee, Cho, Park, Ko, and Park: Effects of Korean Medicine on Postural Instability and Gait Difficulty in Patient with Parkinsonism: Retrospective Study

Abstract

Objectives

The purpose of this study was to investigate the effects of Korean Medicine on postural instability and gait difficulty(PIGD) in patient with parkinsonism.

Methods

We reviewed the charts of patients with parkinsonism who were admitted to the department of Korean internal medicine, stroke and neurological disorders center, Kyung Hee University Hospital at Gangdong from October 2009 to May 2017. We analyzed the data of UPDRS (Unified Parkinson’s disease rating scale) and calculated PIGD related UPDRS before and after the admission.

Results

The average of PIGD score for the 23 patients of Parkinsonism significantly decreased from 8.35 ± 5.13 to 4.52 ± 3.68 after treatment. The average of PIGD score for the 16 patients of idiopathic parkinson’s disease and 7 patients of atypical Parkinsonism decreased from 9.13 ± 4.46 to 4.63 ± 4.15 and from 6.57 ± 6.45 to 4.29 ± 2.56 after treatment, respectively.

Conclusions

These results provide that Korean Medicine has an effect on the motor function of patients who suffer from Parkinsonism with Postural Instability and Gait Difficulty. Furthermore it could be effective for improving activities of daily life.

Table 1
General Characteristics of Patients.
Characteristics Total (n=23) IPD* (n=16) Atypical Parkinsonism (n=7)
Mean of age (year) 66.43 ± 9.80 66.44 ± 11.06 66.43 ± 6.80
Sex (N) Man 3 0 3
Woman 20 16 4
Duration of disease (year) 4.39 ± 2.55 5.31 ± 2.44 2.29 ± 1.25
Duration of treatment (day) 19.70 ± 11.67 18.00 ± 9.81 23.57 ± 15.28
Subtype (N) MSA-P (5)
MSA-C (2)

Values are mean ± standard deviation or number

* IPD : Idiopathic Parkinson’s Disease

† MSA-P : Multiple System Atrophy-Parkinsonian subtype

‡ MSA-C : Multiple System Atrophy-Cerebellar dysfunction subtype

Table 2
Changes in Postural Instability and Gait Difficulty related Unified Parkinson’s Disease Rating Scale after Treatment in Parkinsonism Patients.
Before After p-value
Total PIGD* score 8.35 ± 5.13 4.52 ± 3.68 0.000
Falling 1.41 ± 1.30 0.61 ± 0.94 0.002
Freezing 1.44 ± 1.31 0.74 ± 0.92 0.005
Walking 1.80 ± 0.83 1.05 ± 0.49 0.001
Gait 1.50 ± 1.05 0.91 ± 0.61 0.002
Postural stability 1.70 ± 1.19 1.04 ± 0.93 0.001

Values are mean ± standard deviation

* PIGD : Postural Instability and Gait Difficulty

† p-value is calculated by paired t-test

‡ p-value is calculated by Wilcoxon signed rank test

Table 3
Changes in Postural Instability and Gait Difficulty related Unified Parkinson’s Disease Rating Scale after Treatment in Idiopathic Parkinson’s Disease Patients.
Before After p-value
Total PIGD* score 9.13 ± 4.46 4.63 ± 4.15 0.000
Falling 1.67 ± 1.18 0.63 ± 1.03 0.003
Freezing 1.63 ± 1.09 0.69 ± 1.01 0.002
Walking 2.00 ± 0.88 1.07 ± 0.46 0.006
Gait 1.73 ± 1.10 0.93 ± 0.70 0.004
Postural stability 1.75 ± 1.13 1.06 ± 1.00 0.004

Values are mean ± standard deviation

* PIGD : Postural Instability and Gait Difficulty

† p-value is calculated by paired t-test

‡ p-value is calculated by Wilcoxon signed rank test

Table 4
Changes in Postural Instability and Gait Difficulty related Unified Parkinson’s Disease Rating Scale after Treatment in Atypical Parkinsonism Patients.
Before After p-value
Total PIGD* score 6.57 ± 6.45 4.29 ± 2.56 0.224
Falling 0.86 ± 1.46 0.57 ± 0.79 0.457
Freezing 1.00 ± 1.73 0.86 ± 0.69 0.679
Walking 1.33 ± 0.52 1.00 ± 0.58 0.047
Gait 0.80 ± 0.45 0.86 ± 0.38 0.280
Postural stability 1.57 ± 1.40 1.00 ± 0.81 0.102

Values are mean ± standard deviation

* PIGD : Postural Instability and Gait Difficulty

† p-value is calculated by paired t-test

‡ p-value is calculated by Wilcoxon signed rank test

참고문헌

1. Aminoff MJ, Greenberg DA, Simon RP. Clinical Neurology. 6th ed. New York: Lange Medical books/McGraw-Hill Medical;2005. p. 241–5.


2. Samii A, Nutt JG, Ransom BR. Parkinson’s disease. Lancet. 2004; 363:9423. 1183–93.
crossref

3. Tolosa E, Wenning G, Poewe W. The diagnosis of Parkinson’s disease. Lancet Neurol. 2006; 5:75
crossref

4. Pickering RM, Grimbergen YAM, Rigney U, Ashburn A, Mazibrada G, Wood B, et al. A meta analysis of six prospective studies of falling in Parkinson’s disease. Movement Disorders. 2007; 22:1892–1900.
crossref

5. Balash Y, Peretz C, Leibovich G, Herman T, Hausdorff JM, Giladi N. Falls in outpatients with Parkinson’s disease: frequency, impact and identifying factors. Journal of Neurology. 2005; 252:1310–5.
crossref

6. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. Journal of Neurology, Neurosurgery, and Psychiatry. 2002; 72:721–5.
crossref

7. Ashburn A, Stack E, Pickering RM, Ward CD. A community-dwelling sample of people with Parkinson’s disease: characteristics of fallers and non-fallers. Age & Ageing. 2001; 30:47–52.
crossref

8. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007; 297:77–86.
crossref

9. Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE, et al. Predictors of deterioration in health-related quality of life in Parkinson’s disease: results from the DATATOP trial. Movement Disorders. 2008; 23:653–9.
crossref

10. Tinetti ME, Williams CS. Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home. The New England Journal of Medicine. 1997; 337:1279–84.
crossref

11. Kwakkel G, de Goede CJ, van Wegen EE. Impact of physical therapy for Parkinson’s disease: a critical review of the literature. Parkinsonism Relat Disord. 2007; 13:478–87.
crossref

12. Moretti DV. Are there treatments for atypical parkinsonism? An update on actual options. Rev Neurosci. 2015; 26:5. 547–53.
crossref

13. Yang SB, Kim YJ, Lee HM, Lee HJ, Cho SY, Park JM, et al. Effects of Korean Medicine on Patients with Idiopathic Parkinson’s Disease: A Retrospective Study. J Int Korean Med. 2016; 37:4. 653–660.
crossref

14. Thenganatt MA, Jankovic J. Parkinson disease subtypes. JAMA Neurol. 2014; 71:4. 499–504.
crossref

15. Koh SB, Park KW, Lee DH, Kim SJ, Yoon JS. Gait Analysis in Patients With Parkinson’s Disease: Relationship to Clinical Features and Freezing. 2008; 1:2. 59–64.


16. Zhang G, Xiong N, Zhang Z, Liu L, Huang J, Yang J, et al. Effectiveness of traditional Chinese medicine as an adjunct therapy for Parkinson’s disease: a systematic review and meta-analysis. PLoS One. 2015; 10:3. e0118498
crossref

17. Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA -compliant systematic review and meta-analysis. Medicine. 2017; 96:3. e5836
crossref

18. Kim SN, Doo AR, Park JY, Bae H, Chae Y, Shim I, et al. Acupuncture enhances the synaptic dopamine availability to improve motor function in a mouse model of Parkinson’s disease. PLoS One. 2011; 6:11. e27566
crossref

19. Cho SY, Shim SR, Rhee HY, Park HJ, Jung WS, Moon SK, et al. Effectiveness of acupuncture and bee venom acupuncture in idiopathic Parkinson’s disease. Parkinsonism Relat Disord. 2012; 18:8. 948–52.
crossref

20. Doo KH, Lee JH, Cho SY, Jung WS, Moon SK, Park JM, et al. A Prospective Open-Label Study of Combined Treatment for Idiopathic Parkinson’s Disease Using Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment. J Altern Complement Med. 2015; 21:10. 598–603.
crossref

21. Hartmann A, Müllner J, Meier N, Hesekamp H, van Meerbeeck P, Habert MO, et al. Bee Venom for the Treatment of Parkinson Disease - A Randomized Controlled Clinical Trial. PLoS One. 2016; 11:7. e0158235
crossref

22. Awad K, Abushouk AI, AbdelKarim AH, Mohammed M, Negida A, Shalash AS. Bee venom for the treatment of Parkinson’s disease: How far is it possible? Biomed Pharmacother. 2017; 91:295–302.
crossref

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