Brain, Vol 121, Issue 3 505-514, Copyright © 1998 by Oxford University Press
T Platz, RG Brown and CD Marsden
In this study, the extent to which bradykinesia in patients with idiopathic
Parkinson's disease can be influenced by practice and by specific training
strategies was investigated. Fifteen patients with Parkinson's disease
tested after withdrawal of anti-Parkinson medication, and 15 matched
control subjects, practised a ballistic aiming task. Performance was tested
before, during and after training and again 1 h later. The Parkinson's
disease patients and control subjects were randomly assigned to one of two
training schedules, practising with or without rhythmic auditory cues. At
baseline, the Parkinson's disease patients showed longer movement times,
with a marked decrease in maximum acceleration and deceleration in the
initial open-loop phase compared with those of the control subjects. With
training, they were able to make significant improvement in the speed of
aimed movements, particularly in the early movement phase, without any
deterioration in accuracy. These effects transferred to an untrained limb
and were at least partially maintained after a 1-h delay. While patients
remained impaired relative to control subjects at all phases of training
and follow-up, the patients' performance at the end of training did not
differ significantly from the control subjects' baseline function. Contrary
to expectation, rhythmic auditory cues did not enhance improvement in the
speed of aimed movements in either patients or control subjects. If
anything, less improvement was shown in the cued groups, although there
were suggestions that the aiming skill was retained better over the delay
period. The results demonstrate preserved abilities to improve speed of
single ballistic aiming movements in Parkinson's disease patients and the
possibility of reducing bradykinesia by training.
ARTICLES
Training improves the speed of aimed movements in Parkinson's disease
Klinik Berlin, Department of Neurological Rehabilitation at the FU Berlin, Germany.
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