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Clinical seminar: Update on neurological physiotherapy in movement disorders (CS-11)

Chair: Hanan Khalil (Qatar)
Speakers:
Tamine Capato (Brazil), Natalie Allen (Australia)

Learning objectives
  1. Exploring the Role of Neuroplasticity in Motor Learning: Innovative Physiotherapy Strategies for Parkinson’s Disease To bring new commentaries and perspectives on the importance of the combination plasticity-promoting treatments with targeted physiotherapy. To explored and optimize postural instability gait disorders management using technology from the early to advanced stages (including freezing of gait); to advance our understanding of timing of gait rehabilitation prescription, the high-level of evidence-based of rehabilitation programs (optimal intensity/dose/evidence-based).
  2. Postural control and management of postural abnormalities in Parkinsonism Objective: to describe the physiology of postural control, the potential physiotherapy interventions, gaps and limitations of technology including wearables in detecting postural abnormalities
  3. Innovative Approaches to motor and non-motor symptoms management in Movement disorders: Addressing Challenges in Chorea, Dystonia, and Ataxia. Objective: To present novel concepts and address the challenges in managing gait and balance in movement disorders such as Chorea, Dystonia, and Ataxia. This session will offer new commentaries on integrating available technology and artificial intelligence to enhance gait treatments and develop personalized physiotherapy interventions with targeted outcome measures.
Session outline
Motor learning impairments are a hallmark of basal ganglia disorders, severely affecting gait, postural stability, and overall physiotherapy outcomes. First, we will explore the integration of neuroplasticity-promoting treatments with targeted physiotherapy. This session focuses on advancing physiotherapy strategies for movement disorders, particularly Parkinson’s Disease (PD) and parkisnonism, by exploring the interplay between neuroplasticity, innovative technologies, and the precise timing of interventions.  The discussion will focus on optimizing physiotherapy strategies by addressing individual variability in responses and disease characteristics. The objective is to improve motor function, facilitate behavior change, and enhance the quality of life for individuals with PD.
 
In addition, technological advancements offer new avenues for monitoring and enhancing physiotherapy outcomes in movement disorders. We will examine how integrating technology into rehabilitation plans can personalize interventions, addressing the variability in disease progression and treatment responses. The focus will be on leveraging real-time monitoring tools and outcome measurements to tailor rehabilitation to individual patient needs, ultimately optimizing therapeutic outcomes and stimulating behavior changes in individuals with movement disorders.
 
Finally, we will discuss the physiotherapy time, intensity, and dosing are crucial for improving functional outcomes in PD, particularly in managing freezing of gait and reducing fall risks. This session will provide evidence-based, emphasizing the importance of early intervention and novel techniques. The goal is to equip participants with actionable insights on prescribing and implementing effective gait rehabilitation programs that cater to the disease’s progression and variability.

 

Session delivered by: International Neurological Physiotherapy Association

References
  1. Johansson ME, Cameron IGM, Van der Kolk NM, de Vries NM, Klimars E, Toni I, Bloem BR, Helmich RC. Aerobic Exercise Alters Brain Function and Structure in Parkinson’s Disease: A Randomized Controlled Trial. Ann Neurol. 2022 Feb;91(2):203-216. doi: 10.1002/ana.26291. Epub 2022 Jan 19. PMID: 34951063; PMCID: PMC9306840.
  2. van der Kolk NM, de Vries NM, Kessels RPC, Joosten H, Zwinderman AH, Post B, Bloem BR. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: a double-blind, randomised controlled trial. Lancet Neurol. 2019 Nov;18(11):998-1008. doi: 10.1016/S1474-4422(19)30285-6. Epub 2019 Sep 11. PMID: 31521532.
  3. Radder DLM, Lígia Silva de Lima A, Domingos J, Keus SHJ, van Nimwegen M, Bloem BR, de Vries NM. Physiotherapy in Parkinson’s Disease: A Meta-Analysis of Present Treatment Modalities. Neurorehabil Neural Repair. 2020 Oct;34(10):871-880. doi: 10.1177/1545968320952799. Epub 2020 Sep 11. PMID: 32917125; PMCID: PMC7564288.
  4. Osborne JA, Botkin R, Colon-Semenza C, et al. Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline from the American Physical Therapy Association. Physical therapy. 2021.
  5. Capato TTC, de Vries NM, IntHout J, Barbosa ER, Nonnekes J, Bloem BR. Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial. J Parkinsons Dis. 2020;10(1):333-346. doi: 10.3233/JPD-191752. PMID: 31884492; PMCID: PMC7029328.
  6. Package of interventions for rehabilitation. Module 3. Neurological conditions. 2023, World Health Organization: Geneva.
  7. Keus S, M.M., Graziano M, et al., European physiotherapy guideline for Parkinson’s disease. 2014, KNGF/ParkinsonNet: The Netherlands
  8. Capato TTC, Chen J, Miranda JA, Chien HF. Assisted technology in Parkinson’s disease gait: what’s up? Arq Neuropsiquiatr. 2024 Jun;82(6):1-10. doi: 10.1055/s-0043-1777782. Epub 2024 Feb 23. PMID: 38395424; PMCID: PMC10890908.
  9. Geroin C, Artusi CA, Nonnekes J, Aquino C, Garg D, Dale ML, Schlosser D, Lai Y, Al-Wardat M, Salari M, Wolke R, Labou VT, Imbalzano G, Camozzi S, Merello M, Bloem BR, Capato T, Djaldetti R, Doherty K, Fasano A, Tibar H, Lopiano L, Margraf NG, Moreau C, Ugawa Y, Bhidayasiri R, Tinazzi M; International Parkinson and Movement Disorders Society Task Force on Postural Abnormalities. Axial Postural Abnormalities in Parkinsonism: Gaps in Predictors, Pathophysiology, and Management. Mov Disord. 2023 May;38(5):732-739. doi: 10.1002/mds.29377. Epub 2023 Apr 20. PMID: 37081741.
  10. Quinn L, Kegelmeyer D, Kloos A, Rao AK, Busse M, Fritz NE. Clinical recommendations to guide physical therapy practice for Huntington disease. Neurology. 2020 Feb 4;94(5):217-228. doi: 10.1212/WNL.0000000000008887. Epub 2020 Jan 6. PMID: 31907286; PMCID: PMC7080285.
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