PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media29698310.18565/pharmateca.2019.3.7-13ArticlesСтатьиResearch ArticleThe state of the problem of rehabilitation of patients with Parkinson’s disease. Features of rehabilitation against the background of neurostimulation of subcortical structuresСостояние проблемы реабилитации пациентов с болезнью Паркинсона. Особенности реабилитации на фоне нейростимуляции подкорковых структурBrilEkaterina V.БрильЕ. В

PhD, Associate Professor at the Department of Neurology of Russian Medical Academy Continuous Professional Education, Chief Neurologist of FMBA of Russia, Head of the Federal Neurological Center for Extrapyramidal Diseases and Mental Health, SRC Burnasyan FMBC

к.м.н., доцент кафедры неврологии РМАНПО, главный невролог ФМБА России, рук. Федерального неврологического центра экстрапирамидных заболеваний и психического здоровья ГНЦ ФМБЦ им. А.И. Бурназяна

e.brill@inbox.ruFedorovaN. VФедороваН. В

Кафедра неврологии РМАНПО

TomskyA. AТомскийА. АGamaleyaA. AГамалеяА. АOmarovaS. MОмароваС. МKesarevD. GКесаревД. ГOrekhovaO. AОреховаО. АState Research Center Burnasyan Federal Medical Biophysical Center of FMBA of Russia, Federal Neurological Center for Extrapyramidal Diseases and Mental HealthГНЦ ФМБЦ им. А.И. Бурназяна ФМБА России, Федеральный неврологический центр экстрапирамидных заболеваний и психического здоровьяS.P. Botkin City Clinical HospitalГКБ им. С.П. БоткинаAcad. N.N. Burdenko NMRC for NeurosurgeryНМИЦ нейрохирургии им. акад. Н.Н. Бурденко15032019263VOL 26, NO3 (2019)ТОМ 26, №3 (2019)71328022023Copyright ©; 2019, Bionika MediaCopyright ©; 2019, ООО «Бионика Медиа»2019Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/296983

Interest in the rehabilitation of Parkinson’s disease (PD) has increased significantly in the past two decades. Such interest is most likely due to many factors, of which, we believe, the most important are the increase in the life expectancy of people, the desire to improve its quality; and also to draw more and more attention to the issues of non-drug treatment in connection with the existing limitations of PD pharmacotherapy. In addition, the observed technical progress is associated with the development of new methods and equipment for neurorehabilitation of PD patients. The article presents an overview of current approaches to treatment and problems of rehabilitation of PD patients, and describes some features of the management and rehabilitation of patients against the background of neurostimulation of subcortical structures.

Интерес к реабилитации при болезни Паркинсона (БП) значительно увеличился за последние два десятилетия. Такой интерес, вероятнее всего, обусловлен многими факторами, из которых, как нам представляется, наиболее важными являются увеличение продолжительности жизни людей, стремление повысить ее качество; а также привлечение все большего внимания к вопросам немедикаментозного лечения в связи с существующими ограничениями фармакотерапии БП. Кроме того, наблюдаемый технический прогресс связан с разработкой новых методов и оборудования для нейрореабилитации пациентов с БП. В статье представлен обзор современных подходов к лечению и проблем реабилитации пациентов с БП, описаны некоторые особенности ведения и реабилитации пациентов на фоне нейростимуляции подкорковых структур.

Parkinson's diseaserehabilitationneurostimulationболезнь ПаркинсонареабилитациянейростимуляцияПриказ Минздрава России «О порядке организации медицинской реабилитации» № 1705н от 29.12.2012 (Зарегистрировано в Минюсте России 22 февраля 2013 г. № 27276)Епифанов В.А., Епифанов А.В., Левин О.С. Реабилитация больных, перенесших инсульт. 4-е изд. М., 2014. 248 с. [Epifanov V.A., Epifanov A.V., levin O.S. Rehabilitation of stroke patients. 4th ed. M., 2014. 248 p. (In Russ.)].Li S. Spasticity, Motor Recovery, and Neural Plasticity after Stroke. Front Neurol. 2017;8:120. Doi:10.3389/fneur.2017.00120.Hara Y. Brain Plasticity and Rehabilitation in Stroke Patients. J Nippon Med Sch. 2015;82(1):4-13. Doi: 10.1272/jnms.82.4.Cheng Y.Y., Hsieh W-L., Kao C.L., Chan R.C. Principles of rehabilitation for common chronic neurologic diseases in the elderly. J Clin Gerontol Geriatr. 2012;3(1):5-13.Montagnini M., Javier N.M. Physical therapy and other rehabilitation issues in the palliative care setting. Section. https://www.uptodate.com/contents/ physical-therapy-and-other-rehabilitation-issues-in-the-palliative-care-setting. 2019 Jan.Rochester L., Espay A.J. Multidisciplinary rehabilitation in Parkinson's disease: A milestone with future challenges. Mov Disord. 2015;30(8):1011-13. Doi: 10.1002/mds.26277.Bloem B.R., de Vries N.M., Ebersbach G. Nonpharmacological treatments for patients with Parkinson's disease. Mov Disord. 2015;30(11):1504-20. Doi: 10.1002/mds.26.36.3.Okun M.S. Management of Parkinson Disease in 2017: Personalized Approaches for Patient-Specific Needs. JAMA. 2017;318(9):791-92. Doi: 10.1001/jama.2017.7914.Richfield E.W., Jones E.J., Alty J.E. Palliative care for Parkinson's disease: a summary of the evidence and future directions. Palliat Med. 2013;27(9):805-10. Doi: 10.1177/0269216313495287.Lee M.A., Prentice W.M., Hildreth A.J., Walker R.W. Measuring symptom load in Idiopathic Parkinson's disease. Parkinsonism Relat Disord. 2007; 13(5):284-89.Goy E.R., Carter J.H., Ganzini L. Parkinson disease at the end of life: caregiver perspectives. Neurol. 2007;69(6):611-12.Walker R.W., Churm D., Dewhurst F., et al. Palliative care in people with idiopathic Parkinson's disease who die in hospital. BMJ. Supp Palliat Care. 2014;4(1):64 7. Doi: 10.1136/bmjspcare-2012-000412Miyasaki J.M., Kluger B. Review Palliative care for Parkinson's disease: has the time come? Curr Neurol. Neur Rep. 2015;15(5):26-7. Doi: 10.1007/ s11910-015-0542-4.Lennaerts H., Groot M., Steppe M., et al. Palliative care for patients with Parkinson's disease: study protocol for a mixed methods study. BMC. Palliate Care. 2017;16(1):61. Doi: 10.1186/s12904-017-0248-2.Frazzitta G., Maestri R., Bertotti G., et al. intensive rehabilitation treatment in early Parkinson's disease: a randomized pilot study with a 2-year follow-up. Neurorehabilit Neural Repair. 2015;29(2):123-31. Doi: 10.1177/1545968314542981.Frazzitta R., Maestri M.F., Ghilardi, et al. intensive rehabilitation increases BDNF serum levels in parkinsonian patients: a randomized study. Neurorehabili. Neural. Repair. 2014;28(2):163-68. Doi: 10.1177/1545968313508474.Kaseda Y., iIkeda J., Sugihara K., et al. Therapeutic effects of intensive inpatient rehabilitation in advanced Parkinson's disease. Neurol Clin Neurosci. 2016;5(1):18-21. Doi: 10.1111/ncn3.12088.Keus S.H., Bloem B.R., Hendriks E.J., et al. Evidence-based analysis of physical therapy in Parkinson's disease with recommendations for practice and research. Mov Disord. 2007;22:451-60.NiCE, Parkinson's disease in adults: diagnosis and management in National institute for Health and Care Excellence: Clinical Guidelines, National institute for Health and Care Excellence. London, UK. 2017.Keus S.H.J., Munneke M., Graziano M., et al. European Physiotherapy Guideline for Parkinson's disease, KNGF. ParkinsonNET, Nijmegen, Netherlands. 2014.Sturkenboom I., Ijssen M., Elsacker J.G., et al. Guidelines for Occupational therapy in Parkinson's Disease Rehabilitation, ParkinsonNet/NPF, Nijmegen, Netherlands. 2011.Kalf J.G., de Swart M.B.J., Bonnier M., et al. Guidelines for Speech-Language (erapy in Parkinson's Disease, ParkinsonNet/NPF, Nijmegen, Netherlands. 2011.Bloem B.R., Rompen L., Vries N.M., et al. Parkinson Net: A Low-Cost Health Care Innovation With A Systems Approach From The Netherlands. Health Aff (Millwood). 2017;36(11):1987-96. Doi: 10.1377/ hlthaff.2017.0832.Ypinga J.H.L., de Vries N.M., Boonen L., et al. Effectiveness and costs of specialised physiotherapy given via Parkinson-Net: a retrospective analysis of medical claims data. Lancet. Neurol. 2018;17(2):153-61. Doi: 10.1016/S1474-4422(17)30406-4.Seo H.G., Park S.J., Seo J., et al. Rehabilitation Therapy Utilization in Patients with Parkinson's Disease in Korea. Parkinson's Disease. 2018;2018;9475415). Doi.: 10.1155/2018/9475415.Gal O., Srp M., Konvalinkova R., et al. Physiotherapy in Parkinson's disease: building ParkinsonNet in Czechia. Parkinsons Dis. 2017;2017:8921932. Doi: 10.1155/2017/8921932.Fullard M.E., Thibault D.P., Hill A., et al. Utilization of rehabilitation therapy services in Parkinson disease in the United States. Neurol. 2017;89(11):1162-69. Do: 10.1212/WNL.0000000000004355.Пономаренко Г.Н. Современная модель врача-физиотерапевта. Физиотерапия, бальнеология и реабилитация. 2015;14(2):11-6. [Ponomarenko G.N. A modern model of a physiotherapist. Fizioterapiya, bal'neologiya i reabilitatsiya. 2015;14(2):11-6. (In Russ.)].Tomlinson C.L., Patel S., Meek C., et al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev. 2012;8:CD002817. Doi: 10.1002/14651858. CD002817.de Goede C.J., Keus S.H., Kwakkel G., Wagenaar R.C. The effects of physical therapy in Parkinson's disease: a research synthesis. Arch Phys Med Rehabil. 2001;82:509-15.Crizzle A.M., Newhouse I.J. Is physical exercise beneficial for persons with Parkinson's disease? Clin J Sport Med. 2006;16:422-25.Kwakkel G., de Goede C.J., van Wegen E.E. Impact of physical therapy for Parkinson's disease: a critical review of the literature. Parkinsonism Relat Disord. 2007;13(3):478-87. Doi: 10.1016/S1353-8020(08)70053-1.Goodwin V., Richards S.H., Taylor R.S., et al. The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis. Mov Disord. 2008;23:631-40. Doi: 10.1002/mds.21922.Li F., Harmer P., Liu Y., et al. A randomized controlled trial of patient-reported outcomes with tai chi exercise in Parkinson's disease. Mov Disord. 2014;29:539 45. Doi: 10.1002/mds.25787Mehrholz J., Friis R., Kugler J., et al. Treadmill training for patients with Parkinson's disease. Cochrane Database Syst Rev. 2010;1:CD007830.Юнищенко Н.А. Нарушения ходьбы и постуральной устойчивости при болезни Паркинсона. Дисс. канд. мед. наук. М. 2005.Карпова Е.А., Иванова-Смоленская И.А., Черникова Л.А., Иллариошкин С.Н. Постуральные нарушения при болезни Паркинсона. Неврологический журнал. 2003;2:36-41.Литвиненко И.В., Халимов, Р.Р., Труфанов А.Г. и др. Новые возможности коррекции нарушений ходьбы на поздних стадиях болезни Паркинсона. Успехи геронтологии. 2012;25(2):267-74.Похабов А.В. Реабилитация больных с нарушениями ходьбы при паркинсонизме. Журнал неврологии и психиатрии им. С.С. Корсакова. 2012;10(2):20-4.Амосова Н.А., Смоленцева И.Г. Методы реабилитации при болезни Паркинсона. Журнал неврологии и психиатрии им. Корсакова. 2014;6(2):80-McKee K.E., Hackney M.E. The effects of adapted tango on spatial cognition and disease severity in Parkinson's disease. J Motor Behav 2013;45:519 29. Doi: 10.1080/00222895.2013.834288Foster E.R., Golden L., Duncan R.P., Earhart G.M. Community-based Argentine tango dance program is associated with increased activity participation among individuals with Parkinson's disease. Arch Phys Med Rehabil. 2013;94:2404-9. Doi: 10.1016/j. apmr.2012.07.028tee N.Y., Lee D.K., Song H.S. Effect of virtual reality dance exercise on the balance, activities of daily living, and depressive disorder status of Parkinson's disease patients. J. Phys. Ther. Sci. 2015;27:145-47. Doi: 10.1589/jpts.27.145.de Dreu M.J., van der Wilk A.S., Poppe E., et al. Rehabilitation, exercise therapy and music in patients with Parkinson's disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life. Parkinsonism Relat Disord. 2012;18(1):114-19. Doi: 10.1016/S1353-8020(11)70036-0.Paul S.S., Canning C.G., Song J., et al. teg muscle power is enhanced by training in people with Parkinson's disease: a randomized controlled trial. Clin Rehabil. 2014;28:275-88. Doi: 10.1177/0269215513507462.Dibble L.E., Foreman K.B., Addison O., et al. Exercise and medication effects on persons with Parkinson disease across the domains of disability: a randomized clinical trial. J Neurol Phys Ther. 2015;39:85-92. Doi: 10.1097/NPT.0000000000000086.Brienesse L.A., Emerson M.N. Effects of resistance training for people with Parkinson's disease: a systematic review. J Am Med Dir Assoc. 2013;14:236-41. Doi: 10.1016/j.jamda.2012.11.012.Nadeau A., Pourcher E., Corbeil P Effects of 24 wk of treadmill training on gait performance in Parkinson's disease. Med Sci Sports Exerc. 2014;46:645-55. Doi: 10.1249/MSS.0000000000000144.Uc E.Y., Doerschug K.C., Magnotta V., et al. Phase I/ II randomized trial of aerobic exercise in Parkinson disease inacommunitysetting. Neurol. 2014;83:413 25. Doi: 10.1212/WNL.0000000000000644Shulman L.M., Katzel L.I., Ivey F.M., et al. Randomized clinical trial of 3 types of physical exercise for patients with Parkinson disease. JAMA. Neurol. 2013;70:183-90. Doi: 10.1001/jamaneurol.2013.646.Yang Y.R., Tseng C.Y., Chiou S.Y., et al. Combination of rTMS and treadmill training modulates corticomotor inhibition and improves walking in Parkinson disease: a randomized trial. Neurorehabil. Neural Repair. 2013;27:79-86. Doi: 10.1177/1545968312451915.Dibble L.E., Hale T.F., Marcus R.L., et al. High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson's disease: a preliminary study. Parkinsonism Relat. Disord. 2009;15:752-7. Doi: 10.1016/j. parkreldis.2009.04.009.tee S.J., Yoo J.Y., Ryu J.S., et al. The effects of visual and auditory cues on freezing of gait in patients with Parkinson disease. Am J Phys Med Rehabil. 2012;91:2-11. Doi: 10.1097/ PHM.0b013e31823c7507.Allen N.E., Sherrington C., Paul S.S., Canning C.G. Balance and falls in Parkinson's disease: a metaanalysis of the effect of exercise and motor training. Mov Disord. 2011;26:1605-15. Doi: 10.1002/ mds.23790.Yen C.Y., Lin K.H., Hu M.H., et al. Effects of virtual reality-augmented balance training on sensory organization and attentional demand for postural control in people with Parkinson disease: a randomized controlled trial. Phys Ther. 2011;91:862-74. Doi: 10.2522/ptj.20100050.Mirelman A., Maidan T., Herman T., et al. Virtual realist for gait training: Can it induce motor learning to enhance complex walking and reduce fall risk in patients with Parkinson's disease? J. Gerontol Biol Sci MedSci. 2011;66:234-40. Doi: 10.1093/gerona/ glq201.Pompeu J.E., Mendes F.A., Silva K.G., et al. Effect of Nintendo Wiibased motor and cognitive training on activities of daily living in patients with Parkinson's disease: a randomized clinical trial. Physiother. 2012;98:196-204. Doi: 10.1016/j. physio.2012.06.004.dos Santos A., Pegollo F., Alencar R., et al. A new tool for assessment and balance training of patients with Parkinson's disease based on low cost commercial Wii balance Board. Mov Disord. 2012;27(1):898.Esculier J.F., Vaudrin J., Beriault P., et al. Home-based balance training programme using Wii Fit with balance board for Parkinson's disease: a pilot study J. Rehabil Med. 2012;44:144-50. Doi: 10.2340/ 16501977-0922.Nombela C., Bustillo P.J., Castell P.F., et al. Cognitive rehabilitation in Parkinson's disease: evidence from neuroimaging [serial online]. Front Neurol. 2011;2:82. Doi: 10.3389/fneur.2011.00082.Sammer G., Reuter I., Hullmann K., et al. Training of executive functions in Parkinson's disease. J. Neurol Sci. 2006;248:115-19.Paris A.P., Saleta H.G., de la Cruz Crespo Maraver M., et al. Blind randomized controlled study of the efficacy of cognitive training in Parkinson's disease. Mov Disord. 2011;26:1251-58. Doi: 10.1002/ mds.23688.Руководство по диагностике и лечению болезни Паркинсона / Под ред. С.Н. Иллариошкина, О.С. Левина. М. 2017. 33 сRowland N.C., Sammartino F, Lozano A.M. Advances in surgery for movement disorders. Mov Disord. 2017;32(1):5-10. Doi: 10.1002/mds.26636.Pollak P., Fraix V., Krack P., et al. Treatment Results: Parkinson's disease. Mov Disord. 2002; 17(3):75-83.Шабалов В.А., Томский А.А. Хирургическое лечение болезни Паркинсона. Нейрохирургия. 2003;3:5-15. [Shabalov V.A., Tomskii A.A. Surgical treatment of Parkinson's disease. Neirokhirurgiya. 2003;3:5-15. (in Russ.)].Bril' E.V., Fedorova N.V., Gubareva N.N., et al. Pharmacotherapy on the background of electrical stimulation of the subthalamic nucleus in patient with Parkinson's disease. Neurosci Behavioral Physiol. 2017;47(3):275-80.Moro E. Neurosurgery: Complications of DBS surgery insights from large databases. Nat Rev Neurol. 2016;12:617-18. Doi: 10.1038/ nrneurol.2016.163.Abboud H., Mehanna R., Machado A., et al. Comprehensive, Multidisciplinary Deep Brain Stimulation Screening for Parkinson Patients: No Room for «Short Cuts». Mov Disord Clin Pract. 2014;1:336 41. Doi:10.1002/mdc3.12090Cohen D.B., Oh M.Y., Baser S.M., et al. Fasttrack programming and rehabilitation model: a novel approach to postoperative deep brain stimulation patient care. Arch Phys. Med Rehabil. 2007;88(10):1320-24Tassorelli C., Buscone S., Sandrini G., et al. The role of rehabilitation in deep brain stimulation of the subthalamic nucleus for Parkinson's disease: a pilot study. Parkinsonism Relat Disord. 2009;15(9):675 81. Doi: 10.1016/j.parkreldis.2009.03.006Nardo A., Anasetti F., Servello D., Porta M. Quantitative gait analysis in patients with Parkinson treated with deep brain stimulation: the effects of a robotic gait training. Neurol Rehabilitat. 2014;35:779-88. Doi: 10.3233/NRE-141173Luna N.M.S., Lucareli P.R.G., Sales V.C., et al. Treadmill training in Parkinson's patients after deep brain stimulation: Effects on gaitkinematic. Neurol Rehabilitat. 2018;42(2):149-58. Doi: 10.3233/ NRE-172267Rolston J.D., Englot D.J., Starr P.A., Larson P.S. An unexpectedly high rate of revisions and removals in deep brain stimulation surgery: Analysis of multiple databases. Parkinsonism Relat Disord. 2016;33:72 7. Doi: 10.1016/j.parkreldis.2016.09.014Allert N., Dohle C., Horn J.W., et al. Rehabilitation of Parkinson's patients with deep brain stimulation. Experiences of the Neurological Rehabilitation Center Godeshohe. Nervenarzt. 2011;82:462-67. Doi: 10.1007/s00115-010-3092-7.Allert N., Cheeran B., Deuschl G., et al. Postoperative rehabilitation after deep brain stimulation surgery for movement disorders. Clin Neurophysiol. 2018;129(3):592-601. Doi: 10.1016/j. clinph.2017.12.035.Ünal A., Altug F. Clinical Experience from Turkey in Rehabilitation of Parkinson's Disease after Deep Brain Stimulation: What are we Doing? Physiother Rehabil. 2017;2:2.Agid Y., Schupbach M., Gargiulo M., et al. Neurosurgery in Parkinson's disease: the doctor is happy, the patient less so? J Neural Transm Suppl. 2006;(70):409-14.Schupbach M., Gargiulo M., Welter M.L., et al. Neurosurgery in Parkinson disease: a distressed mind in a repaired body? Neurol. 2006;66(12):1811-16. Doi:10.1212/01.wnl.0000234880.51322.16.Haahr A., Kirkevold M., Hall E.O., stergaard K. From miracle to reconciliation: a hermeneutic phenomenological study explorin the experience of living with Parkinson's disease following Deep Brain Stimulation. Int J Nurs Stud. 2010;47(10):1228-36. Doi: 10.1016/j.ijnurstu.2010.03.006.Haahr A., Kirkevold M., Hall E.O., stergaard K. Living with advanced Parkinson's disease: a constant struggle with unpredictability. J Adv Nurs 2011;67(2):408 17. Doi: 10.1111/j.1365-2648.2010.05459.xHoueto J.L., Mallet L., Mesnage V., et al. Subthalamic stimulation in Parkinson disease: behavior and social adaptation. Arch Neurol. 2006;63(8):1090-95. Doi:10.1001/archneur.63.8.1090.lewis C.J., Maier F, Horstkotter N., et al. The impact of subthalamic deep brain stimulation on caregivers of Parkinson's disease patients: an exploratory study J Neurol. 2015;262(2):337-45. Doi: 10.1007/ s00415-014-7571-9.Shahmoon S., Jahanshahi M. Optimizing psychosocial adjustment after deep brain stimulation of the subthalamic nucleus in Parkinson's disease. Mov Disord. 2017;32(8):1155-58. Doi: 10.1002/ mds.27032.