Current treatments comprise drug therapy such as L-dopa and physical therapy. After 8 to 10 years, drug therapy tends to loose its effect, and even before this stage periods of reduced effect are often observed. However the deficits in motor performance are strongly dependent upon external and psychological factors, e.g. time of day, stressful situations and emotional state. Due to their apparent behavioral deficits, patients with PD often suffer from fear of being observed by others or performance anxiety. This causes additional emotional stress and leads to a deterioration of motor function.
The importance of psychological factors in patients with PD led to the development of a behavioral treatment consisting of several therapeutic aspects: acquisition of relaxation skills and their application in stressful situations, EMG-biofeedback, training of motor skills (e.g. gait, posture, handwriting etc) be using external cues in everyday life, by activitity schedules and social skills training. Evaluation of treatment outcome was carried out with standardized rating scales and tests assessing motor performance.
The research is done in cooperation with the Department of Neurology of the University of Tübingen.
The effectiveness of the behavioral treatment focussing on the control of motor movements was compared to the effects of non-specific psychological treatment of patients with Parkinson's disease (PD). 20 treatment sessions were held over a period of 10 weeks. Behavioral change was assessed by the Motor Performance Test Series (MPS), the Unified Parkinson's Disease Rating Scale (UPDRS), by the psychologist's ratings and patients' self reports. Unspecific placebo-like effects were ruled out using data from several questionnaires. Results indicated that only behavioral treatment was effective in reducing tremor and in improving manual dexterity. It is concluded that behavioral treatment is an effective supplement to the traditional medical treatment with L-Dopa for improving motor performance and reducing tremor in Parkinson's disease.
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