Objective Our objective was to identify factors predicting health-related quality of life (HRQoL) in patients with Parkinson's disease (PD) Methods A cross-sectional study was carried out in 161 PD patients. QoL was assessed with the PDQ-39.Motor symptoms and non-motor symptoms were evaluated by a list of assessment tools including the Hoehn and Yahr scale,The Movement Disorder Society Unified Parkinson Disease Rating Scale et al. The Spearman correlation coefficient r was used to evaluate the correlation between PDQ-39 and motor and non-motor factors. Multiple linear regression models were used to demonstrate whether the factors investigated contribute significantly to QoL. Results PDQ-39 Summary Index was highly correlated with Voice handicap index(r=0.616) and correlated at a moderate level (r=0.30-0.50) with UPDRS-I,UPDRS-II,Parkinson Fatigue Scale,Modified Apathy Evaluation Scale,Geriatric Depression Scale,Gait and Falls Questionnaire,Eating Assessment Tool Scale. Depression,gait,swallowing,voice handicap and gender were independent predictors of HRQoL in the multivariate analysis model. Depression showed to be the most consistent determinant of HRQoL,followed by gait problems,swallowing,voice handicap and gender. Conclusion Depression,gait problems,swallowing,voice handicap and gender are significant factors contributing to a poor quality of life in Parkinson's disease patients. Swallowing and voice handicap,as well as depression,gait problems that are widely recognized,are also factors that cannot be ignored.

Dysphagia commonly occurs in Parkinson's disease (PD) at any stage, which may result in serious complications. The mechanism is uncertain. Swallowing Disturbance Questionnaire (SDQ) and Munich Dysphagia Test-Parkinson's Disease (MDT-PD) are often used for screening dysphagia in PD patients. But Non-motor Symptoms Questionnaire (NMSQ) and Unified Parkinson's Disease Rating Scale (UPDRS) underestimate the severity of dysphagia in PD patients. Videofluoroscopic Swallowing Examination (VFSE) and Videoendoscoptic Swallowing Study (VESS) are the gold standards for the dysphagia. There is no systemic management yet. Interventions includes medication, deep brain stimulation, etc. Early diagnosis and management facilitate to decrease the complications.

Methods The literatures on rehabilitation for Parkinson's disease in the Web of Science Core Collection Database fromthe establishment of the library to December, 2021 were retrieved. The sources, authors, institutions, cited literature and keywords of the literatures were visually analyzed with CiteSpace 5.8.R3 software. ObjectiveTo investigate the hot spots and trends of researches related to rehabilitation for Parkinson's disease. ResultsThe most of researches came from the United States. The author publishing the most researches was Bastiaan R Bloem and the institute was Radboud University. The keywords such as basal ganglia, movement, abnormalities were the most frequent. The top three bursted keywords were physical therapy, non-motor symptoms and stride regulation. Keywords attracting more attention in recent years were non-motor symptoms and virtual reality. ConclusionThe research on rehabilitation for Parkinson's disease is increasing, and new technologies can be used to enhance rehabilitation effects.

ObjectiveTo investigate the current trend of non-drug therapy for gait abnormality of Parkinson's disease. MethodsThe clinical trials about non-drug therapy for gait abnormality of Parkinson's disease were retrieved from the clinical trial registration platform ClinicalTrials.gov, from inception to October 25th, 2022. The records were screened by two researchers independently, and the registration time, registration count, sample sizes, interventions, primary outcome measurements and study design, etc., were summarized and analyzed, according to the PICOS principle. ResultsA total of 218 eligible records were included. The registration count increased in recently years. Almost all of the trials (93.6%) were with a relatively small sample size less than 100, mainly 21 to 30 cases. The major intervention approach was the neuromodulation technique, however, virtual reality and robot-assisted gait training were coming to use in recent years. The primary outcome measurements were the clinical scales, the questionnaires and the exercise examinations. Randomized parallel controlled trials were the most (111, 50.9%). ConclusionThe number of non-drug therapy for gait abnormality of Parkinson's disease increased year by year. The new technologies such as virtual reality and robot-assisted gait training may be used more in the future.

The core symptoms of Parkinson's disease include motor symptoms and non-motor symptoms. For the motor symptoms, the rehabilitation includes the basic training of joints, gait training, the training of core muscle group and posture balance, the training of oral, facial, neck muscle and pharyngeal reflex, the training of lip movement, vocalization, sound volume, rhythm and speed, and the training of deep breathing exercises and abdominal pressure. For the non-motor symptoms, the rehabilitation includes the training of memory, attention, problem solving ability, activities of daily living and others, psychotherapy, family support, social participation, and other comprehensive treatments combined with medicine.

Virtual reality is an integrated technology which simulates the real world via the computer, with characteristics of immersion, interaction and imagination. It is widely used in neurological rehabilitation. Freezing of gait (FOG) is a destructive symptom which appears in late stage of Parkinson's disease, which can be divided into subtypes of moving forward with very small steps, leg trembling in place and total akinesia, and often results in fall and injury of the patients. Virtual reality can simulate the environment of FOG to provide a new idea for the assessment. Virtual reality combined with treadmill training can provide challenging functional training in a complex environment to improve the gait. How it works is remained unclear.

Neurofeedback may improve cognitive function and behaviour by regulating the cerebral neural activities. Neurofeedback works as a kind of therapy for patients with Parkinson's disease, primarily based on electroencephalogram signals and hemodynamic signals. It regulates abnormal neuronal rhythm oscillations in the cortical-spinal system by electroencephalogram neurofeedback and sensory motor rhythm as the main adjustment frequency band, and modulates activation in the cortical-basal ganglia-thalamic-cortical network of brain with the supplementary motor area as the target area via functional magnetic resonance imaging neurofeedback. Neurofeedback effectively improves the motor symptoms of Parkinson's patients, both dynamic and static. However, the number of samples is limited in these researches, and the assessments before and after neurofeedback training are not yet comprehensive. Neurofeedback technology might be a potential effective rehabilitation for patients with Parkinson's disease.