Action Observation Theraphy in Parkinson's Disease
Action Observation Theraphy in Parkinson's Disease
The main objective of this project is to evaluate the effectiveness of Observation of Action
 (Action Observation, AO) both in increasing the speed of movement of the upper limbs, agility
 and locomotion, and in improving the activities and quality of life in people with
 Parkinson's disease (PD) during a 4-6 month follow-up. The second objective is to evaluate
 the feasibility and effectiveness of a tele-rehabilitation protocol using home-based AO
 therapy. The telecommunication technology will provide a complete training through a low-cost
 software run on a touch-screen device, which will show the actions to be imitated several
 times by people with PD. This project will be the first attempt to implement AO-based
 treatment at home and, if successful, will be highly translational to clinical practice
 thanks to the advanced development and broad accessibility of information technology and
 telecommunications in our country. Furthermore, continuous exercise will reduce the risks of
 complications and the frequency of hospital admissions, thus reducing costs for the National
 Health System.
The main objective of this project is to evaluate the effectiveness of Observation of Action
 (AO) both in increasing the speed of movement of the upper limbs, agility and locomotion, and
 in improving activities and quality of life in people with Parkinson's disease (PD) during a
 4-6 month follow-up. The second objective is to evaluate the feasibility and effectiveness of
 a tele-rehabilitation protocol using home-based AO therapy. The telecommunication technology
 will provide a complete training through a low-cost software run on a touch-screen device,
 which will show the actions to be imitated several times by people with PD. This project will
 be the first attempt to implement AO-based treatment at home and, if successful, will be
 highly translational to clinical practice thanks to the advanced development and broad
 accessibility of information technology and telecommunications in our country. Furthermore,
 continuous exercise will reduce the risks of complications and the frequency of hospital
 admissions, thus reducing costs for the National Health System.

 Parkinson's disease (PD) should impose a growing social and economic burden on our country.
 In fact, even with optimal medical management, people with PD experience a worsening of
 mobility and independence in daily activities, with a consequent reduction in quality of
 life. In the last ten years there has been a growing demand to consider rehabilitation as an
 essential adjunct to pharmacological treatment. However, the reference rates for
 physiotherapy for people with Parkinson's disease have been historically low, both because of
 poor compliance by patients with the therapies of the movement and because of the scarce
 availability of physiotherapy services. Action Observation Therapy (AO) has recently been
 described as an effective strategy in stroke rehabilitation (Sale 2011, 2012), since it can
 shape the reorganization of the neural circuit, promote neural plasticity and motor learning.
 . The purpose of this study is to verify the efficacy of AO therapy on PD-related disability
 and to verify the feasibility of a home-based AO protocol.

 The first specific objective of this project is to evaluate the effectiveness of action
 observation as an additional rehabilitative tool to improve upper limb function in terms of
 bradykinesia and dexterity and to investigate the stability of treatment effects after 4 / 6
 months of follow-up regarding functional improvement and quality of life (QoL). The second
 specific objective of this project is to evaluate the effectiveness of the observation of the
 action as an additional rehabilitative tool to improve the balance , gait and, consequently,
 to reduce falls, and to investigate the stability of treatment effects at 4/6 months of
 follow-up in terms of functional improvement and quality of life (QoL). The third objective
 is to evaluate the feasibility and effectiveness of a home telerehabilitation protocol (TR)
 based on AO therapy to improve dexterity and ambulation in people with Parkinson's disease.
Inclusion Criteria:

 -  Diagnosis of idiopathic PD according to the UK BRAIN BANK criteria;

 -  Age between 18 and 80 years;

 -  Able to walk 25 meters without help or with minimal assistance and sufficient strength
 to remain standing for at least 20 minutes without assistance for patient report;
 Stability of drug therapy for Parkinson's disease for at least 4 weeks before the
 start of the study;

 -  Mini-Mental State Examination> 25/30;

 -  HAM-D (Hamilton Depression Scale) <17.

 Exclusion Criteria:

 -  comorbidity with other neurological disorders;

 -  heart or orthopedic problems;

 -  Chronic alcohol abuse.