Objective: To determine whether amplitude training (AT) improves the ability of people with Parkinson’s disease (PD) to independently complete self-care tasks. It was predicted that AT would result in improved accuracy and speed of dressing and would also lead to improved confidence and reduced burden of care with activities of daily living.

Background: AT was initially designed to target proposed pathophysiologic mechanisms underlying bradkinesia by recalibrating the scale of perceived movements ^{1, 2}. Further studies have indicated that AT can improve neuroplasticity, motor performance, quality of life and reduces symptom severity^{1, 2}. Despite a positive correlation between AT and motor performance, no studies have specifically assessed the effect of AT on activities of daily living in PD.

Method: Participants were 10 patients (7 male; mean age 70 years) admitted for acute PD stabilisation at St Andrew’s War Memorial Hospital, Brisbane, Australia over a two month period. AT involved one therapy session training patients to use larger effortful movements to complete a dressing task. This quasi-experimental study measured accuracy and speed of dressing and, patient confidence likert scale pre and post AT.

Results: Dressing time improved by an average of 37.8 seconds with the use of AT. Confidence improved from a mean of 2.5 to 4. Wilcoxon singed rank tests confirmed that AT led to a significant improvement in both speed and confidence with which the participants dressed (p<.01). These improvements were p=.0025 (time) and p=.0055 (confidence).

Conclusion: This preliminary investigation confirms that AT for people with PD can improve accuracy, speed and self confidence in dressing tasks. Due to small participant numbers, further research is needed to examine optimal dose and frequency of AT across other self-care tasks and rehabilitation settings. This research could also investigate AT across stages of PD as a therapy adjunct.

References: 1. Ebersbach, G., Ebersbach A., Edler, D., Kaufhold, O., Kusch, M., Kupsch, A., & Wissel, J. (2010). Comparing exercise in Parkinson’s disease – the Berlin LSVT BIG study, Movement Disorders, 25(12), 1902-1908. 2. Farley, B., Fox, C., Ramig, L., & McFarland, D. (2008). Intensive amplitude-specific therapeutic approaches for PD: toward a neuroplasticity-principled rehabilitation model. Topics in Geriatric Rehabilitation, 24(2), 99-114.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/amplitude-training-in-parkinsons-disease-improved-dressing-independence/