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Virtual reality (VR) has been used in research and clinical practice in the management of Parkinson's disease (PD), potentially enhancing physiotherapy. Adverse events (AEs) associated with VR applications in PD have been poorly explored. We conducted a randomized controlled trial to compare two 12-week interventions using physiotherapy and immersive VR, and analyzed the frequency and type of AEs occurring in 30 people with PD. We reported 144 AEs (8.4% of the sessions), predominantly classified as mild and unrelated to the interventions. Two were serious AEs, one leading to study discontinuation. Notably, discomfort/pain, motor fluctuations, and falls were the most frequently reported, accounting for 63% of the total AEs. Five falls were definitely associated with the 'sense of presence' provided by the fully immersive VR system, which underscores the necessity for careful game selection when designing interventions for PD. Motor fluctuations may have been associated with various factors, which merit further investigation. We also explored the role of SSQ as a measure of cybersickness in PD. In conclusion, it is important to closely monitor and characterize AEs to ensure safety and efficacy in clinical practice as AEs may be more common than previously recognized in VR interventions in PD. [ABSTRACT FROM AUTHOR]

Background: A recent survey reported a high risk of drowning in Parkinson's disease (PD) patients. This study intended to assess PD patients' swimming ability and explore the disease-related characteristics that may affect this.Methods: A cross-sectional study was conducted in idiopathic PD patients. The assessment included swimming in 2 different styles and the evaluation of isolated technical gestures. The primary outcome was the frequency of patients who were able to swim. Limb coordination, blockage episodes, and capacity to maintain the body in a horizontal position were also evaluated.Results: Thirteen patients were evaluated. Three patients were able to swim according to the predefined definition. The inability to maintain the horizontal position and floatability were the main reasons identified for the decrease in swimming performance.Conclusions: Swimming ability is compromised in some PD patients. Further studies are needed to evaluate the global frequency of swimming difficulties in PD patients and their contributing factors. © 2019 International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]

Introduction: The satisfactory symptomatic control of the axial symptoms of Parkinson's disease (PD) remains challenging. As these symptoms are an important cause of disability, new therapeutic strategies should be developed and evaluated. To do this, it is necessary to select the outcomes to be measured and reported in a clinical trial. In this study, we sought to identify the most responsive outcome measures for assessing the efficacy of a multidisciplinary intervention on the axial symptoms of PD. Methods: An exploratory prospective clinical study was conducted. PD patients engaged in a pre-defined multidisciplinary intervention program for parkinsonian patients were assessed at admission and discharge by a multidisciplinary team. The responsiveness to intervention was evaluated and the smallest sample size needed to enable statistically significant results for an expected 30% change from baseline for each outcome was calculated. Results: Twenty-two patients were included in the study. The effect size detected varied between 0.04 and 0.83. The Movement Disorder Society—Unified Parkinson's Disease Rating Scale (MDS-UPDRS) total score and each subsection, the N-FOG questionnaire, the 10-m walk test, and Frenchay Dysarthria Assessment-2 Edition (FDA-2) showed a medium to large effect size. Sample size calculations for 90% power and assuming 30% change from baseline ranged from eight to 180 participants. The outcome measures that require a small number of participants to enable statistically significant results were the FDA-2 rating scale (n = 4 participants), the MDS-UPDRS total score (n = 9), the 10-m walk test (n = 9), and the MDS-UPDRS motor examination (n = 10). Conclusions: The MDS-UPDRS part III and total score and the 10-m walk test were the outcomes with the best responsiveness to a multidisciplinary intervention and required a small number of participants to enable statistically significant results. Further studies are needed to clarify the suitability of the Timed Up and Go test. [ABSTRACT FROM AUTHOR]