Rehabilitation of gait disorders in patients with Parkinson's disease and vascular parkinsonism

Thirty patients with Parkinson's disease (PD) and 30 - with vascular parkinsonism (VP) have been studied. A soft-hardware-controlled complex "Dorozhka" elaborated previously by the authors was used to assess objectively the step length. The coefficient of step length variability (CSLV) which normal value is about 1 has been calculated. A method of tempo-rhythmic correction of gait including the synchronization of step with the rate of individually tailored exogenic sound stimulation has been applied. The dose of antiparkinsonian drugs was not changed during the rehabilitation. The decrease of mean step length and CSLV in patients with PD and VP was found. There were differential-diagnostic differences between individual gait profiles of PD and VP patients: patients with PD had the relatively even decrease of the length of all steps and in patients with VP the initiation of gait with the following increase of step length was affected. The significant increase of step length and CSLV (p<0,01), improvement on GABS and PDQ-39 scales were observed during and after the tempo-rhythmic correction of gait. The improvement of gait was correlated mostly with the increase of CSLV (two-fold in PD and 3-fold in VP). Therefore, the assessment of step variability allows to objectively differentiate the gait in patients with PD and VP and the method of tempo-rhythmic correction of gait with sound stimulation allows to improve significantly parameters of gait and patient's quality of life without changing the dose of antiparkinsonian drugs.