Efficacy of exercise interventions combined with Selegiline in ameliorating freezing of gait in Parkinson's disease patients

Abstract

Objective: To evaluate the efficacy of exercise interventions combined with Selegiline in ameliorating freezing of gait (FOG) in Parkinson's disease (PD) patients.

Methods: A total of 60 PD patients with FOG treated in the First People's Hospital of Fuyang District from January 2020 to January 2023 were retrospectively collected and analyzed. Patients were divided into a control group (n = 28, treated with Selegiline alone) and an observation group (n = 32, treated with Selegiline and exercise interventions). Gait parameters, FOG indices, motor and balance functions, Berg Balance, psychological status, and quality of life were compared between the groups pre- and post-treatment.

Results: After treatment, the observation group exhibited longer step length, higher step speed, and lower step frequency (P = 0.000, 0.003, 0.001, respectively), with enhanced balance as indicated by lower Timed Up and Go Test and higher Berg Balance Scale scores than the control group (P = 0.000, 0.000, respectively). The Beck Depression Inventory and Beck Anxiety Inventory scores were notably lower in the observation group than those in the control group (P = 0.000, 0.004, respectively). Additionally, the observation group showed better quality of life across several dimensions of the Parkinson's Disease Quality of Life Questionnaire, including mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort (P = 0.000, 0.000, 0.000, 0.000, 0.017, 0.000, 0.000, 0.000, respectively) than the control group.

Conclusion: The combination of exercise interventions and Selegiline effectively rectifies the gait parameters, enhances the balance function, alleviates psychological distress, and improves the overall quality of life in PD patients experiencing FOG.

Keywords: Exercise intervention; Parkinson’s disease; Selegilin; balance function; freezing of gait.

Figure 1

Flow chart of case selection.

Figure 2

Comparison of baseline data. The difference between the two groups in terms of gender (A), H-Y staging information (B), age (C), disease duration (D), and BMI (E) is not statistically significant (all P > 0.05). BMI: body mass index; H-Y staging: Hoehn-Yahr staging. OG, observation group; CG, control group.

Figure 3

Comparison of gait parameters between the two groups. Before treatment, no significant differences were observed in stride length (A), cadence (step frequency) (B), and walking speed (C) between the two groups (P > 0.05). After 12 weeks of treatment, the observation group exhibited longer stride length, higher walking speed, and lower step frequency compared to the control group, with these differences being statistically significant (P = 0.000, 0.003, 0.001). OG, observation group; CG, control group.

Figure 4

Comparison of freezing of gait indices between the two groups. Before treatment, no significant difference was found in the FOG-Q (A) and UPDRS III (B) scores between the two groups (Both P > 0.05). After 12 weeks of treatment, the observation group had lower FOG-Q and UPDRS III scores compared to the control group, showing statistically significant differences (P = 0.000, 0.000). OG, observation group; CG, control group. FOG-Q: Freezing of Gait Questionnaire; UPDRS III: part III of the Unified Parkinson’s Disease Rating Scale.

Figure 5

Comparison of gait and balance parameters between the two groups. Before treatment, there were no significant differences in the gait and balance parameters (TUGT and BBS) between the two groups (P > 0.05). After 12 weeks of treatment, the observation group had lower TUGT scores (A) and higher BBS scores (B) compared to the control group, with statistically significant differences (P = 0.000, 0.000). TUGT: Timed Up and Go Test; BBS: Berg Balance Scale.

Figure 6

Comparison of psychological state indices between the two groups. At baseline, the BDI (A) and BAI (B) scores, which assessed psychological state, did not significantly differ between the two groups (P > 0.05). After 12 weeks of treatment, the observation group demonstrated lower BDI and BAI scores than the control group, exhibiting statistically significant differences (P = 0.000, 0.004). BDI: Beck Depression Inventory; BAI: Beck Anxiety Inventory.

Figure 7

Comparison of quality of life between the two groups before treatment. Before treatment, the difference between the PDQ-39 dimension scores of the two groups was not significant (P > 0.05). PDQ-39: Parkinson’s Disease Quality of Life Questionnaire.

Figure 8

Comparison of quality of life between the two groups after treatment. After 12 weeks of treatment, the observation group demonstrated significantly lower scores in the dimensions of mobility, daily life activities, emotional well-being, stigma, social support, cognitive function, communication, and bodily discomfort compared to the control group, showing statistically significant differences (P = 0.000, 0.000, 0.000, 0.000, 0.017, 0.000, 0.000, 0.000). PDQ-39: Parkinson’s Disease Quality of Life Questionnaire.

Figure 9

Comparison of treatment efficacy between the two groups. The treatment efficacy in the observation group was slightly higher than that in the control group, but the difference was not statistically significant (P = 0.143).