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Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trial
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OBJECTIVES: Gait and mobility problems are difficult to treat in people with Parkinson's disease. The Rehabilitation in Parkinson's Disease: Strategies for Cueing (RESCUE) trial investigated the effects of a home physiotherapy programme based on rhythmical cueing on gait and gait-related activity. METHODS: A single-blind randomised crossover trial was set up, including 153 patients with Parkinson's disease aged between 41 and 80 years and in Hoehn and Yahr stage II-IV. Subjects allocated to early intervention (n = 76) received a 3-week home cueing programme using a prototype cueing device, followed by 3 weeks without training. Patients allocated to late intervention (n = 77) underwent the same intervention and control period in reverse order. After the initial 6 weeks, both groups had a 6-week follow-up without training. Posture and gait scores (PG scores) measured at 3, 6 and 12 weeks by blinded testers were the primary outcome measure. Secondary outcomes included specific measures on gait, freezing and balance, functional activities, quality of life and carer strain. RESULTS: Small but significant improvements were found after intervention of 4.2% on the PG scores (p = 0.005). Severity of freezing was reduced by 5.5% in freezers only (p = 0.007). Gait speed (p = 0.005), step length (p<0.001) and timed balance tests (p = 0.003) improved in the full cohort. Other than a greater confidence to carry out functional activities (Falls Efficacy Scale, p = 0.04), no carry-over effects were observed in functional and quality of life domains. Effects of intervention had reduced considerably at 6-week follow-up. CONCLUSIONS: Cueing training in the home has specific effects on gait, freezing and balance. The decline in effectiveness of intervention effects underscores the need for permanent cueing devices and follow-up treatment. Cueing training may be a useful therapeutic adjunct to the overall management of gait disturbance in Parkinson's disease.
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“Nieuwboer et al. [49] investigated a 3-week physical home training program and showed that physical measures improved with 4.2–5.5 % compared with 3 weeks of no therapy.”
From BEWARE: Body awareness training in the treatment of wearing-off related anxiety in patients with Parkinson's disease: study protocol for a randomized controlled trial. (2015) · cites this paper as [49]
Experimental — accuracy not yet measuredIn the citing paper
“and increase retention of learning in PD [9, 10].”
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“In addition, cueing reduces the severity of Freezing of Gait (FOG) [9, 11, 12].”
In the citing paper
“According to the recommendations by Hass et al., the control group's effect sizes can be interpreted as small [38], whereas those of the CuPiD group can be considered as clinically moderate and as comparable to other cueing and treadmill studies [9, 16, 39].”
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Metadata
- Authors
- Nieuwboer, A., Kwakkel, G., Rochester, L., Jones, D., van Wegen, E., Willems, A. M., Chavret, F., Hetherington, V, Baker, K., & Lim, I.
- Affiliations
- KU Leuven (BE)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Northumbria University (GB)
- Corresponding author
- Nieuwboer, A
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2007-02-01
- Volume
- 78
- Issue
- 2
- Pages
- 134-140
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC2077658
- OpenAlex
- W2123171587
- Cited by
- 857
- References
- 67
- Citations by year
- 2026: 28 · 2025: 30 · 2024: 40 · 2023: 30 · 2022: 39 · 2021: 48 · 2020: 43 · 2019: 53 · 2018: 38 · 2017: 39 · 2016: 39 · 2015: 55 · 2014: 61 · 2013: 59 · 2012: 53
- FWCI
- 150.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Teesside University Research Portal (Teesside University) (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- European Commission
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Keywords
- Parkinson's disease, gait disturbance, home-based physiotherapy, freezing of gait, balance, walking speed, step length, falls efficacy, carer strain, quality of life, early versus late intervention, residual effects
- MeSH terms
- Aged, Aged, 80 and over, Postural Balance, Exercise Therapy, Female, Humans, Male, Middle Aged, Outpatients, Parkinson Disease, Quality of Life, Single-Blind Method, Treatment Outcome, Caregivers, Cross-Over Studies, Gait Disorders, Neurologic
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