Peculiarities of manifestation and general rehabilitative signif icance of the phenomenon paradoxical kinesia in Parkinson’s disease

Abstract

The purpose of the study: is to identify the factors contributing to the occurrence of paradoxical kinesias (PK) in Parkinson’s disease (PD) and to assess their frequency and clinical manifestations (according to the results of interviews). All patients interviewed were divided into two groups. The first group (45 people) — patients without symptoms of dementia, the second group (18 people) — patients with symptoms of dementia. The MMSE assessment was conducted no more than three months before this survey to assess the frequency of PK phenomenon, before the introduction of quarantine restrictions. Patients with PD initially have virtually no idea about the phenomenon of PK, but when informed (individually and in groups) in a group of patients without clinically significant cognitive decline, understanding of the essence and possibilities of PK increases from 6.7% to 88.9% of respondents. Patients with PD, cognitively preserved, note the manifestations of PK in the form of a spontane- ous ability to perform movements faster and more dexterously in 82.2% of observations, with vital movements of posture control, walking, and balance observed in 93.3% of patients, and the per- formance of complex acts in 51.1% of observations. Factors contributing to the manifestation of PK are often (in more than 50.0% of cases) in the group of patients without significant cognitive decline is - rhythm, counting, cues (84.4%), listening to music (93.3% of answers), environment (64.4%), strong emotions (93.3%); communication with certain people (88.9 %; answers); quality of sleep (80.0 %); less frequent, but practically applicable are internal order and conscious control (48.9 %) and visualization of the motor act (40.0 %). The realization of the phenomenon of PK with the help of factors that reveal it can be used in conducting classes on motor rehabilitation, but it is necessary to preserve the cognitive poten- tial of patients. The rehabilitation potential of patients with PD is defined as medium or low level. This level of rehabilitation potential is generally sufficient for the implementation of the developed individual rehabilitation programs.