The role of rehabilitation in deep brain stimulation of the subthalamic nucleus for Parkinson's disease: a pilot study.

Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an efficacious therapeutic option in the treatment of advanced Parkinson's disease (PD). The procedure may be however associated with functional impairment of different types and intensity. In this paper we describe the functional impairments detected in a group of 34 subjects with PD who were submitted to DBS. These patients belonged to a cohort of 75 consecutive PD patients who underwent the surgical procedure. The rehabilitation program included physiotherapy exercises for recovery/maintenance of the range of motion, active exercises, exercises for coordination and proprioception, and walking training based on the use of sensory cues, with daily sessions for a period of 4-8 weeks. The motor examination section of unified Parkinson's disease rating scale (UPDRS-ME) and the functional independence measure (FIM) scores showed a consistent and significant improvement in the patients' motor performances. The reported findings suggest that rehabilitation may play an important role in the correction of specific functional impairments caused by or associated with DBS in PD.