Affiliations: Department of Neurology, University Hospital,
Ludwig-Maximilian-University, Munich | Department of Physical Medicine and Rehabilitation,
University Hospital, Ludwig-Maximilian-University, Munich
Note: [] Corresponding author: PD Dr. med. Kai Bötzel, Department of
Neurology, Ludwig-Maximilians University, 81366 Munich, Germany. Tel.: +49 89
7095 3677; Fax: +49 89 7095 3677; E-mail: kBötzel@med.uni-muenchen.de
Abstract: Gait difficulties occur early in the course of Parkinson's disease
(PD) as well as in generalized dystonia. Deep brain stimulation (DBS) is an
effective treatment for patients with PD or dystonia. PD-associated slowness of
gait improves dramatically after this procedure. Since not all gait problems
can be treated with DBS, it is mandatory to assess the patient's symptoms
precisely before an operation can be considered. In advanced stages of PD,
postural deficits causing frequent falls are a major concern and will
necessitate other strategies. In dystonia, walking may become possible only
after this surgical intervention. After the implantation of DBS electrodes,
rehabilitative treatment is necessary to (i) to establish new movement
patterns, (ii) preserve an appropriate activity level, and (iii) treat specific
disability, which resulted from secondary changes of the musculoskeletal system
during pathological muscle tension in dystonia. An integrated multimodal
approach, which has been adopted in our institution is presented.
