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. 2022 Jun 16;14:909622. doi: 10.3389/fnagi.2022.909622

Table 1.

Illustration of rehabilitation procedure for patients with PD.

Intervention Description and dose Selection and adjustment of intervention
One on one physical therapy This session was conducted by one well-trained therapist for 30 minutes per day:
1. warm-up activities (5 minutes): Stretching all the joints and major muscle
2. Active and passive exercises (20 min):
2.1 Stretching: extremities and spine stretching, ROM traction
2.2 Strength training: isometric training, isotonic training, resistance training
2.3 Balance training: tandem, one leg stance, inclined ramp
2.4 Gait training: external cueing (visual or auditory cues), dual-task training
2.5 Adjustment /control of posture: antigravity trunk extension
3 Cool-down (5 min): Stretching all the joints
• H and Y stage 1-2: Items 2.2, 2.3, and 2.4 are required. Difficulty was raised according to patients' adaptation to the intervention. For example, balance training performed on different surfaces like foam and inclined ramp and less cues were provided during gait training.
• H and Y stage>2:All items are required. Difficulty was reduced according to the severity of symptoms.
Balance and gait training The training was conducted by one well-trained therapist using automatized and standardized program supported by C-Mill (conducted in the morning for 30 min per day) and Balance Tutor (conducted in the afternoon for 30 min per day). Difficulty was adjusted according to the severity of symptoms. For example, more reaction times or cues were provided for patients with worse function of gait or balance.
Aerobic training The training was conducted by one well-trained therapist using upper and lower limb trainer (T5XR; Nustep, Ann Arbor, MI, USA) for 30 min per day. Difficulty was adjusted according to patients' adaptation to the intervention. For example, increased resistance level was set for patients with good adaptation to the training.
Speech therapy Three possible kinds of interventions were conducted by one speech therapist for 30 min per day:
(1) counseling for the management of swallowing and language problems;
(2) individual swallowing training
(3) speech therapy to treat hypokinetic dysarthria
The determination of speech therapies for patients with PD was mainly based on their complaints and symptoms, as well as the results of swallowing angiography:
• For patients with PD with mild dysphagia or dysarthria, only one kind of intervention was needed.
• For patients with PD with both dysphagia and dysarthria, we gave two kinds of intervention (2 and 3).
Home exercise program A platform of home exercise program for patients with PD was established by Beijing Rehabilitation Hospital, which consisted of several home exercise video courses. patients with PD keep doing exercise at home and sign up every day after 2-week rehabilitation.

PD, Parkinson's disease; ROM, range of motion; H and Y, Hoehn and Yahr.