| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
PAPER |
1 Oxford Centre for Enablement, Windmill Road, Oxford, UK
2 Department of Economics, University of Surrey, Guildford, UK
3 Thomas Coram Research Unit, Institute of Education, London WC1, UK
4 Department of Neurology, Royal County Surrey Hospital, Guildford
5 Social Services Dept, Royal County Surrey Hospital
6 Specialist Nurse, Surrey Hampshire Borders NHS Trust, Guildford
Correspondence to:
Correspondence to:
Professor Derick T Wade, Oxford Centre for Enablement, Windmill Road, Oxford OX3 7LD, UK;
derick.wade{at}dial.pipex.com
Objective: To determine whether a programme of multidisciplinary rehabilitation and group support achieves sustained benefit for people with Parkinson’s disease or their carers.
Methods: The study was a randomised controlled crossover trial comparing patients and carers who had received rehabilitation four months before assessment with those who had not. Patients were recruited from a neurology clinic, attended a day hospital from home weekly for six weeks using private car or hospital transport, and received group educational activities and individual rehabilitation from a multidisciplinary team. Patients were assessed at entry and at six months using a 25 item self assessment Parkinson’s disease disability questionnaire, Euroqol-5d, SF-36, PDQ-39, hospital anxiety and depression scale, and timed stand-walk-sit test. Carers were assessed using the carer strain index and Euroqol-5d.
Results: 144 people with Parkinson’s disease without severe cognitive losses and able to travel to hospital were registered (seven were duplicate registrations); 94 had assessments at baseline and six months. Repeated measures analysis of variance comparing patients at the 24 week crossover point showed that those receiving rehabilitation had a trend towards better stand-walk-sit score (p = 0.093) and worse general and mental health (p = 0.002, p = 0.019). Carers of treated patients had a trend towards more strain (p = 0.086). Analysis comparing patients before and six months after treatment showed worsening in disability, quality of life, and carer strain.
Conclusions: Patients with Parkinson’s disease decline significantly over six months, but a short spell of multidisciplinary rehabilitation may improve mobility. Follow up treatments may be needed to maintain any benefit.
Keywords: Parkinson’s disease; rehabilitation
Abbreviations: HAD, hospital anxiety and depression scale; NHPT, nine hole peg test; PDQ, Parkinson’s disease questionnaire; SF-36, short form 36 item health survey; UPDRS, unified Parkinson’s disease rating scale
Related Article
J. Neurol. Neurosurg. Psychiatry 2003 74: 148-149.
This article has been cited by other articles:
|
|
 |
|
  P. Zinzi, D. Salmaso, R. De Grandis, G. Graziani, S. Maceroni, A. Bentivoglio, P. Zappata, M. Frontali, and G. Jacopini Effects of an intensive rehabilitation programme on patients with Huntington's disease: a pilot study Clinical Rehabilitation, July 1, 2007; 21(7): 603 - 613. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Jenkinson, C. Heffernan, H. Doll, and R. Fitzpatrick The Parkinson's Disease Questionnaire (PDQ-39): evidence for a method of imputing missing data Age Ageing, September 1, 2006; 35(5): 497 - 502. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Suchowersky, G. Gronseth, J. Perlmutter, S. Reich, T. Zesiewicz, and W. J. Weiner Practice Parameter: neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, April 11, 2006; 66(7): 976 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Gage, J. Kaye, C. Owen, P. Trend, and D. Wade Evaluating rehabilitation using cost-consequences analysis: an example in Parkinson's disease Clinical Rehabilitation, March 1, 2006; 20(3): 232 - 238. [Abstract] [PDF]
|
|
|
|
|
|
G Brichetto, E Pelosin, R Marchese, and G Abbruzzese Evaluation of physical therapy in parkinsonian patients with freezing of gait: a pilot study Clinical Rehabilitation, January 1, 2006; 20(1): 31 - 35. [Abstract] [PDF]
|
|
|
|
|
|
A T Caglar, H N Gurses, F K Mutluay, and G Kiziltan Effects of home exercises on motor performance in patients with Parkinson's disease Clinical Rehabilitation, August 1, 2005; 19(8): 870 - 877. [Abstract] [PDF]
|
|
|
|
|
|
D. T Wade Randomized clinical trials in Clinical Rehabilitation Clinical Rehabilitation, March 1, 2005; 19(3): 233 - 236. [Abstract] [PDF]
|
|
|
|
|
|
O. Suchowersky, G. Gronseth, J. Perlmutter, S. Reich, T. Zesiewicz, and W. J. Weiner Practice Parameter: neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, April 11, 2006; 66(7): 976 - 982. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
