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Movement disorders
Research paper
Efficacy of intensive multidisciplinary rehabilitation in Parkinson’s disease: a randomised controlled study
  1. Davide Ferrazzoli1,
  2. Paola Ortelli1,
  3. Ilaria Zivi1,
  4. Veronica Cian1,
  5. Elisa Urso1,
  6. Maria Felice Ghilardi2,
  7. Roberto Maestri3,
  8. Giuseppe Frazzitta1
  1. 1Department of Parkinson’s Disease, Movement Disorders and Brain Injury Rehabilitation, ‘Moriggia-Pelascini’ Hospital, Gravedona ed Uniti, Italy
  2. 2Department of Physiology, Pharmacology and Neuroscience, CUNY Medical School, New York, New York, USA
  3. 3Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri Spa Società Benefit, IRCCS, Montescano, Italy
  1. Correspondence to Dr Davide Ferrazzoli, Department of Parkinson’s disease, Movement Disorders and Brain Injury Rehabilitation, ‘Moriggia-Pelascini’ Hospital, Gravedona ed Uniti 22015, Italy; davideferrazzoli{at}gmail.com

Abstract

Objective To evaluate whether a 4-week multidisciplinary, aerobic, motor-cognitive and intensive rehabilitation treatment (MIRT) improves the quality of life (QoL) of patients with Parkinson’s disease (PD), in the short-term and long-term period.

Methods This is a prospective, parallel-group, single-centre, single-blind, randomised clinical trial (ClinicalTrials.gov NCT02756676). 186 patients with PD, assigned to experimental group, underwent MIRT; conversely, 48 patients, assigned to control group, did not receive rehabilitation. Parkinson’s Disease Questionnaire-39 was assessed 2 (T0), 10 (T1) and 18 (T2, only experimental group) weeks after the enrolment. We compared T1 versus T0 scores within subjects and delta scores (T1–T0) between subjects. To investigate the long-term effects, we compared T2 and T0 scores in the experimental group.

Results At T0, no between-group differences in the Global Index Score (GBI) were observed (experimental group: 43.6±21.4, controls: 41.6±22.9, P=0.50). At T1, we did not find significant changes in controls (delta score: 1.2±9.9, P=0.23), and we found an improvement in GBI in the experimental group (delta score: −8.3±18.0, P<0.0001), significant also between subjects (P<0.0001). Comparing T2 versus T0 in the experimental group, the GBI maintained a significant improvement (delta score: −4.8±17.5, P<0.0001).

Conclusions A rehabilitation treatment such as MIRT could improve QoL in patients with PD in the short-term and long-term period. Even though the single-blind design and the possible role of the placebo effect on the conclusive results must be considered as limitations of this study, the improvement in outcome measure, also maintained after a 3-month follow-up period, suggests the effectiveness of MIRT on the QoL.

Clinical trial registration NCT02756676: Pre-results.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/jnnp-2017-316437

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    Footnotes

    • PO, RM and GF contributed equally.

    • Contributors DF: wrote the text, conceived and designed the experiments, provided substantial contributions to discussion and edited the manuscript before submission. PO: wrote the text, conceived and designed the experiments, performed the experiments, provided substantial contributions to discussion and generated the figures. IZ: wrote the text, conceived and designed the experiments, and provided substantial contributions to discussion. VC: researched data for the article. EU: researched data for the article. MFG: provided substantial contributions to discussion. RM: analysed the data and did the statistical analysis. GF: conceived and designed the experiments, analysed the data, wrote the text and provided substantial contributions to discussion.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study design and protocol were approved by the local scientific committee (‘Moriggia-Pelascini’ Hospital, Gravedona e Uniti - Como) and were in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki, 1967).

    • Provenance and peer review Not commissioned; externally peer reviewed.

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