Motor, Cognitive Rehabilitation Program May Improve Quality of Life in Parkinson Disease

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Multidisciplinary rehab programs that combine motor, cognitive, and aerobic rehab may benefit quality of life in patients with Parkinson disease.
Multidisciplinary rehab programs that combine motor, cognitive, and aerobic rehab may benefit quality of life in patients with Parkinson disease.

A 4-week aerobic, multidisciplinary motor-cognitive and intensive rehabilitation treatment (MIRT) is associated with short- and long-term quality-of-life (QoL) improvements among patients with Parkinson disease (PD), according to results of a prospective, randomized clinical trial published in the Journal of Neurology, Neurosurgery, and Psychiatry.

The 4-week inpatient MIRT program, which consists of a total of 4 rehabilitative sessions per day for a total of 5 days plus 1 hour of physical activity on day 6, is designed to help patients with PD relearn physical movements. In this study, individuals with PD were randomly assigned to undergo MIRT (n=186) or no rehabilitation (controls, n=48). Researchers administered the PD Questionnaire-39 (PDQ-39) at 2, 10, and 18 weeks after enrollment in the trial. The PDQ-39 was used to assess QoL changes throughout the study period.

At 2 weeks, there were no significant differences between the treatment and control groups with regard to PDQ-39 scores (43.6±21.4 vs 41.6±22.9, respectively; P =.50). The PDQ-39 scores significantly improved at 10 weeks among participants who underwent rehabilitation (delta score: −8.3±18.0; P <.0001), whereas the score did not significantly improve among controls (delta score: 1.2±9.9, P =.23). In addition, there was a sustained QoL improvement at 18 weeks in the treatment group (delta score: −4.8±17.5; P <.0001).

Although the findings from this trial indicate a significant benefit of MIRT for QoL improvement in patients with PD, the trial did not extend beyond 3 months, so the longer-term effects of the rehabilitation strategy remain unknown. In addition, as blinding participants and investigators to therapy was impossible, the observed QoL improvements could have been derived from a placebo effect.

Researchers noted that a speech and language therapist, physiotherapist, or PD nurse "could play an important role in stimulating and motivating patients and maintaining" the effects of MIRT.

Reference

Ferrazzoli D, Ortelli P, Zivi I, et al. Efficacy of intensive multidisciplinary rehabilitation in Parkinson's disease: a randomised controlled study [published online January 10, 2018]. J Neurol Neurosurg Psychiatry. doi: 10.1136/jnnp-2017-316437

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