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Efficacy of a physical therapy program in patients with Parkinson’s disease: A randomized controlled trial

Presented as a poster to the American Physical Therapy Association, February 12–16, 2003, Tampa, FL.
https://doi.org/10.1016/j.apmr.2004.08.008Get rights and content

Abstract

Ellis T, de Goede CJ, Feldman RG, Wolters EC, Kwakkel G, Wagenaar RC. Efficacy of a physical therapy program in patients with Parkinson’s disease: a randomized controlled trial. Arch Phys Med Rehabil 2005;86:626-32.

Objective

To investigate the effects of a physical therapy (PT) program in groups of people with Parkinson’s disease (PD).

Design

Randomized controlled trial with a crossover design.

Setting

Two outpatient rehabilitation clinics in Boston and Amsterdam, respectively.

Participants

Sixty-eight subjects diagnosed with typical, idiopathic PD, Hoehn and Yahr stage II or III, and stable medication use.

Intervention

Group A received PT and medication therapy (MT) for the first 6 weeks, followed by MT only for the second 6 weeks. Group B received only MT for the first 6 weeks and PT and MT for the second 6 weeks.

Main outcome measures

The Sickness Impact Profile (SIP-68), the mobility portion of the SIP-68, the Unified Parkinson’s Disease Rating Scale (UPDRS), and comfortable walking speed (CWS) at baseline, 6-week, 12-week, and 3-month follow-up.

Results

At 6 weeks, differences between groups were significant for the SIP mobility (P=.015; effect size [ES]=.55), for CWS (P=.012; ES=.49), for the activities of daily living (ADL) section of the UPDRS (P=.014; ES=.45), and for the total UPDRS (P=.007; ES=.56). The total SIP and the mentation and motor sections of the UPDRS did not differ significantly between groups. Significant differences were found at 3 months compared with baseline for CWS, the UPDRS ADL, and total scores.

Conclusions

People with PD derive benefits in the short term from PT group treatment, in addition to their MT, for quality of life related to mobility, CWS, and ADLs; long-term benefits were found in CWS, UPDRS ADL, and total scores but varied between groups.

Section snippets

Participants

A total of 68 subjects diagnosed with typical, idiopathic PD participated in this study, which was conducted at 2 sites. Thirty-seven subjects participated at the Boston site in the United States, and 31 participated at the Amsterdam site in the Netherlands. At the Boston site, subjects were recruited from the Department of Neurology at Boston Medical Center and from local support groups in the Boston area. At the Amsterdam site, subjects were recruited from the Department of Neurology at Vrije

Results

A total of 68 subjects (37 from Boston, 31 from Amsterdam) met the inclusion criteria, consented to participate, completed baseline assessments, and were randomly allocated to either group A or group B (see fig 1). All subjects completed all baseline assessments except for the UPDRS, which was not administered to 11 subjects admitted to the study. Sixty-three subjects completed the intervention. Two subjects withdrew from treatment because of medical complications unrelated to PD, 2 withdrew

Discussion

The findings of our present study partially support our main hypothesis in that gains were observed in functional status and quality of life related to physical mobility but not in global quality of life or at the impairment level. Our results reveal significant improvements in the SIP motor score, UPDRS ADL score, UPDRS total score, and CWS in the intervention group (PT and medication), compared with the control group (medication only). No significant differences between groups were found for

Conclusions

People with typical, idiopathic PD within Hoehn and Yahr stage II or III benefit in the short term from PT group treatment in addition to their MT with regard to function related to ADLs, CWS, and QOL related to mobility. Long-term benefits were observed in CWS, UPDRS ADL, and total scores but varied between groups.

Acknowledgments

We thank the physical therapists who implemented the rehabilitation program: Maureen Bourque, Lisa Azzam, Jean Peteet, Ingrid Burgers, Muriel Koolstra, and Nella Guinee; and those who assisted with data collection: Masa Kubo, Chia-ling Ho, Diane Dalton, Dan White, Paula McDonald, Samyra Keus, and Martijn Heijmans.

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