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Published on: December 9, 2014
Association Between a 1-Year Group-Based Telerehabilitation Program and the Quality of Life of People With
Hiroki Saegusa1, Shohei Okusa2, Tomonori Nukariya3
1Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo; Parkinson's Disease Center, Keio University Hospital, Tokyo.
Objective:
This study aimed to (1) investigate changes in the quality of life among people with Parkinson's disease (PwPD) over a 1-year group-based telerehabilitation (TR) program and (2) explore the TR program's perceived impacts from the perspectives of the PwPD and their caregivers.
Design:
Observational and longitudinal study.
Setting:
Group-based TR program.
Participants:
PwPD who voluntarily enrolled in a 1-year group-based TR program.
Interventions:
Group-based TR program that included physical, rhythmic, cognitive, and swallowing exercises plus education about disease management.
Main Outcome Measures:
The primary outcome was Parkinson's Disease Questionnaire-39 (PDQ-39) total score at baseline, 6 months, and 1 year. Secondary outcomes were PDQ-39 domain scores, responses by the PwPD and their caregivers to the self-reported questionnaire to evaluate perceived emotional, physical, and lifestyle effects, and Client Satisfaction Questionnaire-8 (CSQ-8).
Results:
A total of 49 PwPD and 43 caregivers participated; 24 (49%) PwPD and 22 (51%) caregivers met the regular participation criterion (≥80% of scheduled sessions). Baseline characteristics were similar between regular and nonregular participants. Mixed models for repeated measures (MMRM) adjusted for baseline PDQ-39, Hoehn & Yahr stage, and disease duration showed better adjusted PDQ-39 total scores in the regular group than in the nonregular group (group effect P=.046). The emotional well-being domain showed a significant time effect (P=.007), and better adjusted scores in the regular than in the nonregular group at 1 year. The social support domain also favored the regular group (P=.017), and the communication domain showed a significant group × time interaction, indicating more favorable trajectories in the regular group. Both the PwPD and caregivers reported greater emotional benefits than physical benefits, and Client Satisfaction Questionnaire-8 scores indicated high satisfaction in both groups.
Conclusions:
Although causal relationships cannot be inferred, these findings suggest that higher and sustained participation in long-term, group-based TR is associated with maintenance of overall quality of life and improvements in emotional well-being among PwPD.
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