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Outcomes of rehabilitation following device-aided therapy start in parkinson's disease: a randomized controlled trial
Ann Björkdahl1, Annika Khalif2, Marie Gustafsson3
1Department of Clinical Neuroscience, University of Gothenburg, Gothenburg; Rehabilitation Medicine, Sahlgrenska University Hospital, Gothenburg; Department for Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg.
Objective:
To determine whether adding tailored primary care rehabilitation to Device-Aided Therapy in Parkinson's disease improves outcomes more than Device-Aided Therapy alone.
Design:
Open randomized controlled intervention trial.
Subjects/Patients:
Parkinson's patients initiating Device-Aided Therapy.
Methods:
Participants were randomized to receive standard care either with or without 3 months of tailored primary care rehabilitation. The primary outcome was Assessment of Motor and Process Skills, while secondary outcomes included cognitive measures and overall treatment efficacy.
Results:
The study was completed by 45 of 54 included patients. The primary outcome variable indicated that rehabilitation resulted in better maintenance of patient motor skills at 6 and 12 months. However, among several secondary measures, only perceived health improved more in the intervention group. Motor fluctuations improved in both groups and several other disease-specific scales demonstrated non-significant improvements. The rehabilitation group showed better cognitive performance at 12 months.
Conclusion:
Motor skills and perceived health were improved by a 3-month rehabilitation period after the start of Device-Aided Therapy for advanced Parkinson's disease. An observed positive effect of rehabilitation on cognition in the first year after the therapy requires further confirmation.
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