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Article type: Research Article
Authors: Olivares, Adrianaa; * | Comini, Lauraa | Orfano, Jacopob | Froldi, Marcellob | Vezzadini, Giulianab
Affiliations: [a] Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane (Brescia), Pavia, Italy | [b] Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation of the Institute of Castel Goffredo (Mantova), Italy
Correspondence: [*] Address for correspondence: Adriana Olivares, CLS, Istituti Clinici Scientifici Maugeri, IRCCS Via Salvatore Maugeri 4, 27100 Pavia, Italy. Tel.: +39 30 8253281; Fax: +39 30 8253188; E-mail: adriana.olivares@icmaugeri.it.
Abstract: BACKGROUND:Physical exercise combined with occupational therapy (OT) can lead to a global improvement in personal well-being. OBJECTIVE:To assess in PD patients: 1) if a rehabilitation program involving OT, Nordic walking (NW) and therapeutic touch (TT) yields motor/non-motor benefits; 2) if the time collocation of OT within the program influences results. METHODS:This is a pilot study on 17 PD patients undergoing a 10-week rehabilitation program consisting of OT, NW and TT. Patients were randomized to receive OT in the first [Group 1, n = 8] vs. last five weeks [Group 2, n = 9] of the program. Scales (MMSE, FAB, BDI, UPDRS II and III, PDQ39 and AES-S) and 6MWT, Gait speed and length were assessed at three time-points. RESULTS:Thirteen out of 17 patients were analyzed. 6MWT, Gait speed and length improved in time without between-group differences (p < 0.05) as did UPDRII, UPDRSIII, FAB and PDQ39 (p < 0.05). Baseline UPDRS II and III significantly determined Δ6MWT (adjusted R2 = 0.6738) and ΔGAIT speed (R2 = 0.6746) at multiple regression, while ΔGAIT length showed the best regression (adjusted R2 = 0.8247) with impact of age, gender and baseline PDQ39 (ADL and cognition dimensions). CONCLUSIONS:Multidisciplinary rehabilitation including OT can improve motor and non-motor conditions in PD patients. The OT time-collocation at beginning or end of the rehabilitation program does not significantly affect results.
Keywords: Parkinson’s disease, occupational therapy, Nordic walking, multidisciplinary rehabilitation, outcome
DOI: 10.3233/NRE-192772
Journal: NeuroRehabilitation, vol. 45, no. 1, pp. 125-134, 2019
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