Structured Abstract
Parkinson's Disease Structured Abstract - P #6
Occupational and physical therapy produce functional outcomes in clients with Parkinson's disease receiving drug treatment
CITATION: Formisano, R., Pratesi, L., Modarelli, F. T., Bonifati, V., & Meco, G. (1992). Rehabilitation and Parkinson's disease. Scandinavian Journal of Rehabilitation Medicine, 24, 157-160.
LEVEL OF EVIDENCE: IIA2a
RESEARCH OBJECTIVE/QUESTION
The objective of this study was to investigate the effect of physical and occupational therapy on a group of clients with Parkinson's disease who were receiving drug therapy, compared with a group of clients with Parkinson's disease who were only receiving drug therapy.
DESIGN
|
x |
Non-RCT |
|
Single Case |
|
Case Control |
| |
Cohort |
|
Before-After |
|
Cross Sectional |
SAMPLING PROCEDURE
Nonconsecutive. 16 clients were in the treatment group and received physical therapy along with their current drug treatment. 17 clients were in the control group and received only drug treatment.
SAMPLE
|
N = 33 |
Mean age = 66.1 |
Male = 22 |
Female = 11 |
NUMBER OF PARTICIPANTS BY HOEHN AND YAHR'S CLASSIFACATION OF PARKINSON'S DISEASE
STAGE I = 0
STAGE II = 28
STAGE III = 5
STAGE IV = 0
EXCLUSION/INCLUSION CRITERIA = NR
OUTCOMES
| |
Life roles |
x |
Tasks |
x |
Activities |
|
x |
Abilities/habits |
x |
Capacities |
OUTCOME AREAS
|
Outcome area |
Measure |
Reliability |
Validity |
|
Function in daily living tasks |
Northwestern University Disability Measure (NUDS) |
NR for any measure |
NR for any measure |
|
Walking for 10 meters |
Timed test |
|
|
|
Walking around a chair |
Timed test |
|
|
|
Fine motor coordination |
18-hole pegboard test (timed test) |
|
|
|
Physical and motor signs |
Hoehn and Yahr Staging Columbia University Disability Scale |
|
|
NR=Not Reported
INTERVENTION
Description
Physical treatment included passive and active mobilization exercises, walking, finger training, and occupational therapy.
Who delivered
NR
Setting
NR
Frequency
Three times a week. Sessions lasted 1 hour.
Duration
Treatment lasted for 4 months
RESULTS
Participants in the treatment group that received physical and occupational therapy showed significant improvement in function in daily living tasks on the NUDS (p < .05), and the change scores in the treatment group (-2.3 ± 1.1) on the NUDS showed significantly more improvement in function in daily living tasks than the change scores in the control group (-.1 ± .1; p < .05). Participants who received treatment also showed significant improvement over the control group in their ability to walk 10 meters quickly (p < .05). The change scores in the treatment group (-4.3 ± 1.2) showed significantly more improvement in walking 10 meters than change scores in the control group from baseline to follow-up periods (-.2 ± .2). The treatment group had improved motor coordination after 4 months of therapy. Specifically, the treatment group had significantly faster times for fitting cubes with the left hand upon comparison of pre-therapy and post-therapy scores (p < .01). The mean baseline score for fitting cubes with the left hand was 8.0 ± 2.2, and the score at follow-up was 6.7 ± 1.7.
CONCLUSIONS
Biases - co-intervention
This study provides support for the usefulness of physical and occupational therapy to treat clients with Parkinson's disease. Participants who received therapy showed significant improvements in walking and fine motor coordination. However, the validity and reliability of these outcome measures were not reported.
COMMENTARY
A combined treatment of physical and occupational therapy produced positive functional outcomes in a group of clients with Parkinson's disease who were currently being treated with drug therapy.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Susan Murphy, ScD, OTR/L, and Linda Tickle-Degnen, PhD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
