To investigate the effects of group TR on PD patients and to assess its impact TR from the caregivers' perspective.
The subjects were PD patients receiving treatment at Keio University Hospital and Shonan Keiiku Hospital, along with their caregivers. Group TR sessions were conducted twice a week via Zoom Meeting, with each session lasting 40 minutes. Pre-recorded rehabilitation contents were shared during the sessions. The rehabilitation program focused primarily on chair-based physiotherapy, with additional training targeting articulation, swallowing, and cognitive functions. Mini-lectures by therapists and attending physicians were given during breaks and at the end of each session. After one year, a questionnaire survey was conducted. Patient satisfaction was assessed using the Clinical Satisfaction Questionnaire (CSQ), and a self-report questionnaire that we made was administered to evaluate the effects of TR.Patients were asked to identify improvements in activities of daily living (ADL) based on items from the Barthel index scale. The Parkinson disease questionnaire-39 (PDQ-39) was used to assess quality of life. Caregivers were also surveyed to evaluate the effects on patients from their perspective.
Of the 65 participants, 57 patients who participated in the TR program for one year and answered the questionnaire were included in the analysis (87.7% persistence rate, mean age 73.0±4.9 years, mean disease duration 5.2±4.5 years, median Hoehn & Yahr 3) and 49 caregivers. The mean CSQ score was 25.6 out of 32. 52.8% of patients reported improvement in at least one ADL item, 47.1% reported physical improvement, 66.0% reported emotional improvement, and 83.0% had a favorable impression of group TR. Additionally, 39.7% felt that the progression of PD had slowed. These trends were consistent with the caregivers' perspectives. The PDQ-39 total scores tended to decline, and motor skills and ADL scores on the PDQ-39 worsened after one year, but emotional well-being was maintained. Participants were divided into two groups: those who participated in every TR session and those who participated less frequently. Patients who participated regularly (35 patients) showed no significant change in PDQ-39 total scores after one year (p=0.81), while infrequent participants showed significant decline (p=0.01).
Satisfaction with group TR was high among both PD patients and caregivers, with benefits of emotional well-being outweighing physical ones. This may be due to the positive impression of doing it with other participants. The PDQ-39 also showed that group TR contributed to the emotional well-being of PD patients, with twice-weekly participation playing a key role in maintaining quality of life.
These results suggest that group TR is a valuable intervention for PD patients.
telerehabilitation
group
