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F.M. Miyahara1, E. Okamoto2, E. Tardelli Neves Guelfi2, P.Y. Igarasi Barbosa2, M.E. Pimentel Piemonte3
1University of São Paulo, São Paulo, Brazil, 2Brazil Parkinson Association, São Paulo, Brazil, 3University of São Paulo, Department of Physical Therapy Faculty of Medical Science, São Paulo, Brazil
Background: Regardless of the best pharmacological intervention, the progression of the neurodegenerative process of Parkinson´s disease (PD), leads to worsening of the motor and non-motor symptoms. The increased severity of symptoms increases the level of deficiency and incapacity and consequently, decreases the quality of life of the people living with Parkinson disease. Physical therapy has been considering as a powerful adjuvant for pharmacological treatment to manage the motor symptoms and decrease the level of deficiency and incapacity. However, key points for the cost-benefits ratio as the minimal dosage, delivery way for long term results remain uncertain.
Purpose: The aim of this study was to investigate the long-term results of a weekly physical therapy program delivery for patient´s group on disease severity, independence in daily living activities and quality of life of people living with PD.
Methods: Participated this study 54 people with confirmed diagnostic of idiopathic PD, 4 in stage 1, 23 in stage 2, 22 in stage 3 of disease progression according to Hoehn and Yahr Classification, with 66.72 (SD = 8.9) years of age and 10.16 (SD=4.5) years of education, under levodopa reposition treatment. All participants received usual medical care and weekly physical therapy care delivery for groups with 8 patients with a similar level of deficiency. Besides physical therapy, participants were stimulated to make additional physical activities at home. The independence in daily living activities, motor symptoms severity and global disease severity were evaluated by section II, section III and total score of Unified Parkinson´s disease rating scale (UPDRS) respectively; and Health quality of life was evaluated by Parkinson´s disease questionnaire 39 (PDQ-39). All outcomes were evaluated in 3 annual individual sessions: at beginning of study (E1); at one year after (E2) and at two years after (E3). The results obtained in the three annual evaluations were analyzed by ANOVA for repeated measures.
Results: ANOVA showed a significant increase in total scores (p=.007, ES=.85), in section II (p=.002; ES=.91) and in section III (p=.002; ES=.75) in UPDRS over two years, confirmed by Tukey post-hoc test. However, ANOVA showed no statistically significant effect of time for scores in PDQ-39.
Conclusion(s): Medical care associated with physical therapy delivered in weekly group sessions was able to remain the health quality of life regardless of the worsening in disease severity over two years. The physical therapy delivered in weekly group sessions can be considered a strategy with positive cost-benefit ration to keep the health quality of life of people living with PD.
Implications: Weekly group physical therapy is able to maintain the quality of life of patients with Parkinson Disease for two years, even though it is a chronic progressive disease.
Funding, acknowledgements: FAPESP, NeuroMat, Rede Amparo
Keywords: Parkinson Disease, weekly group physical therapy, quality of life
Topic: Neurology: Parkinson's disease
Did this work require ethics approval? Yes
Institution: University of São Paulo
Committee: Comissão de Etica da Faculdade de Medicina na USP
Ethics number: 19504619.5.0000.0065
All authors, affiliations and abstracts have been published as submitted.
