Effects of a physical therapy home-based exercise program for Parkinson's disease

Abstract

INTRODUCTION: Parkinson's disease (PD) is a neurological disorder that causes loss of functional abilities and independence. The aim of this study was to evaluate the effects of a physical therapist-supervised home-based exercise program in patients with PD using the UPDRS scale. MATERIALS AND METHODS: Thirty-three PD patients in the 1.5 to 3 Hoehn and Yahr stages participated in the trial. The patients and their relatives received a booklet with a 12-week home program, with a series of strengthening, stretching and flexibility exercises. The patients were trained by a physical therapist, and each session took 60 minutes, three times a week. RESULTS: We classified our patients in four groups: Group 1 - patients under 60 years of age and less than five years of PD; Group 2 - patients under 60 years of age and more than five years of PD; Group 3 - patients over 60 years of age and less than five years of the disease; and Group 4 - patients over 60 years of age and more than five years of PD. Significant improvement was found in group 1 in mentation, activities of daily living and motor function (p > 0.05). Group 3 presented statistically significant differences in motor function subscale (p > 0.05) and Group 4 showed no worsening in mentation subscale (p > 0.05). Group 2, however, presented no difference in all subscales (p < 0.05). CONCLUSION: Although not all patients improved their UPDRS scores, our data support the use of a home program as an alternative method of physical therapy treatment for PD patients.

Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

“…Previous studies evaluating a self-supervised home-based exercise program found positive effects on the ADL and UPDRS motor examination sections (13,(15)(16)(17) as well as on QoL (15,16,18). All of them provided a manual with exercises on the program, but they varied in the form of monitoring and most of them did not make it clear whether the orientation of the exercises was individualized or in a group.…”

“…Among the advantages of this program are the convenience of being able to perform the exercises at the desired moments, not having to go to a rehabilitation unit and reducing the direct cost to the patient (13,(15)(16)(17). The latter has assumed even greater importance in our population since it is predominantly low-income (33).…”

“…practice (14,16,17). Randomized clinical trials that have evaluated effects of individualized guidance and weekly telephone monitoring in a self-supervised PD home program have not been found in the literature.…”

“…Recently, studies have evaluated the effects of therapeutic home exercise programs whose practice can be supervised by the patient (12)(13)(14)(15)(16)(17)(18).…”

“…However, these programs may have as a disadvantage the lack of assurance of the correct execution of the exercises since the patient and caregivers can understand the guidelines received in a limited way or present insufficient motivation and discipline (16,17).…”