An individual rehabilitation program: evaluation by Parkinsonian patients and their physiotherapists

The objective of this work was to study the feasibility of an individual Parkinson disease (PD) rehabilitation program based on each patient’s prevalent symptoms and to determine the effects of this program on patient’s quality of life as well as the level of patient’s and physiotherapist’s satisfaction with the program. In association with physiotherapists with expertise in PD, a physical medicine and rehabilitation physician, this study elaborated a physical therapy program based on the core areas for physical therapy in PD: transfers; posture; balance and falls; physical capacity and inactivity. Within this program, exercises that were tailored to each patient’s main impairment were selected and proposed to their local physiotherapist for three months. Quality of life was evaluated with PDQ-39 at baseline and following three months of the individualized physical therapy program. An anonymous satisfaction questionnaire was designed for patients and physiotherapists and was filled out at the end of the program. One hundred and three individuals with moderately advanced but clinically stable idiopathic PD were included. Significant improvement was found for the emotional well-being, bodily discomfort and stigma domain (P ≤ 0.05). No significant improvement was found for the other PDQ-39 domains. The mean global satisfaction figures for this program were 6.0 ± 2.4 and 7.2 ± 2.1 for patients and physiotherapists respectively. Most of the patients felt improved by the physiotherapy program and especially for transfer, balance, gait, and mobility.

This study found evidence of the potential benefits of a patient-tailored physiotherapy program. Such a program was feasible and had a favorable impact on patients’ quality of life and on physiotherapists’ practices for PD patients. Specific physiotherapy may be effective to limit physical mobility impairment. The results also pointed out that physiotherapy may be efficient to confine the negative impact of social isolation, pain and emotional reactions. A program of this type should be associated with a therapeutic education intervention such as encouraging patients to perform physical therapy exercises on their own.