Rehabilitation for Self-Management of Parkinsons Disease
Principal Investigator: Robert Wagenaar
Abstract: The overall goal of the proposed research is to determine whether rehabilitation that focuses on self-management of health helps to improve the day-to-day functioning and quality of life of community-living clients with Parkinson's disease (PD), beyond the effects of medical treatment alone. Typically for people with PD, medical treatment declines in effectiveness over a variable number of years, and these individuals face a relentless progression into disability and lowered quality of life that can end in a need for custodial care. If a rehabilitation program can ameliorate disability and support a high quality of life by positively influencing mobility, communication, and healthful daily living skills, it is possible that more intensive use of medication could be postponed. As a result, people with this disease might benefit longer from medication and be less quickly referred to costly inpatient rehabilitation and long term care facilities. The proposed research uses rigorous methodology, which is rare for studies of rehabilitation with this population, and builds on our previous research toward understanding the role of rehabilitation in promoting health in people with PD. In a randomized controlled design, people with PD will be assigned to one of three conditions for a duration of 6 weeks: (i) medication only, (ii)medication plus 2 outpatient group rehabilitation sessions and 1 social activity session per week, or (iii)medication plus 2 outpatient group rehabilitation sessions and 1 home/community rehabilitation session per week. Rehabilitation will occur through integrated physical, occupational, and speech therapy services specialized to the self-management of health needs of people with PD. The first specific aim of the proposed study is to determine if increasing "doses" of self-management rehabilitation (from Conditions i to ii to iii) result in increasingly positive quality of life outcomes. The second aim is to document change in rehabilitation effects at 2 and 6 months post-intervention. The third aim is to describe possible active ingredients in the rehabilitation by measuring neuromuscular and voice function outcomes. The fourth aim is to provide evidence for the validity of self-management outcome measures for use with PD. It is hypothesized that there will be beneficial and lasting effects of rehabilitation for quality of life outcomes.
Funding Period: 2003-06-01 - 2007-05-31
more information: NIH RePORT
- Self-management rehabilitation and health-related quality of life in Parkinson's disease: a randomized controlled trialLinda Tickle-Degnen
Department of Occupational Therapy, Tufts University, Medford, Massachusetts 02155, USA
Mov Disord 25:194-204. 2010..Effects were largest in two targeted domains: communication and mobility. More concerns with mobility and activities of daily living at baseline predicted more benefit from rehabilitation...
- Expressive behavior in Parkinson's disease as a function of interview contextKayoko Takahashi
Boston University College of Health and Rehabilitation Sciences Sargent College, Boston, MA, USA
Am J Occup Ther 64:484-95. 2010..The purpose of this study was to determine whether qualities of the interview context are associated with client motivational behavior in Parkinson's disease...
- Monitoring activity in individuals with Parkinson disease: a validity studyDaniel K White
Sargent College of Health and Rehabilitation Sciences, ScD Program in Rehabilitation Science, Boston University, USA
J Neurol Phys Ther 30:12-21. 2006....
- Test-retest reliability of 24 hours of activity monitoring in individuals with Parkinson's disease in home and communityDaniel K White
Sargent College of Health and Rehabilitation Sciences, ScD Program in Rehabilitation Science, Boston University, Boston, MA 02215, USA
Neurorehabil Neural Repair 21:327-40. 2007..This study examined the test-retest reliability of an activity monitor (AM) in home and community settings in individuals with Parkinson's disease (PD)...
- Changes in walking activity and endurance following rehabilitation for people with Parkinson diseaseDaniel K White
Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA 02218, USA
Arch Phys Med Rehabil 90:43-50. 2009..To investigate changes in walking activity and endurance after interdisciplinary rehabilitation in people with Parkinson disease (PD)...