Parkinson Disease Clinical Trial
Official title:
Impact of an Intensive Multi-Disciplinary Rehabilitation Treatment on Quality Of Life in Subjects With Parkinson's Disease
This study is aimed to evaluate the impact of an intensive, multidisciplinary rehabilitative program on quality of life in patients with Parkinson's Disease.
Parkinson's Disease (PD) is a progressive neurodegenerative disease clinically characterized
by rigidity, bradykinesia and resting tremor. Beyond these symptoms the principal feature of
this condition is the lost of habitual automatic movements and the disruption of different
cognitive-motivational processes. These features are related to a pathological dopaminergic
tone that alters the cortico-striatal pathways with several consequences on motor and
emotional behaviours. Given its complexity PD impact very seriously on patients' quality of
life (QoL).
Dopamine replacement therapy (DRT) is the standard treatment for the motor symptom of PD and
previous studies have demonstrated its positive effect on QoL. However DRT does not reduce
axial PD symptoms such as freezing of gait, postural instability and balance disturbances.
Further, long-term DRT could negatively impact on cognitive and motivational functions and
leads to different motor and behavioural side effects.
In the last years, rehabilitation has been proposed as an effective and complementary
treatment for the management of PD and several evidences highlighted the need of a
multidisciplinary and intensive approach to achieve good results.
To evaluate the impact of an intensive, multidisciplinary rehabilitation treatment (MIRT),
on QoL of subjects with PD. Literature data showed that this type of treatment determine a
positive effect on both motor and non-motor symptoms. Starting from these evidences, in this
study the investigators have examined whether MIRT act positively on QoL and for how long
this potential positive effect is maintained.
250 PD patients with Parkinson's Disease hospitalized for a 4-weeks MIRT were enrolled.
PDQ39 was administered at enrolment, and at three points after discharge: at 1, 3 and 6
months. The investigators decided to evaluate QoL after homecoming in order to avoid an
inpatient state bias. Other outcome measures were considered and assessed at the enrolment
and at discharge: Unified Parkinson's Disease Scale (UPDRS), Parkinson Disease Disability
Scale (PDDS), Berg Balance Scale (BBS), FOG (Freezing of Gait Questionnaire), 6MWT (6
minutes walking Test), Time Up and Go test (TUG). Cognitive and psychopathological status of
patients was also assessed using Mini Mental State Examination (MMSE), Frontal Assessment
Battery (FAB), State Trait Anxiety Inventory (STAY I-II), Beck Depression Inventory (BDI).
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