Short term effects of home exercise program on severity of disease and quality of life in patients with Parkinson’s disease

Abstract

Objective: Parkinson’s disease is a chronic neurodegenerative disease that seriously deteriorates of quality of life of the patients. In this study we aimed to investigate short term effects of home exercise program on quality of life in patients with Parkinson’s disease.

Materials and Methods: Thirty patients with Parkinson’s disease were included in this study. Demographical  and clinical data of all patients were recorded, Unified Parkinson’s Disease Rating Scale (UPDRS) was filled to evaluate severity of illness and Parkinson’s Disease Questionnaire (PDQ-39) was filled to evaluate quality of life. Patients were randomly allocated into two groups as group 1 (n=15) and group 2 (n=15). One month duration home exercise program were given to one group (group1). No extra intervention or advice other than their pharmachological treatment were given  to the other group (group2). One month later, patients in group 1 were reevaluated by PDQ-39 and UPDRS.

Results: There was no statistically significant difference between groups in relation to demographical and clinical features, severity of disease and quality of life scores at the initial evaluation. The PDQ-39 and UPDRS scores of the patients who have taken home exercise programs were found to be significantly better compared to both their own pre-exercise status and to the patients who did not get any exercise program. In the post-exercise evaluation, mobility, activities of daily living, emotional well-being, cognitions, communication, bodily discomfort and total scores of PDQ-39  and mentation, behavior and mood, activities of daily living, motor examination and total scores of UPDRS of the patients who have taken home exercise programs were found to get significantly better. (p<0.05)

Conclusion: In patients with Parkinson’s disease, severity of disease and quality of life gets significantly better after taking a home exercise program. In our opinion, making home exercise programs a part of the treatment plan of patients with Parkinson’s disease will increase their quality of life.

Keywords

• Parkinson's disease,exercise,quality of life

Ev egzersiz programının Parkinson hastalarındaki hastalık şiddeti ve yaşam kalitesi üzerine kısa dönemdeki etkisi

Abstract

Amaç: Parkinson hastalığı, kronik nörodejeneratif bir hastalık olup hastaların yaşam kalitesini ciddi biçimde bozmaktadır. Bu çalışmada ev egzersiz programının Parkinson hastalarının yaşam kalitesi üzerine kısa dönemdeki etkisini araştırmayı amaçladık.

Gereç ve Yöntem: Bu çalışmaya toplam 30 Parkinson hastası alınmıştır. Tüm hastaların demografik ve klinik verileri kaydedilmiş, hastalık şiddetini değerlendirmek için Birleşik Parkinson Hastalığı Değerleme Ölçeği (BPHDÖ), yaşam kalitesini değerlendirmek için Parkinson Hastalığı Anketi (PDQ-39), doldurulmuştur. Hastalar randomize olarak olarak iki gruba ayrılmıştır. Gruplardan birine bir aylık ev egzersiz programı verilmiştir (grup1).  Diğer gruba mevcut farmakolojik tedavileri dışında ek girişim veya öneride bulunulmamıştır (grup2). Grup 1’deki hastalar bir ay sonra PDQ-39 ve BPHDÖ ile tekrar değerlendirilmiştir.

Bulgular: İlk değerlendirmede gruplar arasında demografik ve klinik özellikler, hastalık şiddeti ve yaşam kalitesi skorları açısından istatistiksel olarak anlamlı farklılık yoktu. Ev egzersiz programı alan hastaların PDQ-39 ve BPDHÖ skorlarının hem egzersiz öncesi durumlarıyla karşılaştırıldığında, hem de ev egzersiz programı almayan Parkinson hastalarıyla karşılaştırıldığında anlamlı olarak daha iyi olduğu belirlendi. Ev egzersiz programı alan hastaların egzersiz sonrası değerlendirmelerinde PDQ-39 mobilite, günlük yaşam aktiviteleri, kognitif durum, iletişim, beden konforsuzluğu ve total skorları ve BPHDÖ düşünce-davranış-ruhsal durum, günlük yaşam aktiviteleri, motor muayene ve total skorları anlamlı olarak iyileşmiş bulundu. (p<0.05)

Sonuç: Parkinson hastalarında, ev egzersiz programı sonrasında, yaşam kalitesi ve hastalık şiddetinde anlamlı iyileşme olmaktadır.  Ev egzersiz programlarının Parkinson hastalarının tedavi planın bir parçası haline getirilmesinin, hastaların yaşam kalitesini arttıracağı düşüncesindeyiz.

Keywords

• Parkinson hastalığı,egzersiz,yaşam kalitesi

References

1. KAYNAKLAR
2. 1. DeMaagd G, Philip A. Parkinson's Disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. P T. 2015 Aug;40(8):504-32.
3. 2. Driver JA, Logroscino G, Gaziano JM, et al. Incidence and remaining lifetime risk of Parkinson disease in advanced age. Neurology. 2009 Feb 3;72(5):432-8.3. Calne D. A definition of Parkinson’s disease. Parkinsonism Relat Disord 2005 Jun;11 Suppl 1:S39-40.
4. 4. Leung H, Mok V. Parkinson's disease: aetiology, diagnosis, and management. Hong Kong Med J. 2005 Dec;11(6):476-89.
5. 5. Twelves D, Perkins KS, Counsell C. Systematic review of incidence studies of Parkinson's disease. Mov Disord. 2003 Jan;18(1):19-31.
6. 6. Yamabe K, Liebert R, Flores N, Pashos C. Health-related quality of life, work productivity, and economic burden among patients with Parkinson's disease in Japan. J Med Econ. 2018 Sep;11:1-14.
7. 7. Fransisco GH, Kothari S, Schiess MC, Kaldis T. Rehabilitation of persons with Parkinson’s disease and other movement disorders. In: DeLisa JA, Gans BM, eds. Physical Medicine and Rehabilitation (4th Ed) Philadelpia, Lippincott Williams and Wilkins 2005;809-28.
8. 8. Jöbges M, Spittler-Schneiders H, Renner CI, Hummelsheim H. Clinical relevance of rehabilitation programs for Parkinson's disease. I: Non-symptom-specific therapeutic approaches. Parkinsonism Relat Disord. 2007 May;13(4):195-202.

9. 9. Jöbges M, Spittler-Schneiders H, Renner CI, Hummelsheim H. Clinical relevance of rehabilitation programs for Parkinson's disease. II: Symptom-specific therapeutic approaches. Parkinsonism Relat Disord. 2007 May;13(4):203-13.
10. 10. Caglar AT, Gurses HN, Mutluay FK, Kiziltan G. Effects of home exercises on motor performance in patients with Parkinson's disease. Clin Rehabil. 2005 Dec;19(8):870-7.
11. 11. de Goede CJ, Keus SH, Kwakkel G, Wagenaar RC. The effects of physical therapy in Parkinson's disease: a research synthesis. Arch Phys Med Rehabil. 2001 Apr;82(4):509-15.
12. 12. Hirsch MA, Toole T, Maitland CG, Rider RA. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease. Arch Phys Med Rehabil. 2003 Aug;84(8):1109-17.
13. 13. Nieuwboer A, De Weerdt W, Dom R, Bogaerts K. Prediction of outcome of physiotherapy in advanced Parkinson's disease. Clin Rehabil. 2002 Dec;16(8):886-93.14. Keus SH. Cueing training in the home improves mobility in Parkinson's disease. Aust J Physiother 2007;53(4):285.
14. 15. Canning CG, Allen NE, Dean CM, Goh L, Fung VS. Home-based treadmill training for individuals with Parkinson's disease: a randomized controlled pilot trial. Clin Rehabil. 2012;26(9):817-26.
15. 16. Schenkman M, Hall DA, Barón AE, Schwartz RS, Mettler P, Kohrt WM. Exercise for people in early- or mid-stage Parkinson disease: a 16-month randomized controlled trial. Phys Ther. 2012;92(11):1395-410.
16. 17. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427-42.
17. 18. Fahn, S, Elton RL. and Members of the UPDRS Development Committee. The Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB. and Goldstein M eds. Recent Developments in Parkinson’s Disease, Vol. 2, , Florham Park NJ, McMillan Health Care Information 1987;153-63.
18. 19. Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual Life Res. 1995 Jun;4(3):241-8.
19. 20. Karlsen KH, Larsen JP, Tandberg E, Maeland JG. Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1999 Apr;66(4):431-5.
20. 21. Karlsen KH, Tandberg E, Arsland D, Larsen JP. Health related quality of life in Parkinson's disease: a prospective longitudinal study. J Neurol Neurosurg Psychiatry. 2000 Nov;69(5):584-9.
21. 22. Reuther M, Spottke EA, Klotsche J, Riedel O, Peter H, Berger K et al. Assessing health-related quality of life in patients with Parkinson's disease in a prospective longitudinal study. Parkinsonism Relat Disord. 2007 Mar;13(2):108-14.
22. 23. Xia R, Mao ZH. Progression of motor symptoms in Parkinson's disease. Neurosci Bull. 2012 Feb;28(1):39-48.
23. 24. Antonini A, Barone P, Marconi R, Morgante L, Zappulla S, Pontieri FE et al. The progression of non-motor symptoms in Parkinson's disease and their contribution to motordisability and quality of life. J Neurol. 2012 Dec;259(12):2621-31.
24. 25. Hariz GM, Forsgren L. Activities of daily living and quality of life in persons with newly diagnosed Parkinson's disease according to subtype of disease, and in comparison to healthy controls. Acta Neurol Scand. 2011 Jan;123(1):20-7.
25. 26. Behari M, Srivastava AK, Pandey RM. Quality of life in patients with Parkinson's disease. Parkinsonism Relat Disord. 2005 Jun;11(4):221-6.
26. 27. Sławek J, Derejko M, Lass P. Factors affecting the quality of life of patients with idiopathic Parkinson's disease--a cross-sectional study in an outpatient clinic attendees. Parkinsonism Relat Disord. 2005 Nov;11(7):465-8.
27. 28. Chrischilles EA, Rubenstein LM, Voelker MD, Wallace RB, Rodnitzky RL. Linking clinical variables to health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord. 2002 Jan;8(3):199-209.
28. 29. Quittenbaum BH, Grahn B. Quality of life and pain in Parkinson's disease: a controlled cross-sectional study. Parkinsonism Relat Disord. 2004 Mar;10(3):129-36.
29. 30. Segura APC, Fontes SV, Fukujima MM, Matas SLA. The impact evaluation of physical therapy on the quality of life of cerebrovascular stroke patients. International Journal of Rehabilitation Research 2006; 29:243-246.
30. 31. Taylor NF, Dodd KJ, Prasad D, Denisenko S. Progressive resistance exercise for people with multiple sclerosis. Disability and Rehabilitation 2006;28(18):1119-1126.
31. 32. Tickle-Degnen L, Ellis T, Saint-Hilaire MH, Thomas CA, Wagenaar RC. Self-management rehabilitation and health-related quality of life in Parkinson's disease: a randomized controlled trial. Mov Disord. 2010 Jan 30;25(2):194-204.
32. 33. Ashburn A, Fazakarley L, Ballinger C, Pickering R, McLellan LD, Fitton C. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):678-84.
33. 34. Lun V, Pullan N, Labelle N, Adams C, Suchowersky O. Comparison of the effects of a self-supervised home exercise program with a physiotherapist-supervised exercise program on the motor symptoms of Parkinson's disease. Mov Disord. 2005 Aug;20(8):971-5.
34. 35. King LA, Wilhelm J, Chen Y, Blehm R, Nutt J, Chen Z, Serdar A, Horak FB. Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial. J Neurol Phys Ther. 2015 Oct;39(4):204-12.
35. 36. Baatile J, Langbein WE, Weaver F, Maloney C, Jost MB. Effect of exercise on perceived quality of life of individuals with Parkinson's disease. J Rehabil Res Dev. 2000 Sep-Oct;37(5):529-34.
36. 37. Morberg BM, Jensen J, Bode M, Wermuth L. The impact of high intensity physical training on motor and non-motor symptoms in patients with Parkinson's disease (PIP): a preliminary study. NeuroRehabilitation. 2014 Jan 1;35(2):291-8.
37. 38. Rodrigues de Paula F, Teixeira-Salmela LF, Coelho de Morais Faria CD, Rocha de Brito P, Cardoso F. Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson's disease. Mov Disord. 2006 Aug;21(8):1073-7.
38. 39. Reuter I, Engelhardt M, Stecker K, Baas H. Therapeutic value of exercise training in Parkinson's disease. Med Sci Sports Exerc. 1999 Nov;31(11):1544-9.
39. 40. Carroll LM, Volpe D, Morris ME, Saunders J, Clifford AM. Aquatic Exercise Therapy for People With Parkinson Disease: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2017 Apr;98(4):631-638.
40. 41. Pellecchia MT, Grasso A, Biancardi LG, Squillante M, Bonavita V, Barone P. Physical therapy in Parkinson's disease: an open long-term rehabilitation trial. J Neurol. 2004 May;251(5):595-8.
41. 42. Carne W, Cifu D, Marcinko P, Pickett T, Baron M, Qutubbudin A, Calabrese V, Roberge P, Holloway K, Mutchler B. Efficacy of a multidisciplinary treatment program on one-year outcomes of individuals with Parkinson's disease. NeuroRehabilitation. 2005;20(3):161-7.
42. 43. Ellis T, de Goede CJT, Feldman RG, Wolters EC, Kwakkel G, Wagenaar RC. Efficacy of a physical therapy program in patients with Parkinson's disease: a randomized controlled trial. Arch Phys Med Rehabil 2005;86:626-32.