Effects of a guided self-rehabilitation contract in patients with moderate stage Parkinson disease

Mrs Sandrine JOUDOUXa, Mrs Laurence TARAVELLA-POUSSINa, Ms Emilie HUTINb, Prof Jean-Michel GRACIESb, Dr Nicolas BAYLEb

a Hôpital Albert Chenevier, b GH Henri Mondor

Introduction: This study compared two different applications of Guided Self-rehabilitation Contracts (GSC) in Parkinson's disease, individual (I) or group-wise (C), in a 3-month intensive training focused on balance.

Methods: Fourteen patients were randomized into 2 parallel groups (I and C) with one physical therapy session every 10 days for 3 months. Each session associated education and exercise prescription that each patient had to perform daily between sessions. Each patient was to complete a log recording daily work and wear a pedometer. Evaluations, OFF and ON, included Global Mobility Task (GMT), UPDRS III, proof of effort, 20 m-walk test, 2 minute-endurance test and Functional Reach Test (FRT).

Results: Results of the two groups were similar. Patients worked alone about 40 minutes a day, 6 days per week. Improvements involved the daily number of steps (+19.2%, p = 0.091), UPDRS III-OFF (-30.1%, p = 0.029), GMT-ON (-11.2%, p=0.042) and stride length at comfortable speed (+9.6%, p=0.029).

Conclusion: An intensive rehabilitation program in the form of a GSC is feasible in Parkinson's disease, either individually or collectively; it seems to reduce parkinsonian symptoms and to bring functional benefits.

Keywords : guided self-rehabilitation, Parkinson, physiotherapy, intensive rehabilitation