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Short-term effectiveness of intensive multidisciplinary rehabilitation for people with Parkinson's disease and their carers

Royal Surrey County Hospital, Guildford

Julie Kaye

Surrey Hampshire Borders NHS Trust, Guildford

Heather Gage

Department of Economics, University of Surrey, Guildford

Charles Owen

Thomas Coram Research Centre, Institute of Education, University of London, Oxford

Derick Wade

Rivermead Rehabilitation Centre, Oxford

Objective: To evaluate the short-term effectiveness of an intensive multidisciplinary rehabilitation programme for people with Parkinson's disease and their carers.

Design: Observational, with assessments before and after intervention.

Setting: An elderly care day unit in a district general hospital in south-east England.

Subjects: One hundred and eighteen people with Parkinson's disease and no cognitive impairment, and their carers.

Intervention: Participants attended the day hospital in groups of six patients with their carers for one day per week over six consecutive weeks. After assessment, they received individual treatment from a specialist team. Weekly group activities included relaxation and talks from experts.

Outcome measures: Patients and carers were assessed for: health-related quality of life, psychological well-being, social services need, perceptions of the programme. Patients were additionally assessed for mobility, gait and speech. Carers were assessed for strain.

Results: After treatment significant improvements were recorded in patients' mobility and gait (p < 0.05), speech (p < 0.001), depression (p = 0.029), health-related quality of life (p = 0.001). People with more advanced disease at baseline gained significantly more from treatment (p £ 0.04). Carers were less depressed and had higher health-related quality of life than patients at baseline (p < 0.001) and no improvements in these indicators were recorded after treatment. A high unmet need for social services was identified in 31% of participants, and 10% of carers were found in danger of being unable to continue caring. Participants reported knowledge gains and high levels of satisfaction with both individual therapies and group activities.

Conclusions: This intensive co-ordinated programme provided immediate benefits to people with Parkinson's disease and their carers.

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