Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

Abstract

Introduction: Home therapeutic exercises have been a target of interest in the treatment of the Parkinson's disease (PD). The way that the physical therapist guides and monitors these exercises can impact the success of therapy. Objective: To evaluate the effects of individualized orientation and monitoring by telephone in a self-supervised home therapeutic exercise program on signs and symptoms of PD and quality of life (QoL). Methods: Single-blind randomized clinical trials with 28 people with PD (Hoehn and Yahr 1 to 3). Patients were randomized into two groups: experimental and control. The experimental group had a meeting with individualized guidance about physiotherapy exercises present in a manual, received the manual to guide their activities at home and obtained subsequent weekly monitoring by telephone. The control group received the usual cares by the service. Both were orientated to carry out exercises three times a week during 12 weeks. Was evaluated: (1) activities of daily living (ADL) and motor examination sections of the Unified Parkinson's Disease Rating Scale (UPDRS) and QoL by the Parkinson Disease Questionnaire 39 (PDQ-39). The analysis between groups was performed by the Mann-Whitney test and intragroup through the Wilcoxon (p < 0.05). Results: Significant improvement in ADL (p= 0.001) and motor examination (p= 0.0008) of the UPDRS, PDQ-39 total (p = 0.027) and dimensions mobility (p = 0.027), emotional well-being (p= 0.021) and bodily discomfort (p = 0.027) in the experimental group compared to the control group. Conclusion: The individualized guidance and weekly monitoring by telephone in a self-supervised home therapeutic exercises program promoted positive effects on ADL, motor examination and QoL of people in early stages of PD.

Effects of Physiotherapy Interventions on Fall, Posture and Quality of Life in Parkinson Disease

“…Further studies 24 endorsed the view of home based program that can produce similar effects to improve conditions in PD. A similar study carried out by Shenkman et al 41 , lun et al 42 andAshburn et al 43 that highlighted the same fact that self-supervised program or personalized home based exercise prescribed by Physiotherapist could be an option to cope up with the symptoms of PD at home. On the contrary, progressive resisted training exercise Poliak et al 44 proposed a study which explained the great influence of gym training over the QOL in PD as it improves illness perceptions and enables the participants to socialize and boost confidence.…”

Scope, context and quality of telerehabilitation guidelines for physical disabilities: a scoping review

“…Twenty-three articles were included in the scoping review analysis (figure 1; see table 1 for article characteristics). Eleven [15][16][17][18][19][20][21][22][23][24][25] of the included articles were original research studies, and three were systematic review studies. [26][27][28] The remaining nine [29][30][31][32][33][34][35][36][37] were guidance documents produced by health institutions or health experts.…”

“…25 28-37 The 14 included research studies and systematic reviews had the following general aims: one study assessed use and perceptions of telerehabilitation 15 ; one study examined costs of implementing telerehabilitation 16 ; one study assessed the development of a telerehabilitation technology 17 ; three studies systematically reviewed telerehabilitation literature [26][27][28] ; four studies assessed the feasibility of a telerehabilitation technology [18][19][20][21] ; and four studies examined the effectiveness of the telerehabilitation technology. [22][23][24][25]…”

Conhecimentos, Atitudes E Práticas De Pessoas Com Doença De Parkinson Sobre Um Programa Terapeûtico Domicilar Com Orientação Em Grupo

“…Recentemente, estudos têm avaliado os efeitos de programas de exercícios terapêuticos domiciliares na DP cuja prática pode ser autossupervisionada, ou seja, supervisionada pelo próprio paciente (DERELI;YALIMAN, 2010;GONDIM et al, 2017;KING et al, 2015;LOPES, 2010;SANTOS et al, 2012). Estes programas parecem ser uma alternativa facilitadora de acesso para aqueles com dificuldade de locomoção e/ou financeira, mas seu sucesso parece ser influenciado pela capacidade cognitiva, motivacional e disciplinar do paciente (DERELI; YALIMAN, 2010;LOPES, 2010;SANTOS et al, 2012), bem como pela forma como se orienta e monitora os exercícios LINS;CORIOLANO, 2016;GONDIM et al, 2017).…”

“…Ademais, desenvolver e adaptar programas de exercícios que incorporem preferências específicas podem resultar em intervenções mais eficazes para pacientes com DP (ABRANTES et al, 2012). Dentre estratégias para contornar as barreiras relativas à prática domiciliar, a literatura traz: discussões com o paciente relacionadas a benefícios e barreiras dos exercícios, ajustes periódicos do programa prescrito para aumentar o nível de desafio e melhorar a motivação, uso de vídeos/DVDs com exercícios domiciliares, programas simples, instruções individuais sobre como fazer os exercícios para casa, monitoramento por diário de exercícios ou telefone, monitoramento dos comportamentos relacionados ao exercício, definição de metas e incentivo rotineiro a exercitar-se (ABRANTES et al, 2012;ENE;MCRAE;SCHENKMAN, 2011;GONDIM et al, 2017;QUINN et al, 2010).…”