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

Introduction This study compared two different applications of Guided Self-rehabilitation Contracts (GSC) in Parkinsonu0027s 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 Parkinsonu0027s disease, either individually or collectively; it seems to reduce parkinsonian symptoms and to bring functional benefits.