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. doi: 10.1002/mds.22940.


The purpose of this randomized controlled trial was to determine whether increasing hours of self-management rehabilitation had increasing benefits for health-related quality of life (HRQOL) in Parkinson's disease beyond best medical treatment, whether effects persisted at 2 and 6 months of follow-up, and whether targeted compared with nontargeted HRQOL domains responded more to rehabilitation. Participants on best medication therapy were randomly assigned to one of three conditions for 6 weeks intervention: 0 hours of rehabilitation; 18 hours of clinic group rehabilitation plus 9 hours of attention control social sessions; and 27 hours of rehabilitation, with 18 in clinic group rehabilitation and 9 hours of rehabilitation designed to transfer clinic training into home and community routines. Results (N = 116) showed that at 6 weeks, there was a beneficial effect of increased rehabilitation hours on HRQOL measured with the Parkinson's Disease Questionnaire-39 summary index (F(1,112) = 6.48, eta = 0.23, CI = 0.05-0.40, P = 0.01). Benefits persisted at follow-up. The difference between 18 and 27 hours was not significant. Clinically relevant improvement occurred at a greater rate for 18 and 27 hours (54% improved) than for 0 hours (18% improved), a significant 36% difference in rates (95% CI = 20-52% difference). Effects were largest in two targeted domains: communication and mobility. More concerns with mobility and activities of daily living at baseline predicted more benefit from rehabilitation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Combined Modality Therapy / methods
  • Disability Evaluation
  • Exercise Therapy* / methods
  • Female
  • Follow-Up Studies
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / psychology*
  • Parkinson Disease / rehabilitation*
  • Parkinson Disease / therapy
  • Psychiatric Status Rating Scales
  • Quality of Life* / psychology
  • Self Care* / methods
  • Severity of Illness Index
  • Social Support
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome