Effects of Group, Individual, and Home Exercise in Persons With Parkinson’s Disease
APDM partner Laurie King, PT, PhD, and colleagues have been named winners of the Golden Synapse Award for best article of 2015 by the Journal of Neurologic Physical Therapy.
Dr. King is part of the OHSU Department of Neurology, specializing in clinical implementation of emerging practices and technology in the assessment and rehabilitation of patients with neurologic conditions. She is specifically interested and has completed valuable research in the areas of Parkinson’s Disease and Traumatic Brain Injury. Dr. King aims to translate such scientific findings to the Neurology community, and often teaches courses and provides lectures in the field. King frequently uses APDM Opal sensors in her research, utilizing their ability to provide sensitive and reliable data, and numerous outcome measures.
With the help of APDM Opals, King’s team conducted a randomized clinical trial entitled “Effects of Group, Individual, and Home Exercise in Persons with Parkinson’s Disease.” Past studies in the area had rarely considered how any exercise intervention was delivered. The overall objective of the study was to compare and contrast the success of exercise when administered by a home exercise program, individualized physical therapy, or a group class. The team was also interested in seeing if any common comorbidities often associated with PD had an impact on the success of each intervention.
58 subjects participated in the study, with the average age around 64, all with PD. The subjects were then randomly assigned an exercise program (home, individual physical therapy, or group class). The primary outcome measure was the 7-item Physical Performance Test, an assessment of multiple domains of Physical function using observed performance of tasks that simulate activities of daily living of various degrees of difficulty in elderly persons. Other metrics involving gait and balance were derived using Opals.
Subjects wore sensors on the lumbar, ankles, wrists, and sternum, and were instructed to perform a 2-minute walk. Metrics recorded included those that have shown sensitivity to early PD, good reliability, and a comprehensive characterization of commonly impaired aspects of PD. They include stride velocity, arm swing velocity, trunk velocity, stride time variability, and turn duration.
Other measures of quality of life, depression, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included as well.
Results showed that only the individualized physical therapy group improved in the Physical Performance Test. Opals recorded that this group showed the most improvements in functional balance measures, whereas the group class showed more improvements in gait. The home exercise program showed the least improvement across all outcomes, which may be due to the subjects being unsupervised, where compliance and performance can influence success and efficacy. The study also showed that subjects with comorbidities did better in the program directly supervised by a physical therapist.
Dr. King explains the study abstract here.
The study concluded “combination of both group and 1-on-1 administered physical therapy may be the most effective way to treat mobility disability for people with PD. Furthermore, people with PD who have depression, high number of comorbidities, mild cognitive impairment, high BMI, and advance disease severity should be seen in a physical therapist-supervised program. Taken together, the findings from this study call into question the usefulness of an unsupervised home exercise program to improve mobility in people with PD and other accompanying comorbidities.”
For more information regarding the study, click here.
For more information regarding APDM Gait and Balance, click here.
