Occupational therapy with Nordic walking and therapeutic touch: A pilot study for multidisciplinary rehabilitation in Parkinson's disease

BACKGROUND: Physical exercise combined with occupational therapy (OT) can lead to a global improvement in personal well-being.

OBJECTIVE: To assess in PD patients: 1) if a rehabilitation program involving OT, Nordic walking (NW) and therapeutic touch (TT) yields motor/non-motor benefits; 2) if the time collocation of OT within the program influences results.

METHODS: This is a pilot study on 17 PD patients undergoing a 10-week rehabilitation program consisting of OT, NW and TT. Patients were randomized to receive OT in the first [Group 1, n = 8] vs. last five weeks [Group 2, n = 9] of the program. Scales (MMSE, FAB, BDI, UPDRS II and III, PDQ39 and AES-S) and 6MWT, Gait speed and length were assessed at three time-points.

RESULTS: Thirteen out of 17 patients were analyzed. 6MWT, Gait speed and length improved in time without between-group differences (p < 0.05) as did UPDRII, UPDRSIII, FAB and PDQ39 (p < 0.05). Baseline UPDRS II and III significantly determined Δ6MWT (adjusted R2 = 0.6738) and ΔGAIT speed (R2 = 0.6746) at multiple regression, while ΔGAIT length showed the best regression (adjusted R2 = 0.8247) with impact of age, gender and baseline PDQ39 (ADL and cognition dimensions).

CONCLUSIONS: Multidisciplinary rehabilitation including OT can improve motor and non-motor conditions in PD patients. The OT time-collocation at beginning or end of the rehabilitation program does not significantly affect results.