Predictors of mobility domain of health-related quality of life after rehabilitation in Parkinson's disease: a pilot study.
Thomas Bowman, Elisa Gervasoni, Riccardo Parelli and 4 others
PMID 30607261WHAT IT FOUND
After 20 rehab sessions, mobility-related PDQ-39 scores changed by -6.2 points.
The paper reports this as improvement. Baseline mobility score, disease stage and gender predicted post-rehabilitation change.
Key findings
01In the multivariate model, balance confidence and freezing of gait were significantly associated with baseline mobility-domain scores.
02After 20 sessions of individual balance and gait exercises, with or without biofeedback, in different sensory or dual-task conditions, plus stretching and mobilization, the average mobility-domain change score was -6.2 points, which the paper reports as improvement.
03Baseline mobility-domain score, Hoehn & Yahr stage and gender were significant predictors of mobility-domain change after rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a pilot with 42 recruited participants and 37 analysed post-rehabilitation, so the models are underpowered and the results cannot be generalized to all people with PD. The study used a pre-post design with no comparison group described, so the -6.2 point change cannot be separated from time, medication state, or other parts of the programme. The rehabilitation programme combined balance and gait exercises, biofeedback when used, sensory or dual-task conditions, stretching and mobilization, so the contribution of any single component cannot be separated. Assessments were completed only during the on medication state, so the relationship in the off medication state was not examined. Psychological and non-motor symptoms were not measured, although the paper notes they can affect quality of life. Twelve percent of the sample showed floor effects on the PDQ-39, which may bias the data analysis.
The easy way to misread this
Do not read the -6.2 point change as proof that the rehabilitation programme improved mobility quality of life. This was a pilot with a pre-post design and no comparison group described, five participants were missing post-assessment, and the programme combined balance and gait exercises, biofeedback when used, sensory or dual-task conditions, stretching and mobilization, so no single component can be credited.