Short-term effectiveness of intensive multidisciplinary rehabilitation for people with Parkinson's disease and their carers

Objective: To evaluate the short-term effectiveness of an intensive multidisciplinary rehabilitation programme for people with Parkinson's disease and their carers. Design: Observational, with assessments before and after intervention. Setting: An elderly care day unit in a district general hospital in south-east England. Subjects: One hundred and eighteen people with Parkinson's disease and no cognitive impairment, and their carers. Intervention: Participants attended the day hospital in groups of six patients with their carers for one day per week over six consecutive weeks. After assessment, they received individual treatment from a specialist team. Weekly group activities included relaxation and talks from experts. Outcome measures: Patients and carers were assessed for: health-related quality of life, psychological well-being, social services need, perceptions of the programme. Patients were additionally assessed for mobility, gait and speech. Carers were assessed for strain. Results: After treatment significant improvements were recorded in patients' mobility and gait (p < 0.05), speech (p < 0.001), depression (p = 0.029), health-related quality of life (p = 0.001). People with more advanced disease at baseline gained significantly more from treatment (p £ 0.04). Carers were less depressed and had higher health-related quality of life than patients at baseline (p < 0.001) and no improvements in these indicators were recorded after treatment. A high unmet need for social services was identified in 31% of participants, and 10% of carers were found in danger of being unable to continue caring. Participants reported knowledge gains and high levels of satisfaction with both individual therapies and group activities. Conclusions: This intensive co-ordinated programme provided immediate benefits to people with Parkinson's disease and their carers.