Effects of an intensive rehabilitation program on motor symptoms and quality of life in intermediate stages of Parkinson's disease

Title : Effects of an intensive rehabilitation program on motor symptoms and quality of life in intermediate stages of Parkinson's disease

Abstract:

Introduction: In the intermediate stages of Parkinson's disease (Hoehn & Yahr II–III), patients experience progressive functional decline that affects their quality of life. Intensive rehabilitation may lead to lasting improvement in motor symptoms and quality of life. This study aims to evaluate the effects of an intensive rehabilitation program on motor impairment (MDS-UPDRS III) and quality of life (PDQ-8) in the short term (T1) and medium term (T2).

Methods: A series of 53 patients with Parkinson's disease (stages II–III) completed a 4-week intensive rehabilitation program. Assessments, using the MDS-UPDRS and the PDQ-8 questionnaire, were performed at T0 (before rehabilitation), T1 (after the intensive program), and T2 (six months after a self-rehabilitation phase). Statistical analysis was based on repeated-measures ANOVA.

Results: Motor scores (MDS-UPDRS III) improved significantly after rehabilitation (Z = −6.201; p < 0.001), with partial persistence of the effect at follow-up (T2). Notable improvements were found in the sub-items for posture, gait, freezing, and postural stability.

Estimated means decreased from 14.42 ± 0.96 at T0 to 10.08 ± 0.92 at T1, with a moderate rebound to 11.14 ± 0.96 at T2.

Regarding quality of life, analysis of PDQ-8 scores showed a significant effect of time (p < 0.001), reflecting a rapid benefit after rehabilitation, followed by a slight loss at follow-up.

Conclusion: The intensive rehabilitation program leads to a clinically significant improvement in motor function and quality of life in patients with intermediate-stage Parkinson's disease. Despite a slight decline in the medium term, the benefits remain above baseline, underlining the value of prolonged follow-up and booster rehabilitation strategies to maintain gains.

Keywords: Parkinson's disease, intermediate stages, intensive rehabilitation, quality of life, PDQ-8, MDS-UPDRS III.

Biography:

Dr. Labiba Fadel is an Associate Professor of Physical and Rehabilitation Medicine at the Central Army Hospital in Algiers, Algeria. She specializes in neurorehabilitation and movement disorders. She completed her doctoral thesis on the assessment of motor disorders in intermediate-stage Parkinson’s disease. Also  her clinical and research interests include stroke rehabilitation, musculoskeletal disorders, spasticity management, and functional rehabilitation. She is actively involved in medical education and clinical research in Physical and Rehabilitation Medicine.