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Occupational Therapy Can Benefit People with Parkinsonís Disease
- May 16 2014
Occupational therapy may be able to help people with Parkinson’s disease (PD) more effectively perform everyday activities such as self-care and household chores, according to the first large-scale randomized controlled trial to assess the efficacy of occupational therapy (OT) in PD. The study appears in the April 9 online edition of The Lancet Neurology.
Occupational therapy is designed to help people to effectively perform activities in daily life such as self-care, leisure, household chores and work. Yet, few studies have looked at the effectiveness of occupational therapy for people with Parkinson’s disease.
Researchers led by Professor Bastiaan R. Bloem, M.D., studied the use of occupational therapy at ten Dutch hospitals offering specialized PD care. They recruited 191 participants who were living at home and reported difficulties with daily activities. The participants all had PD for an average of six years and averaged 70 years of age. As is typical of PD, about two-thirds were men and the rest were women. Most of the participants (88 percent) had partners who were their primary care partners.
Participants were randomized into two groups. The intervention group (124 participants) received 16 home-based OT sessions over a 10-week period and a control group (67 participants) received their usual care but no OT. All participants were assessed prior to the trial and at three months and six months following the start of the trial using the Canadian Occupational Performance Measure (COPM), which assesses people’s perceptions of their performance and their overall satisfaction with the therapy. Researchers also measured quality of life and perceived burden of care of the primary care partners in both groups.
- Participants who received 10 weeks of OT reported significantly greater improvement in performance of activities of daily living than participants who did not receive OT, including in daily hygiene, independent dressing or climbing stairs.
- More than half of the participants who received OT experienced improvement following the treatment period versus only 17 percent in the control group.
- The reported improvements were greatest just after completion of the OT sessions and decreased three months following treatment.
- Care partners of people with PD in the intervention group reported improved quality of life but little difference in their burden of care following treatment.
What Does It Mean?
Rehabilitation – physical, occupational and speech therapy – plays an important role in the care of people with Parkinson’s disease. While there is already considerable evidence of the efficacy of physical therapy in reducing disability and improving quality of life for people with PD, few studies had previously looked rigorously at occupational therapy and PD.
The study is notable because it is the first large-scale randomized controlled trial to assess the efficacy of OT in the treatment of people with PD.
The study found clear evidence that OT can improve quality of life for people with PD and can improve people’s ability to perform daily activities. The improvements were greatest just after the completion of the OT sessions, which suggests that maintenance therapy might be needed for more lasting improvement.
Currently, most people with PD referred for OT are those with more advanced disease. And fewer people with PD (according to studies conducted in the UK and the Netherlands) are referred to occupational therapists for care than are referred to PT. This study demonstrated that people with PD with mild disease who are beginning to experience difficulties at home can also benefit from OT.
More research is needed to establish specifics about what type of OT program might work best for people with Parkinson’s disease, including therapy guidelines, duration and the long-term effects. Increased evidence may lead to greater use of OT to help people with PD engage in daily activities at all stages of the disease.
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Reference: Sturkenboom IHWM, Graff MJL, Hendriks JCM, Veenhuizen Y, Munneke M, Bloem BR, Nijhuis-van der Sanden MW (2014) Efficacy of occupational therapy for patients with Parkinson’s disease: a randomised controlled trial Lancet Neurol DOI: 10.1016/S1474-4422(14)70055-9 http://dx.doi.org/10.1016/S1474-4422(14)70055-9
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Source Date: May 16 2014