Outcomes of rehabilitation following device-aided therapy start in parkinson’s disease: a randomized controlled trial

OBJECTIVE: To determine whether adding tailored primary care rehabilitation to Device-Aided Therapy in Parkinson's disease improves outcomes more than Device-Aided Therapy alone. DESIGN: Open randomized controlled intervention trial. SUBJECTS/PATIENTS: Parkinson's patients initiating Device-Aided Therapy. METHODS: Participants were randomized to receive standard care either with or without 3 months of tailored primary care rehabilitation. The primary outcome was Assessment of Motor and Process Skills, while secondary outcomes included cognitive measures and overall treatment efficacy. RESULTS: The study was completed by 45 of 54 included patients. The primary outcome variable indicated that rehabilitation resulted in better maintenance of patient motor skills at 6 and 12 months. However, among several secondary measures, only perceived health improved more in the intervention group. Motor fluctuations improved in both groups and several other disease-specific scales demonstrated non-significant improvements. The rehabilitation group showed better cognitive performance at 12 months. CONCLUSION: Motor skills and perceived health were improved by a 3-month rehabilitation period after the start of Device-Aided Therapy for advanced Parkinson's disease. An observed positive effect of rehabilitation on cognition in the first year after the therapy requires further confirmation.