Review Article: Rehabilitation Programs in the Management of Patients with Parkinson's Disease

Although exercise and physical therapy are commonly recommended to patients with Parkinson's disease (PD), their utility has seldom been objectively validated. In order to determine parameters that might be used in a prospective study of rehabilitation therapy in PD, we reviewed the in-hospital courses of forty-five PD patients admitted to our inpatient PD rehabilitation service between 1987and 1989. The mean length of stay was about one month. Patients' functional performances were evaluated according to a standard protocol at admission, periodically during their stay, and again prior to discharge by both physical and occupational therapists and by the nursing staff. Despite the fact that the average daily dose of anti-Parkinsonian medication did not change over the course of the stay, improvements were noted in patients' abilities to ambulate and to transfer, as well as in dressing and personal hygiene. Timed tests proved less sensitive measures than did estimations or the amounts of assistance patients...