Investigators/Authors: Darweesh Sirwan, Radboud University Medical Centre
Objective: To explore three specific gaps in our knowledge of allied therapy in order to understand the most effective usage for people with Parkinson’s.
Background: The social and economic burden caused by Parkinson’s disease (PD) is expected to rise substantially in the coming decades, emphasizing the need to widely implement treatment modalities that have been proven to be effective for persons with PD. Recently, community-based Allied Health Therapy (physiotherapy, occupational therapy, and speech-language therapy) delivered by specifically trained professionals has yielded beneficial effects on short-term functional outcomes in persons with PD.
Methods/Design: There are three key gaps in our present knowledge of allied therapy which hamper optimal and wider implementation of specialized Allied Health Therapy (AHT). This study will explore: 1) which patient subgroups are most likely to respond favorably to specialized AHT interventions; 2) whether parallel delivery of specialized therapy across multiple disciplines has additional benefits for patients; and 3) whether specialized Allied Health Therapy remains effective over longer periods (more than 5 years).
Relevance to Diagnosis/Treatment of Parkinson’s disease: This project will address these critical gaps in knowledge of Allied therapy, thereby paving the way for personalized rehabilitation for those persons with PD who need it most.
October 2021 Project Update:
It is vital that treatments proven to be effective for persons with PD are implemented. Specialized allied health therapy (AHT) yields good effects for persons with PD. This study looks at how specialized AHT can best be implemented for persons with PD.
In Year 1, we designed the source study. Further, we identified subgroups of persons with PD in which specialized allied health services substantially improve quality of life. Subgroups are defined by age, gender, socioeconomic status, disease-specific characteristics, and coping strategy. Enrollment in the questionnaire-based study took place between March 1, 2020, and December 31, 2020. Because the study enrolment period coincided with the eruption of the COVID-19 crisis, several recruitment activities could not be conducted as planned. Despite this, 988 people with parkinsonism enrolled, including 940 (95%) with PD. Of these participants, 753 (76%) are currently receiving physiotherapy, including 300 participants who are treated by a specialized therapist and 453 who are treated by a generic therapist. Furthermore, 247 (25%) participants are currently receiving speech-language therapy, including 92 by a specialized and 155 by a generic therapist. Also, 221 (22%) participants are currently receiving occupational therapy, including 92 by a specialized and 129 by a generic therapist. Currently, analyses are ongoing to assess differences in quality of life between subgroups of people with PD. Additionally, analyses are ongoing to assess characteristics of people with PD receiving parallel AHT therapy across multiple disciplines. The goal of the last part of our project is to determine the long-term effectiveness of specialized AHT on the reduction of complications in persons with PD. Of note, the data show that specialized AHT becomes more common in persons with PD over time. This will boost the next steps of this project. In total, this study could pave the way for tailored specialized AHT.