title: An individual rehabilitation program: evaluation by Parkinsonian patients and their physiotherapists.
abstract: OBJECTIVE
  The purpose of this work was to study the feasibility of an individual Parkinson disease (PD) rehabilitation program based on each patient's prevalent symptoms and to determine the effects of this program on patient's quality of life as well as the level of patient's and physiotherapist's satisfaction with the program.
  
  
  METHODS
  In association with physiotherapists with expertise in PD, a physical medicine and rehabilitation physician, we elaborated a physical therapy program based on the core areas for physical therapy in PD: transfers; posture; balance and falls; physical capacity and inactivity. Within this program, we selected exercises tailored to each patient's main impairment and proposed this selection to their local physiotherapist for three months. Quality of life was evaluated with PDQ-39 at baseline and after three months of the individualized physical therapy program. We built an anonymous satisfaction questionnaire for patients and physiotherapists that was filled out at the end of the program.
  
  
  RESULTS
  One hundred and three individuals with moderately advanced but clinically stable idiopathic PD were included. Significant improvement was found for the emotional well-being, bodily discomfort and stigma domain (P ≤ 0.05). No significant improvement was found for the other PDQ-39 domains. The mean global satisfaction figures for this program were 6.0 ± 2.4 and 7.2 ± 2.1 for patients and physiotherapists respectively. Most of the patients felt improved by the physiotherapy program and especially for transfer, balance, gait, and mobility.
  
  
  CONCLUSIONS
  Our study found evidence of the potential benefits of a patient-tailored physiotherapy program. Such a program was feasible and had a favorable impact on patients' quality of life and on physiotherapists' practices for PD patients. Specific physiotherapy may be effective to limit physical mobility impairment. Our results also pointed out that physiotherapy may be efficient to confine the negative impact of social isolation, pain and emotional reactions. Such a program should be associated with a therapeutic education intervention such as encouraging patients to perform physical therapy exercises alone.
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France. Electronic address: ory.f@chu-toulouse.fr.
authors.forename: F
authors.initials: F
authors.lastname: Ory Magne
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Fabre
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Pastorelli
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Tardez
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Marchat
authors.affiliation: Department of medicine and physical rehabilitation, Toulouse university hospital, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Marque
authors.affiliation: Department of neurology A, Toulouse university hospital, CHU Purpan, place du Dr Baylac, 31059 Toulouse cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Brefel Courbon
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000523:psychology / Q000534:rehabilitation*; D017060:Patient Satisfaction; D059825:Physical Therapists; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011187:Posture; D057285:Precision Medicine; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Kinésithérapie; Maladie de Parkinson; Parkinson's disease; Physiotherapy; Quality of life; Qualité de vie