title: Towards proactive active living: patients with Parkinson's disease experience of a multidisciplinary intensive rehabilitation treatment.
abstract: BACKGROUND
  Non-pharmacological approaches to PD disease management seem to be a growing and promising field of investigation. Indeed interesting new perspectives are forthcoming from studies on physical rehabilitation and on physical exercise.
  
  
  OBJECTIVE
  To qualitatively describe the rehabilitation experience of Parkinson Disease patients taking part in a multidisciplinary intensive rehabilitation treatment (MIRT) consisting of four weeks of physical therapy and exercise, with three daily sessions, five days a week.
  
  
  METHODS
  Data from a qualitative observational study with patients' interviews were analyzed.
  
  
  METHODS
  PD inpatients of a Neurorehabilitation Department.
  
  
  METHODS
  Convenient sample of 27 PD patients (13 male, 14 female), mean age 70.3±8.5 and mean disease duration 8.25±6.9 years; Hoehn-Yahr stage 3, hospitalized for the 4-week MIRT.
  
  
  METHODS
  Verbatim transcriptions of 27 semi-structured interviews were analysed using the Grounded Theory methodology.
  
  
  RESULTS
  Depressive symptoms were present in 55.5% of the patients measured by Geriatric Depression Scale: mild (N.=8; 30.0%), moderate (N.=6; 22.2%), severe (N.=1; 3.7%). The core category Efficacy of active living identified the becoming conscious of the usefulness of a proactive lifestyle to counterattack disease degeneration. The category Satisfaction described patients' satisfaction upon MIRT, resulting in a perceived enhanced functionality (coherently with quantitative functional parameters improvement at discharge) and a rediscovered autonomy. The category Future described the intention to continue the rehabilitation prescription at home embracing a more dynamic lifestyle. Of interest is that the majority in the interview used body related terms and described perceived changes through the body itself. Verbs of perception (to see, to feel, to perceive) were used in a spontaneous way by all inpatients. The inpatients experienced not only through their mind but also by means of body perceptions how a proactive lifestyle could become a means of disease control.
  
  
  CONCLUSIONS
  The positive subjective response to rehabilitation described qualitatively in this study, opens perspectives for tailoring interventions focusing also on patients' self, self-efficacy and perceived efficacy of active living.
  
  
  CONCLUSIONS
  Patients' proactive disposition may widen the perspective on patients' motivation to rehabilitation. A multidisciplinary intervention may act both on physical and subjective disease aspects; paying attention to patients' subjective feedbacks could contribute reliably to guide for medical decisions in managing tailored and detailed interventions.
authors.affiliation: Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy - anna.giardini@icsmaugeri.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Giardini
authors.affiliation: Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Pierobon
authors.affiliation: Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Callegari
authors.affiliation: Department of Neurorehabilitation, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Bertotti
authors.affiliation: Psychology Unit, Istituti Clinici e Scientifici Maugeri, IRCCS Montescano, Montescano, Pavia, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Maffoni
authors.affiliation: Moriggia-Pelascini Hospital, Gravedona ed Uniti, Como, Italy.|European Foundation for Biomedical Research, S. Isidoro Hospital, Trescore Balneario, Bergamo, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Ferrazzoli
authors.affiliation: Moriggia-Pelascini Hospital, Gravedona ed Uniti, Como, Italy.|European Foundation for Biomedical Research, S. Isidoro Hospital, Trescore Balneario, Bergamo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients; D007407:Interviews as Topic; D008297:Male; D000066530:Neurological Rehabilitation / Q000379:methods / Q000523:psychology* / Q000592:standards; D010300:Parkinson Disease / Q000523:psychology* / Q000534:rehabilitation*; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy