Authors (including presenting author) :
Lai AYL, Ma WWY, Wong JCS, Chan EMF, Kwong SSF
Affiliation :
Physiotherapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Parkinson’s disease (PD) is a progressive disorder presented with a spectrum of motor and non-motor symptoms. Review of previous physiotherapy intervention of PD in our outpatient setting was varied. A study published by The Hong Kong Polytechnic University in 2021, on brisk walking and balance training program, has proved its effectiveness in alleviating motor symptoms, enhancing functional performance, walking capacity, and dynamic balance in Parkinson's Disease (PD) patients. The program is modified for local application in outpatient physiotherapy setting in September 2022 to enhance service to PD patients.
Objectives :
1. To stratify PD patients fulfilling the criteria to evidence-based service
2. To assess the effectiveness of the Brisk Walking and Balance Program
3. To enhance a structured approach in self-management for PD patients and carers
Methodology :
PD patients were assessed with the inclusion criteria of Modified Hoehn and Yahr stage 1-4, without recent anti-PD drug adjustment, and able to walk unaided for 30m. The 10-session 6-month program includes assessment and re-evaluation in 1st and 10th sessions, weekly core training from 2nd to 7th sessions, then bimonthly revision in 8th and 9th sessions.
The core training sessions included: stretching exercises, brisk walking, balance exercises, strengthening exercises, gait correction, and exercise intensity monitoring using heart rate tracking watch or RPE (Rate of perceived exertion). The importance of medium exercise intensity and regular home exercise was emphasized. Video and handbook were produced to enhance engagement. After completion, patients were given information of community PD patient walking group for further practice.
Result & Outcome :
From September 2022 to November 2024, 26 participants completed the training. The Movement Disorder Society Unified Parkinson’s Disease Rating Scale Motor median score (MDS-UPDRS) decreased from 19 pre-program to 18.5 at follow-up (z=-2.079; p=0.038). A lesser score indicates positive changes in this well-recognized motor score. The other clinical outcomes showed an improving trend but not significant. The Mini-Balance Evaluation Systems Test median score changed from 21 to 22; Timed up and go test remained unchanged at 11sec; Timed up and go test with Dual Task changed from 13sec to 14sec despite PD being a progressive disorder.
