Feasibility and Impact of a Function Focused Care Intervention for Parkinson's Disease in the Community

Abstract

Parkinson's disease (PD) results in a progressive loss of function such that family caregivers provide a large percentage of the personal care to PD patients living in the home setting. The aim of this study was to test the feasibility and impact of function-focused care for PD (FFC-PD) developed to optimize function and physical activity among people with PD who live in the community. This pilot study was a single-group, 2 pretest, 3 posttest repeated-measures design to investigate the impact of the FFC-PD intervention over a 12-month period. Measurements included the Self-Efficacy and Outcome Expectations for Exercise and Functional Activities, Yale Physical Activity Scale, Unified Parkinson's Disease Rating Scale, Barthel Index, Schwab & England, Timed Chair Rise, Parkinson's Disease Questionnaire-39, and Geriatric Depression Scale. The impact of FFC-PD on a person with PD showed a statistically significant increase in outcome expectations for exercise, F(3, 60) = 3.09, p = .034; hours a week exercising, F(1, 24) = 4.95, p = .004; mean weekly energy expenditure, F(2,43) = 4.32, p = .017; hours spent in overall activities, F(3, 60) = 6.06, p = .001; decreased disability based on the Unified Parkinson's Disease Rating Scale, F(2, 40) = 9.48, p < .001; improved Parkinson's Disease Questionnaire-39 score, F(3, 60) = 3.81, p = .014; and a trend toward significance on Barthel Index, F(1.6, 31) = 3.47, p = .055. Function-focused care for PD has a significant effect on increasing and on strengthening outcome expectations related to exercise, time spent in exercise, and physical activity and in improving functional performance in people with PD. Further research is needed to explore the use of objective measurements of functional performance and activity and to test FFC-PD in a randomized controlled trial.