Objective: To ascertain whether or not an inpatient multidisciplinary treatment programme for patients with Parkinson's disease or multiple sclerosis resulted in a measurable change in patients' health-related quality of life (HRQL).
Design: Assessments of HRQL were made one week before admission and approximately one month post discharge.
Setting: Six-bed Neurological Rehabilitation Unit at Worthing Hospital on the south coast of England.
Subjects: Fifty-eight patients with Parkinson's disease and 33 patients with multiple sclerosis.
Interventions: All patients received an individually adapted, multidisciplinary rehabilitation programme. The programmes lasted from 5 to 10 days.
Main outcome measures: HRQL scores on the Nottingham Health Profile Part 1 (NHP-1).
Results: Overall post-treatment NHP-1 scores were significantly better than overall pretreatment scores for both the Parkinson's group (z = 2.6, p <0.01) and the multiple sclerosis group (z = 2.1, p <0.05). Sixty-four per cent of patients perceived an overall improvement. The strongest improvement was in ‘physical mobility’ in the multiple sclerosis group (z = 3.0, p <0.01) and in ‘emotional reactions' in the Parkinson's group (z = 2.9, p <0.01).
Conclusions: These results suggest that the multidisciplinary inpatient approach in neurological rehabilitation has identifiable short-term benefits for the majority of patients. A randomized trial with longer follow-up is required to confirm this.
Get full access to this article
View all access options for this article.
References
1.
Sutcliffe R, Prior R, Mawby B, McQuillan W. Parkinson's disease in the district of Northampton Health Authority, United Kingdom. A study of prevalence and disability. Acta Neurol Scand1985; 72: 363–679.
2.
Clarke CE, Zobkiw RM, Gulliksen E. Quality of life and care in Parkinson's disease. Br J Clin Pract1995; 49: 288–293.
3.
Mutch WJ, Dingwall-Fordyce I, Downie AW, Paterson JG, Roy JK. Parkinson's disease in a Scottish city. BMJ1986; 292: 534–536.
4.
Gibberd FB, Page NG, Spencer KM, Kinnear E, Hawksworth JB. Controlled trial of physiotherapy and occupational therapy for Parkinson's disease. BMJ1981; 282: 1196-1196.
5.
Sasco AJ, Paffenbarger RS, Gendre I, Wing AL. The role of physical exercise in the occurrence of Parkinson's disease. Arch Neurol1992; 49: 360–365.
6.
Manyam BV. In: Good DC, Couch JR eds. Handbook of neurorehabilitation. New York: Marcel Dekker, 1994: 594-594.
7.
Rice-Oxley M, Williams ES, Rees JE. A prevalence survey of multiple sclerosis in Sussex. J Neurol Neurosurg Psychiatry1995; 58: 27–30.
8.
Reding MJ, La Rocca N, Madonna M. Acute hospital care versus rehabilitation hospitalisation for the management of nonemergent complications in multiple sclerosis. J Neurol Rehabil1987; 1: 13–17.
9.
Kidd D, Howard RS, Losseff NA, Thompson AJ. The benefit of inpatient rehabilitation for multiple sclerosis. Clin Rehabil1995; 9: 198–203.
10.
Freeman JA, Langdon DW, Hobart JC, Thompson AJ. The impact of inpatient rehabilitation on progressive multiple sclerosis. Ann Neurol1997; 42: 236–244.
11.
Jenkinson C, Wright L, Coulter A. Quality of life measurement in health care. A review of measures, and population norms for the SF-36. Oxford: Oxford University Health Services Research Unit, 1993.
12.
Alonso J, Bucquet D, Hunt S, McKenna S, Niero M, Wilund I. European guide to the Nottingham Health Profile. Montpellier: European Group for Quality of Life and Health Measurement, 1989.
13.
McMillen Moinpour C, McCorkle R, Saunders J. Measuring functional status. In: Frank-Stromborg M ed. Instruments for clinical nursing research. Boston: Jones & Bartlett, 1992: 23–46.
14.
Barnes MP, Bates D, Cartlidge NEF, French JM, Shaw DA. Hyperbaric oxygen and multiple sclerosis: final results of a placebo-controlled double blind trial. J Neurol Neurosurg Psychiatry1987; 50: 1402–1406.
15.
Monks J. Interpretation of subjective measures in a clinical trial of hyperbaric oxygen therapy for multiple sclerosis. J Psychosom Res1988; 32: 365–372.
16.
Jenkinson C, Peto V, Fitzpatrick R, Greenhall R, Hyman N. Self-reported functioning and well-being in patients with Parkinson's disease: comparison of the Short-Form Health Survey (SF-36) and the Parkinson's disease Questionnaire (PD-36). Age Ageing1995; 24: 505–509.
17.
de Boer A, Wijker W, Speelman JD, de Haes JCJM. Quality of life in patients with Parkinson's disease: development of a questionnaire. J Neurol Neurosurg Psychiatry1996; 61: 70–74.
18.
Cella DF, Dineen K, Arnason B et al. Validation of the Functional Assessment of Multiple Sclerosis quality of life instrument. Neurology1996; 47: 129–139.
19.
Ford HL, Tennant A, Johnson MH. The Leeds MSQOL scale: a disease specific measure of quality of life in multiple sclerosis. J Neurol Neurosurg Psychiatry1997; 62: 210-210.
20.
Freeman J, Langdon DW, Hobart JC, Thompson A. The long term effects of neurorehabilitation in multiple sclerosis: a longitudinal study. J Neurol1997; 244 (suppl 3): S10-S10.
