This study aimed at evaluating and describing the QoL and its association with the severity of disease among Brazilian Parkinson's disease (PD) patients. In this cross-sectional study 68 PD patients were interviewed using the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF) and the Hoehn-Yahr (HY) scale. Analysis of variance, chi(2), Kruskal-Wallis and Mann-Whitney U-tests, Spearman and Cronbach reliability coefficients were used to analyze the data. The results indicate: (1) physical capacity was the domain that showed the most deterioration; (2) severity of PD is associated with QoL measured by WHOQOL-BREF; (3) overall QoL, working capacity, activities of daily living (ADL) and self-esteem are affected in both transitional periods in the progression of PD (mild to moderate and moderate to advanced). Satisfaction with general health, pain, energy, positive feelings, personal relationship and satisfaction with home are affected in the first period of transition while mobility, body image, sexual activity and access to information are affected in the second. This study mainly shows specific facets that are affected depending on the specific periods of PD progression, which can help to understand the impact of the disease, the effectiveness of care, and the demand for health care resources.
"Higher QoL in the physical domain was accompanied by higher QoL in the environmental and psychological spheres. The significance of the physical domain for the overall QoL assessment was also confirmed by Hirayama et al., (2008) and Gunaydin et al. (2011). They found that overall QoL level can be raised through improving of this domain. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to analyze correlations between quality of life (QoL), acceptance of illness (AI), and health behaviors (HB) demonstrated by chronically ill patients of advanced age. The study was comprised of 1974 chronically ill primary care patients (mean age 71.60 ± 7.98 years) recruited from 131 primary care practices. QoL was assessed with the World Health Organization Quality of Life Instrument Short Form. The patients’ AI with the Acceptance of Illness Scale (AIS) and the Health Behavior Inventory (HBI) measured four categories of HB: healthy eating habits (HEH), preventive behaviors (PB), positive mental attitudes (PMA) and health practices (HP). The Spearman rank correlation test was used to check correlations between the variables and analysis of multiple regression was used in order to examine the impact of explanatory variables on the response variable. The highest scores were obtained in the Social Relationship Domain of QoL (M = 13.68 ± 2.75) and the lowest in the Psychological Domain of QoL (M = 12.38 ± 2.66) of the patients. The low AI was noted in 65.68% (1221). Lower level of QoL and AI were observed in patients with a larger number of chronic diseases and higher health care utilization. The lowest HB scores were obtained in the category of PMA (M = 3.61 ± 0.73) and HEH (M = 3.36 ± 0.84). The AI level correlated strongest with: Physical Domain of QoL (rS = 0.49, p < 0.0001) and PMA (rS = 0.23, p < 0.0001). HB correlated strongest with Psychological Domain of QoL (rS = 0.33, p < 0.0001). Health behavior programs for chronically ill patients of advanced age should stimulate health behavior categories such as PMA and HEH, and raise the AI level. This would result in a higher QoL and, consequently, a lower health care utilization.
Archives of Gerontology and Geriatrics 01/2013; 56(3). DOI:10.1016/j.archger.2012.12.010 · 1.85 Impact Factor
"Associated with drug therapy, non-pharmacologic therapies related to PD, such as physical exercises and nutrition, helped to attenuate the disease's severity or reduce its progression (Hirayama et al., 2008; Morris et al., 2009). The regular practice of physical exercise is effective to provide improvements in quality of life of this group of patients (White et al., 2006; Hirayama et al., 2008). Forced aerobic exercise affected both the scores in motor sub-section of the UPDRS and the performance in manual skills (Ridgel et al., 2009) while the sensory focused exercise program improved functional mobility and the motor symptoms (Sage & Almeida, 2010) in people with PD. "
"While cadence typically is not modified, in some cases, as a possible adaptation to amplitude regulation disorder, it appears to increase . These gait features progressively worsen with the advance of the disease, which severely limits patients' mobility and quality of life  . "
[Show abstract][Hide abstract] ABSTRACT: This pilot study aimed to identify the effects of a 6-month, multimodal exercise program on clinical and gait parameters in patients with Parkinson's disease. Two groups of participants were enrolled in the study: Trained Group (TG) and Control Group (CG). Individuals in the TG exercised three times a week for 24 weeks (in a multimodal exercise program), while the CG participants maintained their regular activity level. Participants in both the TG and the CG were assessed at pre- and posttest by clinical rates and the spatiotemporal parameters of self-paced walking. The two groups were not significantly different in demographic, clinical, and gait data at baseline. There were no significant differences between groups for clinical data at posttest. The purposed multimodal exercise program has found improvement in some kinematic gait parameters for the TG. Further study in the form of randomized controlled trial would be required to establish effectiveness of the intervention.
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