Association Between a One-Year Group-Based Telerehabilitation Program and the Quality of Life of People with Parkinson's Disease: An Observational Study.

Abstract

This study aimed to (i) investigate changes in the quality of life among people with Parkinson's disease (PwPD) over a 1-year group-based telerehabilitation (TR) program and (ii) explore the TR program's perceived impacts from the perspectives of the PwPD and their caregivers. Observational, longitudinal study. Group-based TR program. PwPD who voluntarily enrolled in a 1-year group-based TR program. Group-based TR program that included physical, rhythmic, cognitive, and swallowing exercises plus education about disease management. The primary outcome was Parkinson's Disease Questionnaire-39 (PDQ-39) total score at baseline, 6 months, and 1 year. Secondary outcomes were PDQ-39 domain scores, responses by the PwPD and their caregivers to the self-reported questionnaire to evaluate perceived emotional, physical, and lifestyle effects, and Client Satisfaction Questionnaire-8 (CSQ-8). Forty-nine PwPD and 43 caregivers participated; 24 (49%) PwPD and 22 (51%) caregivers met the regular-participation criterion (≥80% of scheduled sessions). Baseline characteristics were similar between regular and non-regular participants. Mixed models for repeated measures adjusted for baseline PDQ-39, Hoehn & Yahr stage, and disease duration showed better adjusted PDQ-39 total scores in the regular group than in the non-regular group (group effect p=0.046). The emotional well-being domain showed a significant time effect (p=0.007), and better adjusted scores in the regular than in the non-regular group at 1 year. The social support domain also favored the regular group (p=0.017), and the communication domain showed a significant group × time interaction, indicating more favorable trajectories in the regular group. Both the PwPD and caregivers reported greater emotional benefits than physical benefits, and CSQ-8 scores indicated high satisfaction in both groups. Although causal relationships cannot be inferred, these findings suggest that higher and sustained participation in long-term, group-based TR is associated with maintenance of overall QoL and improvements in emotional well-being among PwPD.