Maladie de Parkinson: description d'un programme interdisciplinaire de rééducation fonctionnelle en groupe

Neurorehabilitation for Parkinson's disease, in the form of physical and occupational therapy, has long been advocated but also seriously questioned with respect to its specific content, its mechanisms, its efficacy and its costs. Many factors may be put forward to explain the lack of consensus surrounding these interventions, including the multiplicity of different programs proposed, the scarcity of controlled studies available and the inadequacy of some assessment methods used. In this article, we describe a new neurorehabilitation program for Parkinson's disease which is characterized by some original features. In particular, the specific functional patients' needs were taken into account instead of the symptoms related to the condition, therapeutic interventions favoured a multidisciplinary approach, patients trained in groups rather than individually, the program combined different methods and was continuously evolving over time, and finally we used simple but goal-oriented measurement methods to assess efficacy. The study included 22 patients. Statistically significant positive results were obtained by the end of the program, suggesting that the program in its current form was indeed capable to generate a functional benefit of sufficient magnitude to be objectively detected by the assessment methods used. In our opinion, our data emphasizes the usefulness of specific neurorehabilitation programs in the global management of Parkinson's disease.