Effects of group physical therapy on the walking speed in patients with Parkinson’s disease

Background. Parkinson’s disease is a progressive neurologic disorder characterized by motor impairments which alter the walking capacity, and lead to reduced walking speed, decreased stride length and increased double support time. Physical therapy interventions are an important part of the non-pharmacological treatment for Parkinson’s disease. Aims. The purpose of this study was to assess whether there is a different outcome regarding improvement of walking speed, when applying a physical therapy program in an individual or in a group manner. Methods. A prospective, observational, cohort type study on 60 patients with Parkinson’s disease was carried out between November 2014 July 2017, in the Clinical Rehabilitation Hospital in Cluj-Napoca, Cluj county, Romania. Patients were randomly divided into 2 groups, and were prescribed either individual (1 patient and 1 physical therapist) or group physical therapy (6 patients and 1 physical therapist). The treatment protocol included 10 sessions of physical therapy, in the same room setting, and patients performed the same routine of exercises, except for the 3 breaks during the sessions in the group therapy for informal socialization. Walking speed was measured by two validated instruments, the 6-minute walk test and the 10-meter walk test, before and after treatment. Results. There was an increase in both groups regarding gait speed after treatment (all p<0.05), except for the values obtained by the 6-minute walk test in the individual therapy group, which did not improve significantly. The 6-minute walk test scores after treatment showed significantly higher values of gait speed in the group therapy, compared to individual therapy (p=0.002). Conclusions. Patients with Parkinson’s disease could benefit more from a group physical therapy program, as gait speed increased significantly. The group approach facilitates interactions and is cost-effective, as it requires only one therapist and more patients.