ABSTRACT
BACKGROUND: Spinal deformity is the oldest disease known to humankind. Many types of treatment methods, including both conservative and surgical, are in use. OBJECTIVE: We aimed to validate a published guideline protocol based on the conservative treatment of spinal deformities. METHOD: A modified Delphi technique was used with a questionnaire sent out to professionals worldwide regarding the conservative treatment of spinal deformities. RESULTS: Our study was completed after two rounds. A strong level of agreement of 80% and more (consensus cut-off point) was achieved in most questions in the first round. Some statements were below this margin, and they were sent to the participants via email in the second round for re-evaluation. Consensus was achieved in almost all of the statements in the second round. Only two items did not reach the cut-off point but were close to this value. CONCLUSION: This proposed Guideline Protocol was approved by the participants using the Delphi method and can be used as a valid tool for the conservative treatment of spinal deformities. CLINICAL IMPLICATIONS: A conservative treatment guideline in spinal deformity management, will provide consistency in treatment and will facilitate comparability with surgery. It will be useful in determining the cost-effectiveness of treatment and in choosing the right patient for the right method of treatment. This guideline might help in this context, and may also create a systematic method for clinicians to use as a reference in both research and clinical practice.
ABSTRACT
OBJECTIVES: To compare the effects of a physiotherapist-supervised exercise programme in an exercise unit and self-supervised home exercise programme on quality of life in patients with Parkinson's disease. DESIGN: Assessor-blinded, quasi-randomized trial (alternate allocation). SETTING: An outpatient exercise unit; home settings. PARTICIPANTS: Thirty patients with idiopathic Parkinson's disease, Hoehn & Yahr I-III, stable medication use. INTERVENTIONS: Patients were included in the physiotherapist-supervised or home group. The exercise programme was performed for 10 weeks, three times/week either under the supervision of a physiotherapist or at home without supervision. MAIN OUTCOME MEASURES: Parkinson's Disease Quality of Life Questionnaire (PDQLQ), Nottingham Health Profile (NHP), Unified Parkinson's Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI). RESULTS: Patients in the supervised physiotherapy group improved more than the home exercise group in Parkinson's Disease Quality of Life Questionnaire (total score, Parkinson's symptoms, emotional function), Nottingham Health Profile total, Unified Parkinson's Disease Rating Scale (all domains) and Beck Depression Inventory scores. CONCLUSIONS: The exercise programme under physiotherapist supervision was found to be more effective at improving activities of daily living, motor, mental, emotional functions and general health quality in patients with Parkinson's disease compared with a self-supervised home programme.
