Objective: This study is a prospective pilot study to investigate the effectiveness of OT ‘CASH’ group therapy on intermediate and advanced PD patients in managing motor and non-motor symptoms and carer stress.

Background: Motor symptoms of PD limit patient’s function, non-motor symptoms impair social functioning and increase carer stress at later stage. Managing carer stress, treating motor and non-motor symptoms are therefore indispensable for a holistic PD treatment. Many studies have defended group intervention’s effectiveness over individual treatment since it enhances mutual support. Therefore, an 8-session OT CASH program was established to cater for the needs of PD patients on a weekly basis. CASH is a program of closed groups for both patients and carers. Each session lasts for 75 minutes. It includes PD information, fall prevention and relaxation education; weighted body-integration exercise; art and craft and three dance movement sessions with a graduation ceremony.

Methods: A prospective pilot study with pre-test/post-test Quasi-experimental design of convenient sampling was conducted in Prince of Wales Hospital from July 2015 to December 2016. 10 PD patients were allocated to receive CFT before CASH; both groups lasted for 8-10 weeks. Assessments were conducted before and after any therapy by Unified Parkinson’s Disease Rating Scale (UPDRS), Modified Barthel Index (MBI), Montreal Cognitive Assessment (MoCA), Parkinson’s Disease Questionnaire (PDQ-8 and PDQ-39), Beck’s Anxiety Inventory (BAI), Geriatric Depression Scale (GDS) and Relative Stress Scale (RSS).

Results: CFT achieved major improvement in PDQ-8 cognitive subtest (p=0.015) and PDQ-39 cognitive subtest (p=0.08) when compared to CASH. There was minimal clinical improvement in UPDRS, MBI and MoCA in CFT when compared to baseline. For CASH, there was significant improvement in PDQ-39 bodily discomfort subtest (p=0.039) when compared to baseline. Clinically, CASH performs better in BAI, RSS negative feeling subtest and RSS total score by 11.96%, 35.14% and 11.78% respectively when compared to baseline. Comparing CASH to CFT, CASH improved by 18.07% and 37.45% in GDS and BAI respectively.

Conclusions: CFT is more effective in maintaining functional performance and enhancing better self-perceived cognitive performance; CASH is more effective in improving non-motor symptoms and carer stress. CFT together with CASH would provide a holistic and effective treatment for PD patients and carers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comparison-of-treatment-effectiveness-of-conventional-functional-training-cft-to-occupational-therapy-ot-multi-modal-cash-program-cash-in-improving-non-motor-symptoms-and-carer-stress-of-parkins/