Rehabilitation Utilization for Parkinson's Disease in Southern Ghana: A Descriptive Cross-Sectional Survey.

Abstract

Background: There is limited literature describing rehabilitation utilization among the Parkinson's disease (PD) population across the world and especially in Africa, despite ample evidence and clinical guidelines in support of rehabilitation for persons with PD (PwPD).

Objectives: To describe the characteristics of PwPD, the types of rehabilitation services and treatment parameters used, and the factors associated with rehabilitation utilization in southern Ghana.

Methods: A descriptive cross-sectional survey was conducted among PwPD receiving care at one primary and two tertiary hospitals selected from southern Ghana. The MDS-UPDRS Part III, PDQ-8, and modified ICF Checklist Clinician Form were used to assess motor function, health-related quality of life, and rehabilitation use. Descriptive and inferential statistics were conducted with significance set at p < 0.05.

Results: Seventy-five PwPD were included, with 61.3% being males. Engagement in physiotherapy and/or gymnasium activities was reported by 40.0% of participants. The most common indication for physiotherapy was gait difficulties. No participant had used occupational therapy or speech therapy. Nonreferral by neurologists and participants' poor knowledge of rehabilitation benefits and needs were the main reasons for nonuse of rehabilitation. Gait retraining and strengthening exercises were the most common physiotherapy interventions received by 73.7% of the participants. Longer PD duration was associated with physiotherapy utilization. A total of 42.4% of participants discontinued physiotherapy services, primarily due to transportation challenges and high treatment cost.

Conclusion: Rehabilitation services are underutilized by PwPD in southern Ghana due to limited referrals, poor awareness of benefits, and related barriers. This highlights the need for more accessible and integrated services.