Group rehabilitation for everyday activities

Intervention: Intervention 1: Intervention Group (1): The treatment is designed based on the group rehabilitation approach and the framework of the Model of Human Occupation (MOHO). MOHO emphasizes the interaction of three core systems of the individual—volition, habituation, and performance capacity—within the environment, aiming to enhance the cognitive, motivational, and motor abilities of the participants. This treatment is delivered as structured and regular group therapy sessions which, in addition to improving individual skills, strengthen social support, increase positive group interactions, and enhance participants' motivation for active engagement in the therapeutic process. The therapeutic methods implemented in the sessions include cognitive exercises such as problem-solving, decision-making, and enhancing attention and focus, using cognitive training tools like memory cards, logical puzzles, and brain games. Motivational exercises incorporate intrinsic motivation enhancement techniques based on the MOHO model, including identifying individual goals and strengthening volition and enthusiasm for activity engagement. Motor and skill exercises involve hand-eye coordination, balance training, and practicing motor skills with the use of therapy balls, simple balance devices such as balance boards and soft cushions, and mild motor aids like hoops and soft ropes. The group therapy also includes group sports programs executed as coordinated collective activities; these sports involve balance exercises, mild strength activities, coordinated hand-eye movements, and simple team activities designed for levels 1 to 3 of Hoehn and Yahr, representing various ability levels from basic to intermediate. Group sports, tailored to participants’ interests and motor capabilities, help promote Primary outcome: Emotional status. Timepoint: Before the start of the intervention, 4 weeks after the intervention, 4 weeks after the completion of the intervention. Method of measurement: The emotional status is assessed using the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory (BDI).;Cognitive function. Timepoint: Before the start of the intervention, 4 weeks after the intervention, 4 weeks after the completion of the intervention. Method of measurement: Cognitive function is evaluated with the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE).;Motor function. Timepoint: Before the start of the intervention, 4 weeks after the intervention, 4 weeks after the completion of the intervention. Method of measurement: Motor planning and performance are measured by Part III of the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS Part III) and the Purdue Pegboard Test. Additionally, a motion analysis system may be used for more precise quantitative assessment of motor function. Secondary outcome: Participation in activity of daily living (ADL). Timepoint: Before the start of the intervention, 4 weeks after the intervention, 4 weeks after the completion of the intervention. Method of measurement: The Canadian Occupational Performance Measure (COPM) for evaluating patient's participation in Activities of daily living.