2.2. Program or Intervention

We used a clinical community model. SIM's primary objective was to create an interdisciplinary approach to PD patients and their caregivers from a medium-income country with low investment in community education and rehabilitation. Secondary objectives include education about the natural course of PD and treatment advances, strengthening the bonds between patient, caregivers, and clinical experts, enhancing the proper home management, building support groups between PD patients and caregivers, and providing support for caregiver burnout. We focus the activities based on constant feedback (questions, suggestions, and personal experiences) from PD patients and caregivers, as well as knowledge from clinical experts. Furthermore, as a result of this integrative model, there is a patient called “patient counsellor,” who is the PD patient's leader and an important communication bridge between the health team and patients.

SIM has been occurring one Saturday per month at Fundación Valle del Lili in Cali, Colombia, since it was established. The activities usually last for approximately four hours per session. The meeting begins with physical and cognitive activation exercises: for example, stretching and exercises aimed at the voice and muscle activation. There are three types of sessions: educational session, cognitive or physical rehabilitation, and leisure activities:

Educational session: the main seminar is given by an expert on the subject; the daily topic is selected based upon patient and caregiver suggestions from previous sessions, common questions made on clinical consultation with the neurologist, and the knowledge of the clinical variability of PD. Once the seminar has ended, questions are answered, and finally, clinical experts hand out recommendations for patients and caregivers on the home management of the PD symptoms reviewed that day. Also, our clinical leader presents a research report about goals reached and new PD focused challenges for our research team.

Cognitive or physical rehabilitation: this session is oriented to reinforce the cognitive and physical performance of PD patients. They are guided by a neuropsychologist and occupational therapist and are focused on cognitive exercises such as executive functions, memory, speech, and attention. Physical rehabilitation focuses on balance and swallowing exercises, stretching, and techniques to avoid falling and how to respond if it occurs. Caregivers learn about cognitive activities to share with the patients as well as strategies to avoid falls at home.

Leisure activities: this session aims to strengthen bonds between all SIM participants, including patients, caregivers, clinical experts, and volunteers. Activities commemorate special days such as St. Valentine's Day, World Parkinson Day, and Christmas. We celebrate with picnics and short run/walk activity, and patients can often show their artistic skills like dancing tango, singing, and declaiming poetry.