Efficacy of multidisciplinary treatment program on long-term outcomes of individuals with Parkinson's disease.
We examined the impact of multidisciplinary clinical management of the Parkinson's Disease Research, Education, and Clinical Center program on Parkinson's disease progression. Initial and follow-up scores on the Part III Motor Examination subscale of the Unified Parkinson's Disease Rating Scale (UPDRS) were examined. Overall, 37 (75.5%) of the 49 patients demonstrated stable or improved UPDRS motor scores at 1- to 3-year follow-up; in the 1-year group (n = 28), 22 patients (78.6%) improved, while 6 (21.4%) worsened. In the 2-year group (n = 15), 10 (66.7%) improved, while 5 (33.3%) worsened. In the 3-year group (n = 6), 5 (83.3%) improved, while 1 (16.7%) worsened. Multidisciplinary interventions included neurology (95.9% of patients), physiatry (93.9%), nursing (87.8%), psychology (42.9%), medication changes (59.2% increases, 18.4% decreases), rehabilitation therapies (physical, occupational, speech-language, 67.3%), functional diagnostic testing (18.4%), support group (16.3%), home exercise instruction (85.7%), and disease and wellness education (81.6%). Improved and worsened patients did not significantly differ on the individual program components. Clinical implications and study limitations are discussed.
Carne
William
W
Southeast Parkinson's Disease Research, Education, and Clinical Center, Hunter Holmes McGuire Department of Veterans Affairs Medical Center (VAMC), Richmond, VA 23249, USA. william.carne@med.va.gov
Cifu
David X
DX
Marcinko
Paul
P
Baron
Mark
M
Pickett
Treven
T
Qutubuddin
Abu
A
Calabrese
Vincent
V
Roberge
Peggy
P
Holloway
Kathryn
K
Mutchler
Brian
B