title: Effectiveness of an inpatient multidisciplinary rehabilitation program for people with Parkinson disease.
abstract: OBJECTIVE
  In the outpatient setting, it can be difficult to effectively manage the complex medical and rehabilitation needs of people with Parkinson disease (PD). A multidisciplinary approach in the inpatient rehabilitation environment may be a viable alternative. The purposes of this study were: (1) to investigate the effectiveness of an inpatient rehabilitation program for people with a primary diagnosis of PD, (2) to determine whether gains made were clinically meaningful, and (3) to identify predictors of rehabilitation outcome.
  
  
  METHODS
  Sixty-eight subjects with a diagnosis of PD were admitted to an inpatient rehabilitation hospital with a multidisciplinary movement disorders program.
  
  
  METHODS
  Subjects participated in a rehabilitation program consisting of a combination of physical therapy, occupational therapy, and speech therapy for a total of 3 hours per day, 5 to 7 days per week, in addition to pharmacological adjustments based on data collected daily. A pretest-posttest design was implemented. The differences between admission and discharge scores on the Functional Independence Measure (FIM) (total, motor, and cognitive scores), Timed "Up & Go" Test, 2-Minute Walk Test, and Finger Tapping Test were analyzed.
  
  
  RESULTS
  An analysis of data obtained for the 68 subjects admitted with a diagnosis of PD revealed significant improvements across all outcome measures from admission to discharge. Subjects with PD whose medications were not adjusted during their admission (rehabilitation only) (n=10) showed significant improvements in FIM total, motor, and cognitive scores. Improvements exceeded the minimal clinically important difference in 71% of the subjects. Prior level of function at admission accounted for 20% of the variance in the FIM total change score.
  
  
  CONCLUSIONS
  The results suggest that subjects with a diagnosis of PD as a primary condition benefited from an inpatient rehabilitation program designed to improve functional status.
authors.affiliation: Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Boston, MA 02215, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Ellis
authors.forename: Douglas I
authors.initials: DI
authors.lastname: Katz
authors.forename: Daniel K
authors.initials: DK
authors.lastname: White
authors.forename: T Joy
authors.initials: TJ
authors.lastname: DePiero
authors.forename: Anna D
authors.initials: AD
authors.lastname: Hohler
authors.forename: Marie
authors.initials: M
authors.lastname: Saint-Hilaire
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome