Efficacy of a multidisciplinary treatment program on one-year outcomes of individuals with Parkinson's disease

Issue title: Rehabilitation and Neurologic Repair in Parkinson's Disease

Guest editors: Ronald T. Seelx and David X. Cifuy

Article type: Research Article

Authors: Carne, William^{a; b; *} | Cifu, David^{a; b; d} | Marcinko, Paul^a | Pickett, Treven^b | Baron, Mark^{a; c} | Qutubbudin, Abu^{a; b; c} | Calabrese, Vincent^{a; c} | Roberge, Peggy^a | Holloway, Kathryn^{a; d} | Mutchler, Brian^e

Affiliations: [a] Southeast PADRECC, McGuire VAMC, Richmond, VA, USA | [b] Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA | [c] Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA | [d] Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA | [e] McGuire VAMC, Richmond, VA, USA | [x] Crawford Research Institute, Shepherd Center, 2020 Peachtree Road, NW, Atlanta, GA 30309, USA. Tel.: +1 404 367 1240; Fax: +1 404 350 3081; E-mail: ron_seal@shepherd.org | [y] Virginia Commonwealth University, Box 980661, 1223 East Marshall Street, Richmond, VA 23298-0661, USA. E-mail: dcifu@hsc.vcu.edu

Correspondence: [*] Address for correspondence: William F. Carne, Ph.D., McGuire VAMC PADRECC, Department of Neurology (127), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA. Tel.: +1 804 675 5391; Fax: +1 804 675 5683; E-mail: William.Carne@med.va.gov

Abstract: The efficacy of the multidisciplinary treatment approach to the management of Parkinson's disease (PD) was examined at a regional Veteran's Administration Parkinson's Disease Research, Education and Clinical Center (PADRECC). The records of 43 consecutive individuals with PD were examined. The Unified Parkinson's Disease Rating Scale (UPDRS) was employed to assess disease progression. Changes between initial and one-year follow-up UPDRS motor functioning (Part III) scores were compared to expected disease progression from prior research. In this cohort, thirty patients (69.8%) had improved, 2 were unchanged (4.7%) and 11 patients (25.6%) had worsened at the mean 12.2-month follow-up period. The range of multidisciplinary interventions included neurology (100%), physiatrist (93%), and psychology (41.9%) visits, medication changes (60.5%), rehabilitation therapy (62.8%), functional diagnostic testing (16.3%), support group (9.3%), home exercise programs (86%), and disease and wellness education (83.7%). Statistical analyses of the individual components of the program did not demonstrate significant differences between improvers and non-improvers. Clinical implications and study limitations are discussed.

Keywords: Disease progression, outcomes, Parkinson's disease, UPDRS, multidisciplinary team

DOI: 10.3233/NRE-2005-20303

Journal: NeuroRehabilitation, vol. 20, no. 3, pp. 161-167, 2005