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Logo for the Journal of Rehab R&D
Volume 42 Number 6, November/December 2005
Pages 779 — 786


Abstract - Efficacy of multidisciplinary treatment program on long-term outcomes of individuals with Parkinson's disease

William Carne, PhD;1-2* David X. Cifu, MD;1-3 Paul Marcinko, MHA;1 Mark Baron, MD;1,4 Treven Pickett, PsyD;2 Abu Qutubuddin, MD;1-2,4 Vincent Calabrese, MD;1,4 Peggy Roberge, RN;1 Kathryn Holloway, MD;1,3 Brian Mutchler, PsyD5

1Southeast Parkinson's Disease Research, Education, and Clinical Center, Hunter Holmes McGuire Department of Veterans Affairs Medical Center (VAMC), Richmond, VA; Departments of 2Physical Medicine and Rehabilitation, 3Neurosurgery, and 4Neurology, Virginia Commonwealth University, Richmond, VA; 5Hunter Holmes McGuire VAMC, Richmond, VA
Abstract — 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.
Key words: disease progression, intervention, levodopa, movement disorder, multidisciplinary team, neurology, outcomes, Parkinson's disease, rehabilitation, Unified Parkinson's Disease Rating Scale.

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