To measure the impact of intensive multimodal neurorehabilitation in patients with moderately advanced with Parkinson’s disease (PD)

Dedicated neurorehabilitation is an essential part of the comprehensive care regimen for PD patients. Intensive multimodal therapy may be especially efficacious for motor and non-motor symptoms in moderately advanced patients, who are at higher risk of falling and losing independent function. Few studies have been conducted in inpatient setting, where pharmacological intervention and therapies can be personalized. Here we present initial functional and quality of life outcomes for patients who participated in our tailored rehabilitation program.

120 patients with PD (H&Y Stage 3-4) were admitted to the Parkinson’s neurorehabilitation unit. Admission criteria included loss of independence in key life function and falls within the past year. Patients participated in a structured inpatient, personalized multidisciplinary program with an emphasis on physical, occupational, and speech therapies. The patients were also followed by Movement Disorders specialists, who tailored pharmacotherapy. Average length of stay in the program was 14.8 days. A variety of clinical and self-reported scales were completed at admission and discharge: Beck’s Depression Inventory (BDI), Sleep Scale (PDSS), Timed Up and Go (TUG), Vocal Volume, and Parkinson’s Disease Questionnaire (PDQ-39). The statistical methods utilized were two-sample paired t-tests and correlation analyses.

The following results were statistically significant (p≤0.05): BDI scores decreased from M=16.64 (SD±10.83) to M=12.98 (SD±9.34); PDSS scores increased from M=88.12 (SD±26.30) to M=105.5 (SD±24.47); TUG scores decreased from M=57.46 (SD±47.50) to M=40.59 (SD±33.75); Vocal Volume scores increased from M=55.34 (SD±4.96) to M=60.79 (SD±6.26); PDQ-39 scores decreased from M=43.75 (SD±17.96) to M=37.01 (SD±18.57).

Neurorehabilitation is integral in the holistic treatment of PD as medications have limited efficacy in advanced stages of this progressive disease. Although uncontrolled, the study indicates that individualized, multimodal rehabilitation intervention in moderately advanced PD has a global effect on function.