Parkinson's Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life

J Neurol. 2020 Apr;267(4):954-965. doi: 10.1007/s00415-019-09657-7. Epub 2019 Dec 3.

Abstract

Parkinson's disease (PD) is the world's fastest growing neurological disorder disabling patients through a broad range of motor and non-motor symptoms. For the clinical management, a multidisciplinary approach has increasingly been shown to be beneficial. In Germany, inpatient Parkinson's Disease Multimodal Complex Treatment (PD-MCT) is a well-established and frequent approach, although data on its effectiveness are rare. We conducted a prospective real-world observational study in 47 subjects [age (M ± SD): 68.5 ± 9.0 years, disease duration: 8.5 ± 5.3 years, modified Hoehn and Yahr stage (median, IQR): 3, 2.5-3] aiming at evaluating the effectiveness of 14-day PD-MCT in terms of quality of life (Parkinson's Disease Questionnaire, EuroQol), motor [Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III], Timed Up and Go Test, Purdue Pegboard Test) and non-motor symptoms (revised Beck Depression Inventory). Six weeks after hospital discharge, a follow-up examination was performed. PD patients with a predominantly moderate disability level benefited from PD-MCT in terms of health-related quality of life, motor symptoms and non-motor symptoms (depression). Significant improvements were found for social support, emotional well-being and bodily discomfort domains of health-related quality of life. Sustainable improvement occurred for motor symptoms and the subjective evaluation of health state. We found a higher probability of motor response especially for patients with moderate motor impairment (MDS-UPDRS III ≥ 33). In conclusion, Parkinson's Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life. A more detailed selection of patients who will benefit best from this intervention should be examined in future studies.

Keywords: Inpatient; Multidisciplinary care; Parkinson’s disease; Quality of life.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Depression / rehabilitation*
  • Disabled Persons
  • Dyskinesias / etiology
  • Dyskinesias / rehabilitation*
  • Exercise Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced
  • Language Therapy
  • Male
  • Massage
  • Middle Aged
  • Neurological Rehabilitation / methods*
  • Occupational Therapy
  • Outcome Assessment, Health Care*
  • Parkinson Disease / complications
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / rehabilitation*
  • Quality of Life*
  • Severity of Illness Index