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

Scherbaum, Raphael; Hartelt, Elke; Kinkel, Manuel; Gold, Ralf; Muhlack, Siegfried; Tönges, Lars

doi:10.1007/s00415-019-09657-7

Cited by 35 publications

(49 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The predominant motor phenotype consisted of the postural instability/gait difficulty (PIGD) variant in our population (PIGD 59.6%), whereas tremor dominant (TD) phenotypes were 25.5% and indeterminate (ID) were only 14.9% [ 27 ] of the cases. Two-thirds of the patients had at least mild cognitive impairment as evaluated by the MoCA [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…The Timed Up-and-Go Test also showed a persistent improvement (DC: −2.5 ± 0.9 s p = 0.015, FU: 2.4 ± 0.9 s p = 0.027). The Berg Balance Scale and the Purdue Pegboard Test improved significantly until DC (BBS 2.4 ± 0.7 points p = 0.003, PPT 3.0 ± 0.5 sticks p = 0.000004), which did not maintain until FU [ 15 ]. Concerning motor complications, the significant improvement of MDS-UPDRS IV occurred with a relative change of −38.1% at DC ( p = 0.002) ( Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Under a significance level of 0.05, there were further putative predictors identified, such as a disease duration <8 years and a daily levodopa equivalent dose (LED) of <595 mg led to 4.75-fold higher odds to show an improvement in motor aspects of daily living (MDS-UPDRS part II). A normal cognition with MoCA scores ≥ 26 showed 0.23-fold lower odds for motor response in MDS-UPDRS part III than with mild cognitive impairment (MCI) [ 15 ]. Concerning motor response in the TUG, having less than 3.5 h of occupational therapy per week led to 4.5-fold higher odds to profit.…”

Section: Resultsmentioning

confidence: 99%

“…The main clinical outcome criteria consisted in the evaluation of motor skills, non-motor function and quality of life [ 15 , 21 ]. In order to stage disease severity, the modified Hoehn and Yahr scale was applied [ 22 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…Multidisciplinary settings include, e.g., physiotherapy, occupational therapy, speech and language therapy, specially trained nurse care and neuropsychological testing as well as possible pharmacological adjustments [ 13 ]. This approach has become a core element of PD management and has been shown to have a beneficial impact on motor and non-motor symptoms but also on quality of life [ 14 , 15 ]. Recent studies demonstrated that the inclusion of specialized therapists can prevent major disease complications and hospital admissions and can help to reduce overall disease costs [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Hartelt

Scherbaum

Kinkel³

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

Parkinson’s disease Multimodal Complex Treatment (PD-MCT) is a multidisciplinary inpatient treatment approach that has been demonstrated to improve motor function and quality of life in patients with Parkinson’s disease (PD). In this study, we assessed the efficacy of PD-MCT and calculated predictors for improvement. We performed a prospective analysis in a non-randomized, open-label observational patient cohort. Study examinations were done at baseline (BL), at discharge after two-weeks of inpatient treatment (DC) and at a six-week follow-up examination (FU). Besides Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III as a primary outcome, motor performance was measured by the Timed Up-and-Go (TUG), the Berg Balance Scale (BBS) and the Perdue Pegboard Test (PPT). Until DC, motor performance improved significantly in several parameters and was largely maintained until FU (MDS-UPDRS III BL-to-DC: −4.7 ± 1.2 (SE) p = 0.0012, BL-to-FU: −6.1 ± 1.3 p = 0.0001; TUG BL-to-DC: −2.5 ± 0.9 p = 0.015, BL-to-FU: 2.4 ± 0.9 p = 0.027; BBS BL-to-DC: 2.4 ± 0.7 p = 0.003, BL-to-FU: 1.3 ± 0.7 p = 0.176, PPT BL-to-DC: 3.0 ± 0.5 p = 0.000004, BL-to-FU: 1.7 ± 0.7 p = 0.059). Overall, nontremor items were more therapy responsive than tremor items. Motor complications evaluated with MDS-UPDRS IV occurred significantly less frequent at DC (−1.8 ± 0.5 p = 0.002). Predictor analyses revealed an influence of initial motor impairment and disease severity on the treatment response in different motor aspects. In summary, we demonstrate a significant positive treatment effect of PD-MCT on motor function of PD patients which can be maintained in several parameters for an extended time period of six weeks and identify predictors for an improvement of motor function.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Hartelt

Scherbaum

Kinkel³

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

Cerebellar transcranial magnetic stimulation improves motor function in Parkinson's disease

Grobe‐Einsler,

Baljasnikowa,

Faikus

et al. 2024

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectiveTo determine whether an accelerated protocol of 48 Hz cerebellar repetitive transcranial magnetic stimulation results in improved motor function in individuals with Parkinson's disease.MethodsIn this double‐blind randomized sham‐controlled study, 35 individuals with Parkinson's disease and stable medical treatment were randomized to either sham or verum transcranial magnetic stimulation. The stimulation was applied bilaterally and medial over the cerebellum and comprised a novel accelerated protocol encompassing two sessions per day on 5 consecutive days. Patients were assessed at baseline, on day 5 after the last stimulation and 1 month post intervention. Measurements included dynamic posturography, UPDRS III, 8‐Meter walk test, and Timed Up and Go test.ResultsThe accelerated protocol was safe and feasible in an outpatient setting. Patients in the verum group showed significant improvement (p < 0.001) of motor symptoms as measured in the UPDRS III. Improvement was mainly carried by the domains rigor, bradykinesia, and gait and persisted after 1 month (p = 0.009), whereas tremor remained unchanged.InterpretationThe effect of a high‐dose transcranial magnetic stimulation in patients with Parkinson's disease is encouraging and comparable to other studies using much longer stimulation protocols. This short‐term intervention of 5 days facilitates the future application in an outpatient setting. Reduction in hospitalization rates directly benefits patients with motor impairment.

show abstract

Activities of Daily Living Are Improved by Inpatient Multimodal Complex Treatment for PD—a Real‐World Cohort Study

Ziegler

Messner

Paulig

et al. 2022

Movement Disord Clin Pract

View full text Add to dashboard Cite

Background The multimodal complex treatment for Parkinson's disease (MCT) provides inpatient care by a multi‐disciplinary team for people with Parkinson's disease (PwP) in Germany. Objectives We conducted a 5‐year real‐world mono‐center cohort study to describe the effectiveness of MCT in the full cohort and various subgroups and outcome predictors. Methods We collected an anonymized dataset between Jan 2015 and Dec 2019, involving N = 1773. The self‐reported MDS‐UPDRS part II was used as primary outcome, and clinical routine data for explanatory variables. PwP were categorized as responders or non‐responders according to a response of at least 3 points 4 weeks after discharge. Results N = 591 complete data records were available for statistical analyses. The full group improved by −2.4 points on the MDS‐UPDRS II (P = <0.0001). 47.7% (n = 282) and 52.3% (n = 309) were coded as responders and non‐responders, respectively. A clinically meaningful response was positively associated to age (χ2 = 11.07, P = 0.018), as well as baseline‐severity of the MDS‐UPDRS II (χ2 = 6.05, P = 0.048) and negatively associated to the presence of psychiatric disorder (χ2 = 3.9, P = 0.048) and cognitive dysfunction (χ2 = 7.29, P = 0.007). Logistic regression showed that baseline severity of the MDS‐UPDRS II predicted therapy success. PwP with moderate baseline‐severity had an about 2fold chance (OR 2.08; 95% CI 1.20–3.61; P = 0.009) and with severe an about 6fold chance (OR 5.92; 95% CI 2.76–12.68; P < 0.0001) to benefit clinically meaningful. Discussion In a naturalistic setting of a specialized Parkinson's center, MCT improved ADL disability of PwP at least 4 weeks after discharge. Moderately and severely impaired patients were more likely to achieve clinically meaningful responses.

show abstract

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

Cited by 35 publications

References 71 publications

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Parkinson’s Disease Multimodal Complex Treatment (PD-MCT): Analysis of Therapeutic Effects and Predictors for Improvement

Cerebellar transcranial magnetic stimulation improves motor function in Parkinson's disease

Activities of Daily Living Are Improved by Inpatient Multimodal Complex Treatment for PD—a Real‐World Cohort Study

Contact Info

Product

Resources

About