Short- and Long-Term Effect of Parkinson’s Disease Multimodal Complex Treatment

Abstract

Parkinson´s disease multimodal complex treatment (PD-MCT) is a multidisciplinary inpatient treatment option increasingly applied in Germany. However, data on its effectiveness are rare. Data were collected at the Department of Neurology of the University Hospital Jena, Germany. In 2019, 159 patients were admitted to our neurology ward for PD-MCT. Patients were followed for up to 12 months, and their data were retrospectively analyzed to assess the short- and long-term treatment effects. The treatment led to an improvement in motor function assessed by Movement Disorder Society sponsored revision of the unified Parkinson´s disease rating scale part III (MDS-UPDRS III) and motor performance (Tinetti test). Improvement of MDS-UPDRS III was associated with lower age, higher MDS-UPDRS III at admission, and less depression (assessed by Hospital Anxiety and Depression Scale and Beck-Depression Inventory II). One month after the hospital stay, 36.8% of the patients reported feeling better, while 32.6% reported feeling worse. If the patients were not depressed, they were more likely to have reported feeling better. PD-MCT is an effective inpatient treatment option. However, to improve patients’ satisfaction, screening and treatment for depression is essential. The effectiveness of different treatment durations has to be elucidated in further studies.

Parkinson’s disease multimodal complex treatment improves gait performance: an exploratory wearable digital device-supported study

“…Additionally, in terms of clinical scores, we found significant improvements in motor severity, balance, dexterity, motor complications, functional mobility, and executive functions. Recent observational studies [ 18 , 19 , 21 , 22 ] pointed out similar positive effects of both short-term [ 18 , 19 ] and long-term [ 21 , 22 ] PD-MCT. Multidisciplinary inpatient interventions have been shown to improve quality of life, daily functioning and motor symptoms, with differences in effectiveness depending on the duration and intensity of the interventions as well as the stage of the disease [ 94 – 99 ].…”

“…Thereby, partially insufficient effects of dopaminergic therapy, e.g., on axial motor functions [16] are counterbalanced by positive effects of exercise on gait and balance [17]. The Parkinson's Disease Multimodal Complex Treatment (PD-MCT) is a multidisciplinary inpatient approach with favorable effects on motor symptoms and quality of life [18][19][20][21][22] which is applied up to 24% of all PD inpatients in Germany [20]. It is guided by the principles of individualized [23], i.e., tailored, and person-centered [24] health care.…”

Patterns and Predictors of Medication Change after Discharge from Hospital: An Observational Study in Older Adults with Neurological Disorders

“…We found that changes due to missing effects are more common in Parkinson s disease than in the other disorder groups. This is probably due to the fact that, in the case of Parkinson's disease, medication is frequently adjusted during the inpatient stay and certain expectations of a prompt improvement in motor function are associated with this [35]. If this improvement does not occur, people with Parkinson s disease seem to be more willing to adjust medication on their own.…”

Fear of Falling Does Not Influence Dual-Task Gait Costs in People with Parkinson’s Disease: A Cross-Sectional Study

“…Inclusion criteria were as follows: PD diagnosis according to Movement Disorder Society (MDS) diagnosis criteria, admission to hospital for PD multimodal complex treatment [35,36], able to walk 50 m without personal assistance, absence of severe dyskinesias affecting gait, adequate vision and/or hearing or successful use of corrective aids if required. Exclusion criteria were as follows: non-PD-related gait impairment, spasticity, cerebrovascular disorders, neuropathy, deep brain stimulation, levodopa/carbidopa enteral infusion, and apomorphine infusion.…”