Parkinson's disease multimodal complex treatment (PD-MCT)

  • 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 \(\pm\) 1.2 (SE) \(\it p\) = 0.0012, BL-to-FU: −6.1 \(\pm\) 1.3 \(\it p\) = 0.0001; TUG BL-to-DC: −2.5 \(\pm\) 0.9 \(\it p\) = 0.015, BL-to-FU: 2.4 \(\pm\) 0.9 \(\it p\) = 0.027; \(\it BBS\) BL-to-DC: 2.4 \(\pm\) 0.7 \(\it p\) = 0.003, BL-to-FU: 1.3 \(\pm\) 0.7 \(\it p\) = 0.176, PPT BL-to-DC: 3.0 \(\pm\) 0.5 \(\it p\) = 0.000004, BL-to-FU: 1.7 \(\pm\) 0.7 \(\it p\) = 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 \(\pm\) 0.5 \(\it p\) = 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.

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Metadaten
Author:Elke HarteltGND, Raphael ScherbaumORCiDGND, Manuel KinkelGND, Ralf GoldORCiDGND, Siegfried Martin MuhlackGND, Lars TöngesORCiDGND
URN:urn:nbn:de:hbz:294-75830
DOI:https://doi.org/10.3390/jcm9061874
Parent Title (English):Journal of Clinical Medicine
Subtitle (English):analysis of therapeutic effects and predictors for improvement
Publisher:MDPI
Place of publication:Basel
Document Type:Article
Language:English
Date of Publication (online):2020/10/21
Date of first Publication:2020/06/16
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:MDS-UPDRS Part III; Parkinson's disease; motor complications; motor symptoms; multimodal complex treatment
Volume:9
Issue:6, Article 1874
First Page:1874-1
Last Page:1874-15
Institutes/Facilities:St. Josef-Hospital Bochum, Neurologische Klinik
Protein Research Department
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International