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

• Published in: Journal of neurology Vol. 267; no. 4; pp. 954 - 965
• Main Authors: Scherbaum, Raphael, Hartelt, Elke, Kinkel, Manuel, Gold, Ralf, Muhlack, Siegfried, Tönges, Lars
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2020; Springer Nature B.V
• Subjects: 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; Medical treatment; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Movement disorders; Neurodegenerative diseases; Neurological Rehabilitation - methods; Neurology; Neuroradiology; Neurosciences; Occupational Therapy; Original Communication; Outcome Assessment, Health Care; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson Disease - rehabilitation; Parkinson's disease; Patients; Quality of Life; Severity of Illness Index; Social interactions; Inpatient; Parkinson’s disease; Multidisciplinary care; Quality of life
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-019-09657-7

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.