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Multidisciplinary Intensive Rehabilitation Program for People with Parkinson’s Disease: Gaps between the Clinic and Real-World Mobility

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  • Moriya Cohen

    (Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
    Ezra Lemarpeh Center, Bnei Brak 5111501, Israel)

  • Talia Herman

    (Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel)

  • Natalie Ganz

    (Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel)

  • Inbal Badichi

    (Ezra Lemarpeh Center, Bnei Brak 5111501, Israel)

  • Tanya Gurevich

    (Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
    Sagol School of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
    Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel)

  • Jeffrey M. Hausdorff

    (Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel
    Sagol School of Neuroscience, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
    Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
    Rush Alzheimer’s Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA)

Abstract

Intensive rehabilitation programs improve motor and non-motor symptoms in people with Parkinson’s disease (PD), however, it is not known whether transfer to daily-living walking occurs. The effects of multidisciplinary-intensive-outpatient rehabilitation (MIOR) on gait and balance in the clinic and on everyday walking were examined. Forty-six (46) people with PD were evaluated before and after the intensive program. A 3D accelerometer placed on the lower back measured daily-living walking during the week before and after the intervention. Participants were also stratified into “responders” and “non-responders” based on daily-living-step-counts. After the intervention, gait and balance significantly improved, e.g., MiniBest scores ( p < 0.001), dual-task gait speed increased ( p = 0.016) and 6-minute walk distance increased ( p < 0.001). Many improvements persisted after 3 months. In contrast, daily-living number of steps and gait quality features did not change in response to the intervention ( p > 0.1). Only among the “responders”, a significant increase in daily-living number of steps was found ( p < 0.001). These findings demonstrate that in people with PD improvements in the clinic do not necessarily carry over to daily-living walking. In a select group of people with PD, it is possible to ameliorate daily-living walking quality, potentially also reducing fall risk. Nevertheless, we speculate that self-management in people with PD is relatively poor; therefore, to maintain health and everyday walking abilities, actions such as long-term engaging in physical activity and preserving mobility may be needed.

Suggested Citation

  • Moriya Cohen & Talia Herman & Natalie Ganz & Inbal Badichi & Tanya Gurevich & Jeffrey M. Hausdorff, 2023. "Multidisciplinary Intensive Rehabilitation Program for People with Parkinson’s Disease: Gaps between the Clinic and Real-World Mobility," IJERPH, MDPI, vol. 20(5), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:3806-:d:1075544
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    References listed on IDEAS

    as
    1. Timothée Cuignet & Camille Perchoux & Geoffrey Caruso & Olivier Klein & Sylvain Klein & Basile Chaix & Yan Kestens & Philippe Gerber, 2020. "Mobility among older adults: Deconstructing the effects of motility and movement on wellbeing," Urban Studies, Urban Studies Journal Limited, vol. 57(2), pages 383-401, February.
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