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

Moriya Cohen, Talia Herman, Natalie Ganz, Inbal Badichi, Tanya Gurevich and Jeffrey M. Hausdorff ()
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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
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
Jeffrey M. Hausdorff: Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6492416, Israel

IJERPH, 2023, vol. 20, issue 5, 1-12

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.

Keywords: Parkinson’s disease; gait; balance; self-management; wearables; multidisciplinary rehabilitation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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