Objective: The current study reports findings from a year-long community-based multidisciplinary program for individuals with Parkinson’s disease (PD).

Background: Parkinson’s disease is a multimodality disorder affecting different domains of a person’s daily functioning. Several behavioral interventions including speech therapy, cognitive therapy, physical exercise programs including Tai Chi, and recreational therapy have been reported to create a positive impact on overall functioning of individuals with PD.

Method: Six participants with mild-moderate PD (Males=4) with average disease duration of 6 years participated in a 90- minute weekly program comprising of speech therapy program (called LOUD Crowd^®) and alternative recreational therapy (including balance, upper and lower body strengthen, coordination, and basic core stabilizing interventions) and Tai Chi program. One of the participants was lost to attrition at the end of 10 months. Data were collected for Biodex BioSway, the Timed Up and Go (Tug) Test, the Modified Falls Efficacy Scale, Dementia Rating Scale (DRS-2), and the Voice Handicap Index (VHI) at baseline and at the end of 1-year period.

Results: Specific to recreational therapy outcomes, statistically significant changes were noted for pre to post Tug Scores (Z = -2.023, p= .043). In addition, the Biodex BioSway pre-post results indicated statistically significant positive correlations with the overall stability index eyes open and the anterior/posterior index eyes open scales (correlation coefficient = .975, p= .01), the overall stability index eyes open and the medial lateral index eyes open scale (correlation coefficient = .975, p= .01), the overall stability index eyes closed and the anterior/posterior index eyes closed scale (correlation coefficient = .900, p= .05), and the anterior/posterior index eyes closed and the medial lateral index (correlation coefficient = .949, p= .05). Specific to voice outcomes, 3/5 participants showed improvements in live loudness ratings and 2/5 participants reported better VHI scores at the end of 1-year. Finally, 3/5 participants showed improved cognitive functioning based on DRS-2 scores at the end of the year.

Conclusion: Overall, results demonstrated improvements in the physical functioning, gait-related confidence, voice functioning and cognitive skills of participants with PD due to the multidisciplinary program.

References: 1. Alberta Health Services. Timed-up-and-go (TUG) test. Journal of American Geriatric Society, 39, 142-148. 2. Biodex Medical Systems Inc. BioSway Portable Balance System operation manual. http://www.biodex.com/sites/default/files/950460man_10202revd.pdf. Accessed December 4, 2018. 3. Jacobson, B.H., Johnson, A., Grywalski, C., Silbergleit, A., Jacobson, G., Benninger, M.S., … Newman, C.W. (1997). The Voice Handicap Index (VHI): Development and validation. American Journal of Speech-Language Pathology, 6, 66- 70. 4. Miller, N. (2012). Speech, voice and language in Parkinson’s disease: Changes and interventions. Neurodegenerative Disease Management, 2(3), 279-289. 5. Mattis, S. (2004). The Dementia Rating Scale-2 (DRS- 2).Lutz, FL: Psychological Assessment Resources. 6. Parkinson’s Foundation. (2020). Retrieved on February 6, 2020 from https://www.parkinson.org/Understanding-Parkinsons/Statistics?_ga=2.72066199.580164167.1554047767-1543185907.1554047767 7. Poewe, W., Seppi, K., Tanner, C.M., Halliday, G.M., Brundin, P., Volkmann, J., … , Lang, A.E. (2017). Parkinson disease. Nature Reviews Disease Primers, 3, 17013. doi: 10.1038/nrdp.2017.13. 8. Tinetti, M., Richman, D.et al. (1990). Falls efficacy as a measure of fear of falling. Journal of Gerontology, 45(6), 239.

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