Session Information
Date: Thursday, June 23, 2016
Session Title: Parkinson's disease: Clinical trials, pharmacology and treatment
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To analyze the effect of the POP rehab program for advanced PD patients on motor- and non-motor symptoms up to 2 years and determine whether definite nursing home admission can be delayed.
Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder with motor, cognitive and behavioral symptoms. Patients develop serious physical and neuropsychiatric impairments and eventually lose their ability to live independently. Therefore, multidisciplinary PD rehabilitation was started in a so-called Point of Parkinson (POP), to take care of advanced PD patients with multiple problems, interfering with independent living.
Methods: A total of 24 advanced PD patients (13 men/11 women), median age of 71 years were included in this program. Assessments were performed at baseline, 6 weeks, 3 months and 2 years after inclusion. Primary endpoints were improvement of activities of daily living, measured with the AMC Linear Disability Scale (ALDS) and whether the patients could live independently at home after the POP program. Secondary endpoints included changes in motor- and cognitive performance (SCOPA-SPES/ SCOPA-Cog), behavioral symptoms (SCOPA-PS), neuropsychiatric disturbances (NPI/ BDI) and Quality of Life (PDQL).
Results: A total of 83% of the patients could return home after the POP program. After 2 years, 65% was still able to live independently at home. The ALDS score improved with a mean of 9.9 points (p=.001) after the POP program. A positive effect was seen in 78% of the PD patients, which decreased over time, but was still positive after 2 years. A significant improvement was seen in SCOPA-SPES (mean 2.8 points, p=.005), SCOPA-Cog (mean 4.1 points, p=.000), SCOPA-PS (mean 1.2 points, p=.001), NPI (mean 1.1 points, p=.002), BDI (mean 1.45 points, p=.000) and PDQL (mean 5.3 points, p=.042). The most important driver of these changes was related to optimization of medication. Dopaminergic medication was increased from a mean daily dose of 1137 mg to 1521 mg. In 74% of the PD patients LEDD had to be increased and in 54% of the PD patients rivastigmine was increased with a mean of 7. 6 mg.
Conclusions: The POP program, including optimization of medication, significantly delayed nursing home admission in 83% of the included PD patients, whereas still 65% of the PD patients lived independently after 2 yrs, which was accompanied by improvements of motor- and non-motor symptoms.
To cite this abstract in AMA style:
E.T. Steendam-Oldekamp, W.A.W.F. Rutgers, T. van Laar. Multidisciplinary Parkinson rehabilitation in the Netherlands: The effectiveness of points of Parkinson (POP) [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/multidisciplinary-parkinson-rehabilitation-in-the-netherlands-the-effectiveness-of-points-of-parkinson-pop/. Accessed November 24, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/multidisciplinary-parkinson-rehabilitation-in-the-netherlands-the-effectiveness-of-points-of-parkinson-pop/