Efficacy of short-term multidisciplinary intensive rehabilitation in patients with different Parkinson's disease motor subtypes: a prospective pilot study with 3-month follow-up  

作　　者：Ke-Ke Chen Zhao-Hui Jin Lei Gao Lin Qi Qiao-Xia Zhen Cui Liu Ping Wang Yong-Hong Liu Rui-Dan Wang Yan-Jun Liu Jin-Ping Fang Yuan Su Xiao-Yan Yan Ai-Xian Liu Bo-Yan Fang 

机构地区：[1]Beijing Rehabilitation Medical College,Capital Medical University,Beijing,China [2]Parkinson Medical Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing,China [3]Peking University Clinical Research Institute,Beijing,China

出　　处：《Neural Regeneration Research》2021年第7期1336-1343,共8页中国神经再生研究（英文版）

基　　金：supported by the National Key Research and Development Program Sub-project, No.2018 YFC0115405(to BYF);the Start-up Fund for Scientific Research Talents of Beijing Rehabilitation Hospital, Capital Medical University of China, No.2019 R-006(to ZHJ)。

摘　　要：Parkinson's disease(PD) can be classified into three motor-based subtypes: postural instability/gait difficulty(PIGD), tremor dominant(TD), and indeterminate.The neuropathophysiological mechanisms of the three motor subtypes are different, which may lead to different responses to therapy.Sixty-nine patients with idiopathic Parkinson's disease(Hoehn–Yahr stage ≤ 3) were screened from 436 patients with Parkinsonism recruited through outpatient services and the internet.According to the Movement Disorder Society Unified Parkinson's Disease Rating Scale(MDS-UPDRS) TD/PIGD ratio, the patients were divided into PIGD(TD/PIGD ≤ 0.09;n = 36), TD(TD/PIGD ≥1.15;n = 19), and indeterminate(TD/PIGD = 0.90–1.15;n = 14) groups.All patients received 2 weeks of multidisciplinary intensive rehabilitation treatment(MIRT) during hospitalization, as well as a remote home rehabilitation health education class.Compared with the scores at admission, all patients showed significant improvements in their MDS-UPDRS III score, walking ability, balance, and posture control at discharge.Moreover, the MDS-UPDRS III score improvement was greater in the PIGD group than in the TD group.The follow-up data, collected for 3 months after discharge, showed that overall symptom improvement in each group was maintained for 1–3 months.Furthermore, there were no significant differences in the duration or grade effects of symptom improvement among the three groups.These findings suggest that 2 weeks of MIRT is effective for improving motor performance in all three motor subtypes.Patients in the PIGD group had a better response after hospitalization than those in the TD group.This study was approved by the Institutional Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University of China(approval No.2018 bkky022) on May 7, 2018 and registered with the Chinese Clinical Trial Registry(registration No.Chi CTR1900020771) on January 19, 2019.

关 键 词：balance gait MOTOR NEURODEGENERATION Parkinson's disease posture REHABILITATION TREMOR 

分 类 号：R455[医药卫生—运动医学] R493[医药卫生—治疗学]