Carne William, Cifu David X, Marcinko Paul, Baron Mark, Pickett Treven, Qutubuddin Abu, Calabrese Vincent, Roberge Peggy, Holloway Kathryn, Mutchler Brian
Southeast Parkinson's Disease Research, Education, and Clinical Center, Hunter Holmes McGuire Department of Veterans Affairs Medical Center (VAMC), Richmond, VA 23249, USA.
J Rehabil Res Dev. 2005 Nov-Dec;42(6):779-86. doi: 10.1682/jrrd.2005.03.0054.
We examined the impact of multidisciplinary clinical management of the Parkinson's Disease Research, Education, and Clinical Center program on Parkinson's disease progression. Initial and follow-up scores on the Part III Motor Examination subscale of the Unified Parkinson's Disease Rating Scale (UPDRS) were examined. Overall, 37 (75.5%) of the 49 patients demonstrated stable or improved UPDRS motor scores at 1- to 3-year follow-up; in the 1-year group (n = 28), 22 patients (78.6%) improved, while 6 (21.4%) worsened. In the 2-year group (n = 15), 10 (66.7%) improved, while 5 (33.3%) worsened. In the 3-year group (n = 6), 5 (83.3%) improved, while 1 (16.7%) worsened. Multidisciplinary interventions included neurology (95.9% of patients), physiatry (93.9%), nursing (87.8%), psychology (42.9%), medication changes (59.2% increases, 18.4% decreases), rehabilitation therapies (physical, occupational, speech-language, 67.3%), functional diagnostic testing (18.4%), support group (16.3%), home exercise instruction (85.7%), and disease and wellness education (81.6%). Improved and worsened patients did not significantly differ on the individual program components. Clinical implications and study limitations are discussed.
我们研究了帕金森病研究、教育与临床中心项目的多学科临床管理对帕金森病进展的影响。对统一帕金森病评定量表（UPDRS）第三部分运动检查子量表的初始得分和随访得分进行了检查。总体而言，49例患者中有37例（75.5%）在1至3年的随访中表现出UPDRS运动评分稳定或改善；在1年组（n = 28）中，22例患者（78.6%）病情改善，而6例（21.4%）病情恶化。在2年组（n = 15）中，10例（66.7%）病情改善，而5例（33.3%）病情恶化。在3年组（n = 6）中，5例（83.3%）病情改善，而1例（16.7%）病情恶化。多学科干预措施包括神经病学（95.9%的患者）、物理医学与康复（93.9%）、护理（87.8%）、心理学（42.9%）、药物调整（增加59.2%，减少18.4%）、康复治疗（物理、职业、言语治疗，67.3%）、功能诊断测试（18.4%）、支持小组（16.3%）、家庭锻炼指导（85.7%）以及疾病与健康宣教（81.6%）。病情改善和恶化的患者在各个项目组成部分上没有显著差异。文中讨论了临床意义和研究局限性。
