García-Bustillo Álvaro, Ramírez-Sanz José Miguel, Garrido-Labrador José Luis, Olivares-Gil Alicia, Valiñas-Sieiro Florita, Allende-Río Marta, González-Santos Josefa, González-Bernal Jerónimo Javier, Jahouh Maha, Calvo-Simal Sara, Simón-Vicente Lucía, Mariscal Natividad, Díez-Pastor José Francisco, García-García David, Arnaiz-González Álvar, Trejo-Gabriel-Galán José, Cubo Esther
Health Sciences Department, University of Burgos, Paseo de Los Comendadores s/n, 09001, Burgos, Spain.
Computer Engineering Department, University of Burgos, Av. Cantabria s/n, 09006, Burgos, Spain.
Parkinsonism Relat Disord. 2025 Jan;130:107215. doi: 10.1016/j.parkreldis.2024.107215. Epub 2024 Nov 22.
The interaction between frailty and Parkinson's disease (PD) is still unknown. This study aimed to study the effectiveness of a multidisciplinary telemedicine program in reducing frailty in Parkinson's disease.
Longitudinal, randomized, case-control study. All participants in the office were evaluated at baseline, four, and eight months (V0, V1, and V2). Patients included in the telemedicine program received additional multidisciplinary care with nurse, neurologist, and occupational therapist interventions from V0 to V1. PD motor, non-motor symptoms, frailty and health-related quality of life (HR-QoL) were assessed using recommended PD rating scales.
Fifty patients were included, 25 patients in the telemedicine group, and 25 patients in the control group. Frailty was highly correlated with performance in activities of daily living, and freezing of gait, balance, gait speed, and motor impairment, moderately correlated with hand grip strength, number of daily steps, and HR-QoL, and slightly correlated with age and level of physical fatigue. Frailty was reduced in the telemedicine group, compared to the control group, from V0 to V1 (p = .0001) and from V0 to V2 (p = .007). In addition, gait freezing, balance, gait speed, fatigue, non-motor symptoms, and HR-QoL were also improved in the telemedicine group (p values < .05).
By leveraging multidisciplinary telemedicine interventions in addition to in-office visits, healthcare providers can deliver patient-centric care, improving frailty, non-motor symptoms, gait impairment, and quality of life in Parkinson's disease. These hybrid interventions could solve current barriers to health systems with limited capacity.
衰弱与帕金森病（PD）之间的相互作用尚不清楚。本研究旨在探讨多学科远程医疗项目在减轻帕金森病患者衰弱方面的有效性。
纵向、随机、病例对照研究。所有在办公室的参与者在基线、四个月和八个月（V0、V1和V2）时接受评估。纳入远程医疗项目的患者从V0到V1接受了护士、神经科医生和职业治疗师的额外多学科护理干预。使用推荐的帕金森病评定量表评估帕金森病的运动、非运动症状、衰弱和健康相关生活质量（HR-QoL）。
共纳入50例患者，远程医疗组25例，对照组25例。衰弱与日常生活活动能力、步态冻结、平衡、步速和运动障碍高度相关，与握力、每日步数和HR-QoL中度相关，与年龄和身体疲劳程度轻度相关。与对照组相比，远程医疗组从V0到V1（p = .0001）和从V0到V2（p = .007）衰弱程度降低。此外，远程医疗组的步态冻结、平衡、步速、疲劳、非运动症状和HR-QoL也有所改善（p值< .05）。
通过在门诊就诊之外利用多学科远程医疗干预，医疗服务提供者可以提供以患者为中心的护理，改善帕金森病患者的衰弱、非运动症状、步态障碍和生活质量。这些混合干预措施可以解决当前能力有限的卫生系统的障碍。
