Neural Regeneration Research ›› 2021, Vol. 16 ›› Issue (7): 1336-1343.doi: 10.4103/1673-5374.301029

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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 

Ke-Ke Chen1, #, Zhao-Hui Jin2, #, Lei Gao2, Lin Qi2, Qiao-Xia Zhen2, Cui Liu2, Ping Wang2, Yong-Hong Liu2, Rui-Dan Wang2, Yan-Jun Liu2, Jin-Ping Fang2, Yuan Su2, #br# Xiao-Yan Yan3, Ai-Xian Liu2, Bo-Yan Fang2, *#br#   

  1. 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
  • Online:2021-07-15 Published:2021-01-07
  • Contact: Bo-yan Fang, MD, fangboyanv@ccmu.edu.cn.
  • Supported by:
    This study was supported by the National Key Research and Development Program Sub-project, No. 2018YFC0115405 (to BYF); the Start-up Fund for Scientific Research Talents of Beijing Rehabilitation Hospital, Capital Medical University of China, No. 2019R-006 (to ZHJ). 

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Abstract: 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. 2018bkky022) on May 7, 2018 and registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900020771) on January 19, 2019.

Key words: balance, gait, motor, neurodegeneration, Parkinson’s disease, posture, rehabilitation, tremor