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Intensive inpatient rehabilitation for persons with Parkinson’s disease: last resort or pre-emptive strike?
  1. Danique L M Radder1,
  2. Jorik Nonnekes2,
  3. Bastiaan R Bloem1
  1. 1Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  2. 2Donders Institute for Brain Cognition and Behaviour, Department of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  1. Correspondence to Professor Bastiaan R Bloem, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen, 6500 HB, The Netherlands; Bas.Bloem{at}radboudumc.nl

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We discuss the tremendous challenges to reliably demonstrate the benefits of multidisciplinary inpatient care for patients with Parkinson’s disease and sketch important areas for future research

Parkinson’s disease (PD) is a complex neurodegenerative disorder with a wide variety of motor and non-motor symptoms. Optimal management involves a multidisciplinary approach, combining pharmacotherapy and non-pharmacological interventions. Evidence for several non-pharmacological interventions, such as physiotherapy, is growing fast.1 However, it is unclear whether combining these monodisciplinary interventions into a bundled multidisciplinary team approach offers additional benefits and at what costs. Even less is known about how such multidisciplinary care should be organised, for example, on an outpatient basis (perhaps in the community) or using intensive inpatient rehabilitation. In their JNNP paper, Ferrazzoli and colleagues2 describe their experience with the latter approach.

Specifically, using a single-blind randomised controlled trial, they evaluated whether an intensive 4-week multidisciplinary and inpatient rehabilitation programme improved quality of life (QoL, measured with the PDQ-39) in persons with PD. Using a somewhat odd (pragmatically dictated) 4:1 ratio, patients were allocated to this rehabilitation programme (n=186) or a waiting list without rehabilitation (n=48). Treatment included daily sessions of physiotherapy, occupational therapy, speech-language therapy and balance/gait training. Each patient received a personalised approach, tailored to their specific …

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