AUTHOR=Meloni Mario , Saibene Francesca Lea , Di Tella Sonia , Di Cesare Monica , Borgnis Francesca , Nemni Raffaello , Baglio Francesca 

TITLE=Functional and Cognitive Improvement After an Intensive Inpatient Multidisciplinary Rehabilitation Program in Mild to Severe Parkinson's Disease: A Retrospective and Observational Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.626041

DOI=10.3389/fneur.2021.626041

ISSN=1664-2295

ABSTRACT=Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor (resting tremor, rigidity, bradykinesia, postural instability and gait disturbances) and non-motor symptoms (cognitive, neuropsychiatric and autonomic problems). In recent years, several studies demonstrated that neurorehabilitation therapy is an effective treatment in addition to pharmacological personalized interventions in Persons with Parkinson’s Disease (PwPD).  The main aim of this study was to explore the short-term changes in functional, cognitive and geriatric domains after a multidimensional rehabilitation program in PwPD (as primary condition) in Mild-Moderate (M-Ms) to Severe (Ss) stages. Our second aim was to compare the effects of multidimensional rehabilitation in M-Ms versus Ss of PD. 24 PwPD in M-Ms to Ss [age (mean,SD)=76.25ys±9.42; M/F=10/14; H&Y (median;IQR)=4.00;1.75] were included in a retrospective, observational study. Motor, cognitive, functional and neuropsychiatric aspects were collected in admission (T0) and in discharge (T1). PwPD were involved in a person-tailored (to individual’s needs), inpatient, intensive (5 to 7 days per week), multidisciplinary (combining cognitive, physical, occupational and speech therapies), comprehensive and rehabilitative program. According to MDS-UPDRS-III cut-off, PwPD were classified in M-Ms or Ss (M-Ms≤59; Ss>59). 87.50% of our sample reported significant reduction of functional disability at Barthel Index (BI) (p<0.001). A significant improvement in Token Test (p=0.021), semantic fluency (p=0.036) Rey’s Figure-Copy (p<0.001) and Raven’s Coloured Progressive Matrices (p=0.004) was observed. The pain intensity perception (p<0.001) and the risk of developing pressure ulcers (p<0.001) as assessed respectively by the Numeric Rating Scale and by the Norton Scale was improved. With regard to the second aim, in M-Ms group we found a positive correlation between the number of neuromotor sessions and the change in functional disability and language comprehension; in Ss group, on the other hand, despite a higher number of hospitalization days, the total number of completed sessions was positively associated with the change in visuo-constructional abilities. Our findings suggest that an intensive, inpatient, multidisciplinary rehabilitation program may improve functional abilities, some strategic cognitive functions and geriatric aspects in PwPD with Mild-Moderate motor impairment.