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. 2024;14(1):135-166.
doi: 10.3233/JPD-230117.

Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement

Jennifer G Goldman  1   2 , Daniele Volpe  3   4   5 , Terry D Ellis  6 , Mark A Hirsch  7   8 , Julia Johnson  9 , Julia Wood  10 , Ana Aragon  11 , Roberta Biundo  12 , Alessandro Di Rocco  13 , Glenn S Kasman  14 , Robert Iansek  15 , Janis Miyasaki  16 , Victor M McConvey  17 , Marten Munneke  18 , Serge Pinto  19 , Karen A St Clair  20 , Santiago Toledo  2 , Michele K York  21 , Ronnie Todaro  22   23 , Nicole Yarab  23 , Kristin Wallock  23
Affiliations

Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement

Jennifer G Goldman et al. J Parkinsons Dis. 2024.

Abstract

Background: Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD.

Objective: The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care.

Methods: The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions.

Results: The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages.

Conclusions: Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.

Keywords: Interdisciplinary; multidisciplinary; neuropsychology; occupational therapy; physical therapy; rehabilitation; speech language pathology.

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Conflict of interest statement

All Task Force members received honorarium from the Parkinson’s Foundation for their participation in the Task Force initiative unless noted.

Dr. Goldman has received grant/research support from Acadia Pharmaceuticals, American Parkinson’s Disease Foundation, Lewy Body Dementia Association, Michael J. Fox Foundation, and Parkinson’s Foundation; she has received honoraria from the International Parkinson and Movement Disorder Society and Parkinson’s Foundation.

Dr. Ellis receives funding paid to Boston University from NIH and NSF to support research. She also receives funding paid to Boston University from Parkinson’s Foundation and the American Parkinson Disease Association to support education and outreach activities. Dr. Ellis participates on various committees for the Parkinson’s Foundation, American Parkinson Disease Association, and the Michael J. Fox Foundation, and the Movement Disorder Society; all roles are unpaid.

Dr. Hirsch receives grant and other funding paid to Wake Forest School of Medicine including from: Wake Forest Clinical and Translational Science Institute, Dutch Brain Foundation, and Dutch Parkinson Patient Association. He is a board member on the Scientific Program Planning Board of the International Association of Parkinsonism and Related Disorders, and on the Editorial Board of the Journal of Parkinsonism and Related Disorders. He is also a member of the advisory board of the Parkinson Association of the Carolinas; this role is unpaid. Dr. Hirsch declined honorarium for the Task Force initiative.

Ms. Johnson received honoraria from the Parkinson’s Foundation.

Dr. Biundo has received honoraria from Bial Pharmaceuticals. She is supported by the Ministry of Health under grant number GR-2016-02361986.

Ms. St. Clair received honoraria from the Parkinson’s Foundation.

Dr. York serves on the Michael J. Fox Foundation steering committee Registry for the Advancement of Deep Brain Stimulation in Parkinson’s Disease.

Todaro, Yarab, and Wallock – Parkinson’s Foundation, NY

All other authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Task Force process.
Fig. 2
Fig. 2
Core Rehabilitation Care Team and Other Relevant Healthcare Professionals for PD.
See this image and copyright information in PMC

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