John Dean – Parkinson’s Rehab Teams: Moving Beyond a One-Size-Fits-All Approach

Outline

REVIEW OF PARKINSON’S DISEASE AND RELATED DISORDERS

• History of Parkinson’s

PARKINSON’S MEDICATIONS

• Basic methods of action for primary PD medication
• Common ancillary medications for:
  • Psychological symptoms
  • Orthostatic hypotension
  • Incontinence
  • Daytime fatigue/sleepiness
  • Cognitive changes
• Timing of PT/OT/ST interventions in conjunction with meds

{CASE STUDY} RECENTLY DIAGNOSED MALE WITH YOUNG ONSET PD

ADVANCED THERAPIES FOR PARKINSON’S

• Deep brain stimulator surgery (side effects and issues)
• Enteral suspension of carbidopa/levodopa
• Ablative surgeries
• On the horizon – subcutaneous continuous release of apomorphine and carbidopa/levodopa, A2A receptor antagonists and other targets

{CASE STUDY} FEMALE WITH MID-STAGE PD, S/P DBS SURGERY

OVERVIEW AND HISTORY OF REHAB TEAM APPROACHES TO TREATMENT

• Center of Excellence Model
• Interdisciplinary and transdisciplinary team models around the world

KEY ASPECTS OF PARKINSON’S TEAM DEVELOPMENT

• Key training and competencies
• Roles of key members including discipline-specific competencies
  • Gait and balance deficits
  • Functional transfers
  • ADLs
  • Communication and swallowing deficiencies

ASSESSMENTS AND DOCUMENTATION

• Intake and evaluation
• Key metrics of clinical progress including minimum detectable-change

SPECIAL TOPICS

• Dual task treatment for PD with PT/OT/ST team
  • Key concepts with research underpinning
  • Techniques for team approaches
    • Sequencing activities
    • Safety awareness
    • Memory deficits
• Marketing a team-based Parkinson’s program
  • Including sample presentations for consumer populations as well as medical presentations
  • Sample press release
• Differential diagnosis of atypical Parkinson’s disorders
  • Specific clinical features
    • Progressive supranuclear palsy
    • Corticobasal ganglionic degeneration
    • Multiple system atrophy

{CASE STUDY} FEMALE W/ 4-YEAR HISTORY OF UNSPECIFIED PARKINSONISMS