Efficacy on Non-motor and Motor symptoms and Quality of Life using a multidisciplinary telemedicine program in high-risk fall patients with Parkinson’s disease. (S32.003)

Abstract

<h3>Objective:</h3> This study aims to evaluate the efficacy of a multidisciplinary telemedicine (TM) program to improve lifestyles, the burden of motor and non-motor symptoms (NMS), and quality of life (QoL) in fall patients with Parkinson’s disease (PD) and high risk of fall. <h3>Background:</h3> Falls in PD are very frequent, with devastating consequences, worse QoL, increasing comorbidity, and social isolation. Telerehabilitation has shown promising effects on motor symptoms, but the effectiveness of a multidisciplinary TM intervention in addition to standard clinical care on NMS, QoL and lifestyle remains unclear <h3>Design/Methods:</h3> Longitudinal, randomized study. PD Patients with high risk of falling and restricted access to multidisciplinary care were included (NCT04694443). A multidisciplinary TM program plus standard care was allocated to the study group for 4 months and compared to controls (in-office visits, standard care). TM included occupational therapy, nutrition, and PD clinical management. After discontinuing TM, both groups were compared at 8 months. Gait and PD motor severity were assessed using wearable sensors, MDS-UPDRS, Mini-Best and Freezing of gait questionnaire (FOGQ); quality of life (EuroHis-QoL8) and NMS (NMSS), Apathy Severity (LARS) and Depression/Anxiety Scale (BDI-II). Clinical information at baseline vs. 4 and 8-months visits were compared using parametric/non-parametric tests as needed. <h3>Results:</h3> 51 PD patients, 48.6 % males, median Hoehn Yhar stage 2 (1;3), mean age 68.6 ± 9.7 years were included. At 4 months, compared to controls, patients on TM had an improvement in the MDS-UPDRS II (p=0.01), Mini-Best (p&lt;0.0001) FOGQ (p=0.01); EuroHis-QoL8 (p=0.004); LARS (p&lt;0.0001) and BDI-II scores (p=0.004). After discontinuing TM at 8 months, FOG (p=0.01), and Mini-Best (p=0.001) scores were better in the TM group compared to controls. <h3>Conclusions:</h3> A multidisciplinary TM intervention alongside with standard care improves gait, QoL and NMS in PD patients with a high risk of falling. Long-term benefits on gait were observed more likely attributed to lifestyle modifications <b>Disclosure:</b> Dr. Cubo Delgado has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Cubo Delgado has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Zambon. Dr. Cubo Delgado has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Cubo Delgado has received research support from Spanish health ministry. The institution of Dr. Cubo Delgado has received research support from European union grant. Alvaro Garcia Bustillo has nothing to disclose. Dr. Arnaiz-Gonzalez has nothing to disclose. Florita Valiñas has nothing to disclose. Marta Allende Del Río has nothing to disclose. José Miguel Ramírez Sanz has nothing to disclose. Jose Luis Garrido_Labrador has nothing to disclose. Mrs. Olivares Gil has nothing to disclose. Dr. Diez Pastor has nothing to disclose. Jose Maria Trejo has nothing to disclose. Jeronimo González-Bernal has nothing to disclose. Josefa Gonzalez-Santos has nothing to disclose.