A Team Approach to Parkinson's Disease Care

Jul 11, 2011

When it comes to treating Parkinson's disease, deciding which of the many treatments to choose can be overwhelming for both patients and caregivers; the number of doctors, specialists and treatment options available are numerous. While there is currently no cure for Parkinson's, there are numerous treatment options, including medications, surgical procedures and specialized therapies. Use of these treatments has been shown to improve quality of life, but Parkinson's is a very individualized disease, and personal assessment is necessary for successful treatment. However, a personalized approach to treatment could involve services at multiple locations from multiple physicians, therapists, and other specialists.

The New York Methodist Hospital Center for Parkinson's Disease and Other Movement Disorders simplifies this process by consolidating all services related to the diagnosis and treatment of Parkinson's disease. According to Miran Salgado, M.D., chairman of neurosciences at NYM, "What we have is an interdisciplinary approach to Parkinson's disease." The Center is staffed by an expert specialty care team that includes neurologists specializing in movement disorders, neurosurgeons, neuropsychologists, psychologists, psychiatrists, physician assistants, speech-language therapists and nurses.

The newest addition to the Center's staff is a patient care coordinator, who sets up an appointment schedule for patients, provides treatment regimen charts, arranges Access-A-Ride trips for patients who require assistance getting to NYM, and makes sure that insurance companies cover specific medications.

"The patients can call the coordinator with their concerns and hear a friendly voice; someone who is knowledgeable about the disease, and can provide reassurance for what can be a difficult time," said Salome Macikowski, the patient care coordinator.

The Center is also an affiliate of the American Parkinson's Disease Society, and serves as its official Information and Referral Center in Brooklyn. Through this affiliation, the Center offers APDA support groups, brochures, and general information about diet, exercise, medications and surgeries which can help patients with the symptoms of the disease.
Parkinson's disease is a degenerative disorder of the central nervous system that results from the death of cells in the midbrain. Early symptoms are movement-related, including tremors, rigidity, slowness of movement and difficulty with walking and gait. Later, cognitive and behavioral problems may arise, sometimes with dementia.

Among the options offered by the Center are pharmacological treatment, swallowing and speech-language pathology, occupational therapy, psychiatric, psychological, and neuropsychological services. In addition, the Hospital's physical therapy program offers both inpatient and outpatient services, with individual rehabilitation plans that focus on improving muscle strength, balance, quality of movement, increasing flexibility, reducing stiffness, and decreasing the risk for future falls. To achieve these goals, a variety of treatment methods are used, including balance transfer, and robotically-assisted gait training and neuromuscular re-education with a device called the Lokomat. This robotic orthosis moves the patient's legs in a natural walking pattern while a computer controls the pace of walking and measures the body's response to the movement. The repetitive walking pattern is used to help the brain and spinal cord work together to re-route signals that were interrupted by injury or illness. Similarly, the Armeo, an attachment to the robotic orthosis for the upper extremity, helps to rehabilitate arm movement. NYM is the first hospital in New York-and one of the first in the United States-to acquire this equipment.

Advanced neurosurgical procedures, such as deep brain stimulation (DBS) are also offered. This procedure involves placing electrodes in the region of the brain that is related to symptoms such as tremor or rigidity, and is a possible treatment option if medications no longer provide relief. NYM is the only hospital in Brooklyn where DBS is performed.

"With various disciplines working collaboratively to develop the treatment plan, and with the coordinator, the patients' physical, mental and emotional needs are all considered," said Dr. Salgado.

While patients may be referred by their physicians to the Center, physician referral is not necessary. Call 718.246.8820 for more information.

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