User groups of inpatient multidisciplinary therapies for Parkinson's disease in Germany: a bicenter prospective observational study
In Germany, multidisciplinary care for people with Parkinson’s disease (PwP) is mainly delivered in inpatient settings. However, differences between users of Parkinson’s Disease Multimodal Complex Therapy (PD-MCT) and Geriatric Complex Therapy (GCT) have not been systematically examined. This real-world bicenter prospective observational study included PwP undergoing 14-day inpatient PD-MCT or GCT at two German university hospitals. Demographic and clinical characteristics were assessed at baseline, and device-based gait measures were collected before and after therapy. Group comparisons were performed using parametric and non-parametric tests and ANCOVA adjusted for age. An exploratory logistic regression identified predictors of gait speed–based therapy response. Between 2017 and 2022, 100 PwP received GCT and 102 PD-MCT. Compared with PD-MCT users, GCT users were significantly older, had longer disease duration, higher disease severity, poorer lower extremity and cognitive function, lower quality of life, greater fear of falling, and worse gait performance at normal and fast pace. Most differences persisted after age adjustment. Logistic regression showed that lower fear of falling and higher baseline gait speed predicted therapy response, independent of therapy type, age, sex, disease duration, or disease stage. GCT users represent a more impaired and older subgroup of PwP, particularly regarding mobility limitations independent of age. Whether current PD-MCT and GCT users reflect their intended target populations remains unclear. Analyses of health insurance data may support more targeted multidisciplinary care and inform future clinical and public health strategies.
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