Effective Multidisciplinary Collaboration Involving Rehabilitation Treatment, Nutrition, and Medication Management for Patients with Parkinson Disease with Fatigue and Dysautonomia：A Case Report
- VernacularTitle:疲労や自律神経障害を有するパーキンソン病患者に対し，リハビリテーション治療と栄養管理，内服管理を中心とした多職種連携が有効だった1例
- Author:
Keisuke YASUDA
1
;
Syuuichirou SUZUKI
2
;
Keigo OKUYAMA
1
;
Youko HATANAKA
3
;
Yuri KASHIWAGI
4
;
Masahiro AOKI
5
Author Information
- Keywords: Parkinson disease; fatigue; dysautonomia; rehabilitation treatment; nutrition management
- From:The Japanese Journal of Rehabilitation Medicine 2024;():23053-
- CountryJapan
- Language:Japanese
- Abstract: Introduction：Here we report the case of a patient with Parkinson disease (PD) who showed improved physical function and non-motor symptoms, including fatigue and dysautonomia, through a multidisciplinary collaboration involving rehabilitation treatment, nutrition, and medication management.Case：A 77-year-old woman with PD was hospitalized for condition assessment and environmental adjustments and complained of fatigue and dizziness. She presented with decreased physical function, sarcopenia, orthostatic hypotension, and an impaired circulatory response during exercise. A multidisciplinary conference was conducted to address these issues, and we decided to implement rehabilitation treatment, nutrition, and medication management.The rehabilitation program consisted of 1 h/day physiotherapy sessions involving stretching exercises, muscle-strengthening exercises, and walking training. Because she often made medication administration errors, a nurse managed them on her behalf. Nutrition management was established to ensure sufficient energy for her total energy expenditure.At discharge, a notable improvement was recorded in Part 1 of the Movement Disorder Society Unified Parkinson's Disease Rating Scale, and the patient's complaints of fatigue and dizziness had subsided. Additionally, physical function measures such as skeletal muscle mass, comfortable walking speed over a 10-m distance, 6-min walking distance, and Berg Balance Scale score improved. To optimize the patient's home environment, home nursing, home-visit rehabilitation, and meal delivery services were introduced to manage her medication and nutritional needs.Discussion：In addition to rehabilitation treatment, the reconsideration of a patient's daily living activities, such as taking medications and meals, is important for improving their physical function and non-motor symptoms including fatigue and dysautonomia.
