Outpatient video-assisted Parkinson therapy
The outpatient video-assisted Parkinson's therapy is a form of treatment in which a new drug setting for Parkinson's disease is carried out as an alternative to a stay of several weeks in the clinic using video documentation in the home environment.
The video-documented treatment allows particularly careful observation, analysis, documentation and therapy of the motor phenomena and enables an individual drug setting that also takes into account the daily routine, eating habits, the social environment and the individual motor and non-motor performance requirements of the person concerned.
It is therefore particularly suitable for patients whose mobility varies greatly during the day (“motor fluctuations”). The method is used, among other things, in the context of integrated care and implants a contractually regulated, structured collaboration between specialized hospitals and resident neurologists in the course of video-assisted Parkinson's therapy. This cross-sectoral structure is intended to avoid disruptions in treatment, as previously occurred when switching between inpatient and outpatient care.
The course of treatment
In the patient's house or apartment, an observation unit networked with the treating hospital doctor is set up, consisting of a video camera, a loudspeaker and a printer device. Using a transponder / wristband, the patient independently and technically very easily triggers a recording of around two minutes. During the video recordings, an announcement from the attending physician is heard, which prompts the patient to perform certain movement sequences and asks for a self-assessment of his condition with a school grade.
The recordings are transmitted overnight to the Parkinson's specialist in the hospital and the cooperating neurologist in the practice and are then evaluated by them. An evaluation unit is available to you for this purpose, which allows an evaluation of the video recordings using several scales and documents the course of the treatment comprehensively and clearly. Based on four to six video recordings per day, a differentiated initial result is created within a few days. A therapy plan is drawn up and the medication is implemented gradually. The current medication plan is printed out daily at the patient's home. In addition, the doctor can store voice messages and is in regular contact with the patient over the phone.
During the treatment, the patient is cared for by telephone by a nurse specially trained in Parkinson's disease. It teaches non-drug strategies and discusses specific exercises that the patient can perform in front of the camera.
Treatment usually lasts 30 days. It ends with a final examination by the resident neurologist , who continues the treatment of the patient on an outpatient basis. After completion of the therapy , the documentation of the treatment, including the video recordings, is burned on CD and given to the treating doctors in the hospital and in the practice. The course of treatment, the assignment of video recordings, assessment and medication thus remain transparent and available at all times for further consultation questions.
literature
Reference book
- U. Meier, HC Diener, Integrated Care in Neurology . Thieme, Stuttgart year 2007, 130 S, ISBN 978-3-13-143671-9
Trade journals
- Frank Marzinzik, Michael Wahl, Christoph M Doletschek, Constanze Jugel, Charlotte Rewitzer and Fabian Klostermann: Evaluation of a telemedical care program for patients with Parkinson's disease. In: Journal of Telemedicine and Telecare. 18, 2012, p. 322, doi : 10.1258 / jtt.2012.120105 .
- Rosemarie Plötzeneder, review Parkinson's therapy by video: Helps doctor and patient . Medical Tribune, p. 2 (2006), ISSN 1863-6977
- Heike E. Krüger-Brand, therapy in the living room . Deutsches Ärzteblatt, pp. C430 - C433 (2006),
- R. Ehret, Outpatient video surveillance of Parkinson's patients in the neurological practice . Neurology, pp. 21-23 (2005), ISSN 0722-1541
