Fast-Track Programming and Rehabilitation Model: A Novel Approach to Postoperative Deep Brain Stimulation Patient Care

Cohen, David B.; Oh, Michael; Baser, Susan; Angle, Cindy; Whiting, Alex; Birk, Catherine; Whiting, Donald

doi:10.1016/j.apmr.2007.06.770

Cited by 24 publications

(16 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…24 Several recent studies have evaluated inpatients with PD in inpatient rehabilitation, but within specific patient subpopulations. 12Y14 Outcomes of patients receiving deep brain stimulation with subsequent transfer to rehabilitation has been recently reported by Cohen et al 12 In this study, persons with PD showed significant improvements in total FIM and Unified Parkinson Disease Rating Scale scores after inpatient care as the stimulator was adjusted (mean of adjustments, 6.2 times per patient). Although a larger FIM change was shown in the Cohen study in comparison with our study, their patient population was, on average, much younger.…”

Section: Discussionmentioning

confidence: 82%

“…12Y15 Two previous studies of inpatient rehabilitation care for patients with PD have demonstrated functional improvements in selected subgroups of patients with PD, including those walking independently for short distances 14 or after implantation of a deep brain stimulator. 12 Movement strategies provided during inpatient treatment, evaluated in the first study, significantly improved a 2-min walk test by a mean of 20.9 m compared with 10.9 m for the conventional exercise group. A third study evaluating rehabilitation outcomes concurrent with medication adjustment reported significant improvements in the Functional Independence Measure (FIM) total score; however, 62% of subjects in their study did not require physical assistance before admission.…”

mentioning

confidence: 98%

See 1 more Smart Citation

Do Co-Morbidities and Cognition Impact Functional Change and Discharge Needs in Parkinson Disease?

Marciniak

Choo²,

Toledo

et al. 2011

American Journal of Physical Medicine &Amp; Rehabilitation

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 82%

mentioning

confidence: 98%

Do Co-Morbidities and Cognition Impact Functional Change and Discharge Needs in Parkinson Disease?

Marciniak

Choo²,

Toledo

et al. 2011

American Journal of Physical Medicine &Amp; Rehabilitation

View full text Add to dashboard Cite

show abstract

“…The GUIDE study was designed to assess whether DBS settings derived using a neuroanatomically based computer model could provide comparable efficacy to those determined through traditional, monopolar review-based programming. Various methods have been previously proposed in an effort to expeditiously determine optimal DBS settings [8,9,10]. However, because of the multiplicity of variables involved (e.g.…”

Section: Discussionmentioning

confidence: 99%

Model-Based Deep Brain Stimulation Programming for Parkinson's Disease: The GUIDE Pilot Study

Pourfar

Mogilner

Farris

et al. 2015

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: Achieving optimal results following deep brain stimulation (DBS) typically involves several months of programming sessions. The Graphical User Interface for DBS Evaluation (GUIDE) study explored whether a visual programming system could help clinicians accurately predetermine ideal stimulation settings in DBS patients with Parkinson's disease. Methods: A multicenter prospective, observational study was designed that utilized a blinded Unified Parkinson's Disease Rating Scale (UPDRS)-III examination to prospectively assess whether DBS settings derived using a neuroanatomically based computer model (Model) could provide comparable efficacy to those determined through traditional, monopolar review-based programming (Clinical). We retrospectively compared the neuroanatomical regions of stimulation, power consumption and time spent on programming using both methods. Results: The average improvement in UPDRS-III scores was 10.4 ± 7.8 for the Model settings and 11.7 ± 8.7 for the Clinical settings. The difference between the mean UPDRS-III scores with the Model versus the Clinical settings was 0.26 and not statistically significant (p = 0.9866). Power consumption for the Model settings was 48.7 ± 22 μW versus 76.1 ± 46.5 μW for the Clinical settings. The mean time spent programming using the Model approach was 31 ± 16 s versus 41.4 ± 29.1 min using the Clinical approach. Conclusion: The Model-based DBS settings provided similar benefit to the Clinical settings based on UPDRS-III scores and were often arrived at in less time and required less power than the Clinical settings.

show abstract

“…Nearly 40% of this group responded with an improvement of more than 2 hours of “on” time compared to the case before surgery [7]. There are some DBS centers that advocate initiation of programming at an earlier stage while the patients are still hospitalized as this method is more patient convenient and avoids an extra programming visit [8]. In addition to the microlesion effect confounding the initial results, impedance fluctuations in the tissue surrounding the DBS lead can also contribute to inaccurate assessment.…”

Section: Current Approach To Dbs Programmingmentioning

confidence: 99%

DBS Programming: An Evolving Approach for Patients with Parkinson’s Disease

Shukla

Zeilman

Fernández

et al. 2017

Parkinson's Disease

View full text Add to dashboard Cite

Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols. In this review, we will discuss the current practice and the recent advances in DBS programming including the use of interleaving, fractionated current, directional steering of current, and the use of novel DBS pulses. These technological improvements are focused on achieving a more efficient control of clinical symptoms with the least possible side effects. Other promising advances include the introduction of computer guided programming which will likely impact the efficiency of programming for the clinicians and the possibility of remote Internet based programming which will improve access to DBS care for the patients.

show abstract

Fast-Track Programming and Rehabilitation Model: A Novel Approach to Postoperative Deep Brain Stimulation Patient Care

Cited by 24 publications

References 25 publications

Do Co-Morbidities and Cognition Impact Functional Change and Discharge Needs in Parkinson Disease?

Do Co-Morbidities and Cognition Impact Functional Change and Discharge Needs in Parkinson Disease?

Model-Based Deep Brain Stimulation Programming for Parkinson's Disease: The GUIDE Pilot Study

DBS Programming: An Evolving Approach for Patients with Parkinson’s Disease

Contact Info

Product

Resources

About