INTEGRATING PHYSICAL THERAPY AS A KEY COMPONENT IN A MULTIDISCIPLINARY TEAM DESIGNED TO MANAGE THE CARE OF PATIENTS WITH PARKINSON DISEASE. Keith Myers* 1. Rehabilitation Services, Shands Hospital at the University of Florida, Gainesville, FL; 2. Movement Disorder Center, University of Florida, Gainesville, FL UNIQUE: The University of Florida Movement Disorder Center (UFMDC) was established in July 2002 to bring together University of Florida doctors and researchers with special expertise in Parkinsons disease and other Movement Disorders. As the number of patients with Parkinsons disease grows in our population it is imperative that we develop a framework to improve interdisciplinary communication, education, and training regarding the treatments to restore function for patients with various movement disorders. This is a true multidisciplinary team which includes members from each of the following specialty areas: Neurology, Neurosurgery, Neuroscience, Neuropsychology, Neuroanesthesia, Psychiatry, Communicative Disorders, Speech Language Pathology, Human Brain Tissue Bank, Biomedical Engineering, and Neurophysiology. PURPOSE: To integrate physical therapy services into the multidisciplinary team at the University of Florida Movement Disorder Center, and demonstrate how this would improve the quality of care and quality of life for patients with Parkinsons disease. FOUNDATION: Over one million Americans suffer from Parkinsons disease (PD) with 60,000 new cases of Parkinsons disease diagnosed in the United States each year. The incidence of PD increases with age and is estimated at 20 per 100,000. PD and its associated morbidities cost society approximately 5.6 billion dollars per year. Its cost in quality of life for affected individuals, however, cannot be measured. Parkinsons disease is considered a movement disorder where the primary signs include rigidity, tremor, postural instability, and difficulty initiating and terminating movement. Physical Therapists diagnose and manage movement dysfunction to enhance physical and functional abilities. Our involvement in the treatment of patients with PD is critical. The UFMDC manages the care approximately 700 patients per year, of which 368 have Parkinsons disease. DESCRIPTION: Integrating Physical Therapy into the Movement Disorder Center was dependent on three main areas: 1) Coordination between the Director of Rehabilitation Services and the Co-Director of the UFMDC 2) Acceptance of Physical Therapy by the UFMDC Director and team, 3) Identification of a point person (Physical Therapist) to facilitate open communication, cross training and education opportunities. Once the point person was established they began attending weekly interdisciplinary conferences to review patient cases and discuss research initiatives within the UFMDC. OBSERVATIONS: Patients impairments and quality of life are evaluated bi-weekly using standardized tests and questionnaires. Patients are also evaluated at 6 month and 12 month follow up appointments to assess any changes following termination of skilled PT intervention. Using the following tools patients have demonstrated steady improvement with PT intervention: Parkinsons Disease Questionnaire 39 (PDQ-39), Beck Depression Index (BDI), Short Form Health Survey (SF-12), Berg Balance Test, Timed Up and Go Test, and Flexibility and Strength measures using standard goniometry and manual muscle testing. CONCLUSIONS: Patients with Parkinsons disease gain great benefit from skilled Physical Therapy intervention and regular exercise to improve quality life through improved safety and independence with mobility. Patients who have been treated at the University of Florida Movement Disorder Center show significant improvements in flexibility, strength, balance and gait independence through Physical Therapy intervention. It is apparent that we need to advocate treatments for these patients that support improved mobility as well as lifelong health and fitness. Through the integration of Physical Therapy into this multidisciplinary team our clinic referrals from Neurology alone have increased more than 150%. Collaborative efforts of this nature can help us to more effectively reach patients who will benefit from skilled Physical Therapy intervention. FUNDING SOURCE: None KEYWORDS: Movement disorders, Multidisciplinary team, Parkinson Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.