Parkinson's Elevated: improving healthspan

As Parkinson's disease (PD) progresses, relatively mild symptoms advance to a major disorder that affects every organ system in the body. Current care for people with PD (PwP) reacts to rising disability. There is a missed opportunity to keep PwP as healthy as possible. In this perspective, we...

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Main Authors: Kathleen E. McKee, Miriam R. Rafferty, Theadora W. Sakata, David M. Hedges, Garett J. Griffith, Maddison M. K. Bingham, Stephanie A. Obradovich, M. Nicholas Francis, Daniel M. Corcos
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Sports and Active Living
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Online Access:https://www.frontiersin.org/articles/10.3389/fspor.2025.1529075/full
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author Kathleen E. McKee
Miriam R. Rafferty
Miriam R. Rafferty
Theadora W. Sakata
Theadora W. Sakata
Theadora W. Sakata
David M. Hedges
Garett J. Griffith
Maddison M. K. Bingham
Stephanie A. Obradovich
M. Nicholas Francis
Daniel M. Corcos
author_facet Kathleen E. McKee
Miriam R. Rafferty
Miriam R. Rafferty
Theadora W. Sakata
Theadora W. Sakata
Theadora W. Sakata
David M. Hedges
Garett J. Griffith
Maddison M. K. Bingham
Stephanie A. Obradovich
M. Nicholas Francis
Daniel M. Corcos
author_sort Kathleen E. McKee
collection DOAJ
description As Parkinson's disease (PD) progresses, relatively mild symptoms advance to a major disorder that affects every organ system in the body. Current care for people with PD (PwP) reacts to rising disability. There is a missed opportunity to keep PwP as healthy as possible. In this perspective, we spell out our vision for a proactive, value-based health care model built around a patient-centered integrated practice unit (IPU) for PD. The IPU will provide integrated interdisciplinary care overseen by a specialized Parkinson's primary care physician working closely with a movement disorders neurologist. The IPU will implement an evidence-based exercise program for people early in the disease. The focus of this intervention is a heart rate driven high-intensity aerobic exercise program, which is the only treatment with evidence that it can slow disease progression. It will also include resistance exercises, flexibility exercise and balance exercise. For people whose disease is moderate or severe, the IPU will provide care curated through a network of rehabilitation providers with expertise in PD all of whom understand the exercise prescription. By integrating care, slowing disease progression, and incorporating specialized rehabilitation we anticipate improving healthspan. In creating the IPU as a fully capitated (shared-risk) model in which the IPU and the insurance company assume joint accountability for quality and cost of care we anticipate demonstrating financial sustainability of implementing the exercise prescription and providing integrated care.
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spelling doaj-art-ec50957d5640498dbbed74db1d5d034d2025-08-20T02:01:47ZengFrontiers Media S.A.Frontiers in Sports and Active Living2624-93672025-06-01710.3389/fspor.2025.15290751529075Parkinson's Elevated: improving healthspanKathleen E. McKee0Miriam R. Rafferty1Miriam R. Rafferty2Theadora W. Sakata3Theadora W. Sakata4Theadora W. Sakata5David M. Hedges6Garett J. Griffith7Maddison M. K. Bingham8Stephanie A. Obradovich9M. Nicholas Francis10Daniel M. Corcos11Department of Neurology, Intermountain Medical Center Neurosciences Institute, Intermountain Health, Salt Lake City, UT, United StatesShirley Ryan AbilityLab, Chicago, IL, United StatesDepartment Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, United StatesDepartment of Neurology, Intermountain Medical Center Neurosciences Institute, Intermountain Health, Salt Lake City, UT, United StatesDepartment of Family Medicine, Intermountain Health, Salt Lake City, UT, United StatesHealthcare Delivery Institute, Intermountain Health, Salt Lake City, UT, United StatesDepartment of Analytics, Select Health, Salt Lake City, UT, United StatesDepartment of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United StatesDepartment of Neurology, Intermountain Medical Center Neurosciences Institute, Intermountain Health, Salt Lake City, UT, United StatesNeurologic Physical Therapy, Intermountain Park City Hospital, Park City, UT, United StatesLifestyle Medicine and Wellness Center, Intermountain Park City Hospital, Park City, UT, United StatesDepartment of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United StatesAs Parkinson's disease (PD) progresses, relatively mild symptoms advance to a major disorder that affects every organ system in the body. Current care for people with PD (PwP) reacts to rising disability. There is a missed opportunity to keep PwP as healthy as possible. In this perspective, we spell out our vision for a proactive, value-based health care model built around a patient-centered integrated practice unit (IPU) for PD. The IPU will provide integrated interdisciplinary care overseen by a specialized Parkinson's primary care physician working closely with a movement disorders neurologist. The IPU will implement an evidence-based exercise program for people early in the disease. The focus of this intervention is a heart rate driven high-intensity aerobic exercise program, which is the only treatment with evidence that it can slow disease progression. It will also include resistance exercises, flexibility exercise and balance exercise. For people whose disease is moderate or severe, the IPU will provide care curated through a network of rehabilitation providers with expertise in PD all of whom understand the exercise prescription. By integrating care, slowing disease progression, and incorporating specialized rehabilitation we anticipate improving healthspan. In creating the IPU as a fully capitated (shared-risk) model in which the IPU and the insurance company assume joint accountability for quality and cost of care we anticipate demonstrating financial sustainability of implementing the exercise prescription and providing integrated care.https://www.frontiersin.org/articles/10.3389/fspor.2025.1529075/fullParkinson's diseasehealthspanintegrated practice unitproactive carehigh-intensity aerobic exercise
spellingShingle Kathleen E. McKee
Miriam R. Rafferty
Miriam R. Rafferty
Theadora W. Sakata
Theadora W. Sakata
Theadora W. Sakata
David M. Hedges
Garett J. Griffith
Maddison M. K. Bingham
Stephanie A. Obradovich
M. Nicholas Francis
Daniel M. Corcos
Parkinson's Elevated: improving healthspan
Frontiers in Sports and Active Living
Parkinson's disease
healthspan
integrated practice unit
proactive care
high-intensity aerobic exercise
title Parkinson's Elevated: improving healthspan
title_full Parkinson's Elevated: improving healthspan
title_fullStr Parkinson's Elevated: improving healthspan
title_full_unstemmed Parkinson's Elevated: improving healthspan
title_short Parkinson's Elevated: improving healthspan
title_sort parkinson s elevated improving healthspan
topic Parkinson's disease
healthspan
integrated practice unit
proactive care
high-intensity aerobic exercise
url https://www.frontiersin.org/articles/10.3389/fspor.2025.1529075/full
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