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Clinical Care

Parkinson's Movement Disorders

Physical, Occupational, and Speech Therapy

Duke's Department of Physical and Occupational Therapy provides quality care directed at evaluation and improvement of function. The staff is experienced in working with patients with Parkinson’s disease and other movement disorders. Therapists are available on site to meet the needs of patients by offering evaluation and treatment as well as providing education to the patient and their families. Duke's Division of Speech Pathology and Audiology provides an exceptional standard of care for patients suffering from speech, swallowing, and hearing disorders. The Speech Pathology and Audiology Clinic provides services to those patients with speech and swallowing difficulties.

Clinical Social Work

Our licensed clinical social worker collaborates with the medical team to ensure optimal patient outcomes. Direct patient support through counseling services, and resources to patients and their families to include information regarding home health care, support groups, medical disability, and numerous other assistance programs.

Surgical Aspects

Many patients with movement disorders may continue with symptoms despite medications (or due to medications), including residual tremor, extra movements such as dyskinesias or dystonia, or a decreased effectiveness of medications over time. In this situation the next step to consider would be surgery to help treat the abnormal movements for improved quality of life. Surgical treatments for movement disorders include well-established procedures, particularly deep brain stimulation (DBS), and occasionally, experimental procedures (ie, gene therapy, growth factor treatment, stem cells, etc). These surgical treatments are highly individualized, both during the surgical procedure, as well as afterwards, with changes in stimulation settings customized for each patient to achieve the optimal treatment of the movement disorder. Thus, we offer both conventional surgical procedures as well as the option of experimental treatments when these arise. During surgery we also offer the possibility of participating in research if the patient is interested, aimed at both understanding brain function as well as improving the effectiveness of treatments.

Clinical Research

Current clinical research efforts are highly focused on Parkinson’s disease and involve the study of motor symptoms, such as wearing-off and dyskinesias, and non motor symptoms, including impulse control disorders, such as pathological gambling, and psychosis and cognitive disorders.

Clinical trials help develop new and innovative treatments for illnesses including Parkinson’s disease. The clinical trials program at Duke is well established and offers multiple trials for patients with early to advanced Parkinson’s disease.

These trials may provide symptomatic therapy as well as potential neuroprotective intervention. Clinical trials are the means by which Parkinson’s patients today can improve the treatment of Parkinson’s disease in the future.