Movement Disorders/Parkinson's Program


Pickup Family Neurosciences Institute’s Movement Disorders Program had its origins in 1994 with emphasis on specialized patient evaluation, advanced medical therapy and community support groups throughout Orange County. The program treats patients with movement disorders including Parkinson’s disease, dystonia, essential tremor and gait problems, enabling them to achieve their highest level of independence.

Additionally, our program has incorporated a very active Deep Brain Surgery surgical treatment with our neurosurgical lead, Dr. Christopher Duma, who has longstanding experience with some of the highest annual volumes in Southern California. Targeted physical therapy is team based and provided in the Outpatient Rehabilitation Department with physical therapists, occupational therapists and speech therapists, who have extensive training and experience in assessment and treatment of movement disorders. Additionally, they offer several forced-use exercise classes and a driving rehabilitation program.

The Movement Disorders Program supports the community of people with Parkinson’s disease and their families by offering 10 support groups, an Annual Parkinson’s Symposium and Parkinson’s wellness patient education programs throughout the year.


The Movement Disorders Program has two movement disorders neurologists with combined expertise of 40 years in managing patients with movement disorders. The program is led by Program Director Sandeep Thakkar, D.O. (neurologist), Janet Chance, M.D. (neurologist), Christopher Duma, M.D., F.A.C.S. (neurosurgeon), and Julie Treat, M.S.N., R.N., nurse navigator.

Patients with Parkinson’s who are admitted to Hoag have their home medications and schedule reviewed by the Movement Disorders Nurse Navigator to ensure consistency of timing while in the hospital.


The Functional ADL section of the Parkinson’s UPDRS Scale is used to determine how our patients are subjectively rating functional status. This guides the assessment and provides continuity of care from one visit to the next. Patients complete the scale at each follow-up visit with a Movement Disorders Neurologist. These questions include topics such as depression and motivation, speed and swallowing; dressing and hygiene, falling and walking, tremor and pain.

Data from the first two quarters of 2016 results show: 714 patients, 1,370 visits, with average age of 75, average years of Parkinson’s diagnosis of 7, and average total Functional ADL sub-score of UPDRS of: 16/56.

The data is being used to determine the needs of the Parkinson’s population that we serve. As an example, it was noted that swallowing scores began to trend up between 4-7 years with Parkinson’s diagnosis. This led the program to offer a baseline swallow evaluation by our Speech Therapy department for all patients between years 4-7 of Parkinson’s diagnosis.

Support & Education

A multidisciplinary case conference is held each month to review complex patient cases. This unique forum offers the opportunity for members of all disciplines, including physicians, nurses, physical therapists, speech therapists, and other health care professionals to share information about innovative new therapies. All patients who are candidates for surgery are reviewed by this team to optimize care. Patients benefit from this combined expertise and experience.