Physiotherapy beneficial for Parkinson’s patients

Aug 14 2012

By Helen Albert, Senior MedWire Reporter

Results from a systematic review and meta-analysis published in the BMJ suggest that physiotherapy interventions benefit Parkinson's disease (PD) patients, at least in the short term.

Regarding more long-lasting effects, the researchers say that "large, well designed, randomized controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating PD in the longer term."

Claire Tomlinson (University of Birmingham, UK) and colleagues selected 39 trials including 1827 participants for review, 29 of which were included in the meta-analysis due to sufficiently in-depth data being unavailable for the other 10 studies. The mean follow-up period for the trials was under 3 months.

To be eligible, trials had to be randomized, include patients with PD, and compare a physiotherapy intervention with no intervention or a placebo therapy. A wide range of physiotherapy types such as general physiotherapy, exercise, treadmill training, cueing, dance, and martial arts were included.

There were 18 potential physiotherapy outcomes in total categorized as: improvements to gait (seven sub outcomes), functional mobility and balance (four sub outcomes), falls, clinician-rated disability, mental wellbeing, activities of daily living, motor skills, and patient-rated quality of life (two sub outcomes).

Physiotherapy resulted in significant improvements to nine out of the 18 outcomes outlined above. The three outcomes that appeared to gain the greatest improvements after physiotherapy were gait speed (gait sub outcome), the Berg balance scale (functional mobility and balance sub outcome), and clinician‑rated disability according to the unified PD rating scale.

These three factors improved significantly with physiotherapy, by a respective 0.04 m/s, +3.71 points, and -6.1 points.

While these results are promising, the authors write: "A larger and better quality body of evidence is required before a recommendation for change in practice can be made."

They emphasize that "the majority of the studies in this review were small and had a short follow-up period," and add that "larger randomized controlled trials are needed, particularly those focusing on improving trial methodology and reporting."

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