Does attendance at a multidisciplinary outpatient rehabilitation program for people with Parkinson's disease produce quantitative short term or long term improvements? A systematic review

Abstract

A systematic review was conducted of the evidence for the effectiveness of the outcomes from treatment by multidisciplinary outpatient rehabilitation programs which were provided by more than one allied health or nursing discipline for people diagnosed with Parkinson's disease (PD). The search yielded only 4 studies ranging from poor to good quality, on the outcomes of multidisciplinary rehabilitation. There were no available random controlled trials on short term outcomes although some limited evidence from lower quality studies suggested significant short term gains are achieved in gait speed and step length. No consistent evidence is available for other outcome measures. From the available evidence for longer term outcomes over a period of 4-6 months post intervention the improvements in outcome measures for gait are not significant. The results of this systematic review suggest that there is limited evidence to suggest short term gains in outcomes for people with PD attending multidisciplinary programs but over a 4-6 month period these gains are no longer significant. Overall, there is very limited high level evidence available to show whether multidisciplinary out-patient programs produce effective, either short or long term, outcomes for PD and further research is needed.

Health-Related Quality of Life and Physical Function in Individuals with Parkinson’s Disease after a Multidisciplinary Rehabilitation Regimen—A Prospective Cohort Feasibility Study

“…As PD is a disease affecting multiple aspects of life, international PD rehabilitation guidelines [ 21 ] recommend a multidisciplinary team approach as best clinical practice. Systematic reviews on multidisciplinary rehabilitation have concluded that lower quality studies show positive short-term effects on gait speed and step length, but these improvements are no longer significant at 4–6 months post intervention [ 22 , 23 ]. However, a recent randomized controlled trial (RCT) has shown that an 8-week multidisciplinary rehabilitation program containing task-oriented physical exercises and cognitive-behavioral training improved motor impairments, balance, ADL, and HRQOL after 1 year in IPD [ 24 ].…”

A randomised controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson’s disease: study rationale and protocol

“…Another recent systematic review 25 similarly reported insufficient of high level evidence to demonstrate whether multidisciplinary outpatient programs produce effective short or longer term outcomes for people with PD. In addition, no studies have been identified that examine whether delivering an interdisciplinary PD specific program with dual-tasking activities improves not only physical abilities but also the quality of life and the cognition of PD clients.…”

In‐patient multidisciplinary rehabilitation for Parkinson's disease: A randomized controlled trial

“…5,6 However, evidence on their effectiveness is still limited. [7][8][9] Nonrandomized controlled studies reported benefits on functional performances, transfers, walking abilities, mood disorders, and QoL. [10][11][12][13] Randomized controlled trials reported benefits on functional status, activities of daily living (ADL), mood disorders, and QoL after the intervention, but long-term effects were not evaluated.…”