Multidisciplinary Rehabilitation for People with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Abstract

Introduction. Guidelines endorse to implement an integrated and multidisciplinary team approach in the management of people with Parkinson’s disease (PD). However, there is no net and clear finding that shows the supremacy of multidisciplinary team interventions over conventional interventions for people with PD. Therefore, we perform a systematic review and meta-analysis to determine the supremacy of multidisciplinary interventions for people with PD. Methods. A systematic review and meta-analysis of randomized controlled trials were conducted. PubMed, Physiotherapy Evidence Database, Cochrane Library, and Google Scholar were searched from inception until May 2021. Randomized controlled trials comparing multidisciplinary intervention with conventional physiotherapy were included. The outcome measures were gait balance, disability status, quality of life, and depression level. The PEDro scale was used to systematically appraise methodological quality. Two reviewers screened, extracted, and performed a quality assessment of included studies independently. Review Manager V.5.4 (Cochrane Collaboration) software was used for statistical analysis. Heterogeneity was analyzed using I2 statistics, and a standardized mean difference with 95% CI and P value was used to calculate the treatment effect for outcome variables. Results. A total of 6 studies with 1260 participants were included. The average PEDro methodological quality score was 6.67. No statistically significant difference between multidisciplinary and conventional rehabilitation on functional capacity (SMD: 0.69; 95% CI: −0.13, 1.51; P = 0.10 ), disability status (SMD: 0.65; 95% CI: −0.16, 1.46; P = 0.11 ), and quality of life (SMD: 0.28; 95% CI: −0.31, 0.59; P = 0.08 ) was found. However, there is a statistically significant improvement in caregivers' anxiety levels in the multidisciplinary group (SMD: 0.39; 95% CI 0.06, 1.73; P = 0.02 ). Conclusion. This systematic review and meta-analysis show no significant difference between multidisciplinary and conventional rehabilitation on functionality, disability, and quality of life. Caregivers' anxiety levels show improvement following multidisciplinary interventions. However, large-scale studies with long-term follow-up were required for concrete and clinical recommendations.

A meta-analysis of the effect of multidisciplinary comprehensive care on health-related quality of life and Unified Parkinson’s Disease Rating Scale in Parkinson’s disease

“…This was likewise emphasized in a previous work that employed a similar meta-analysis technique and yielded advantageous outcomes for multidisciplinary comprehensive care and standard care for subjects with PD. 66,67 Since in the present meta-analysis it was impossible to define whether the differences in gender, age and ethnicity are related to the outcomes, future randomized controlled trials are needed to evaluate these factors.…”

The multifaceted impact of structured training program on persons with Parkinson disease and their adult caregiver: A protocol for a systematic review

“…Despite the availability of literature emphasizing training either in the form of self-management, educational programs, and even multidisciplinary, the distinct feature of structured training is subject to argument. [11] A few systematic reviews either evaluating the effect of self-management programs, [10,11,13] multidisciplinary rehabilitation programs, [14,15] or integrative care [16] on PwPD have been documented. The review by Tennigkeit et al [11] is the only review to date evaluating the effect of a structured self-management program on PwPD.…”

“…A few systematic reviews either evaluating the effect of self-management programs, [ 10 , 11 , 13 ] multidisciplinary rehabilitation programs, [ 14 , 15 ] or integrative care [ 16 ] on PwPD have been documented. The review by Tennigkeit et al [ 11 ] is the only review to date evaluating the effect of a structured self-management program on PwPD.…”

“…A review [ 14 ] reporting a multidisciplinary care model for PwPD in recent years concludes multidisciplinary care model may yield improvement in health-related QoL (HRQoL) and Unified Parkinson Disease Rating Scale while another review [ 15 ] shows no superiority between the multidisciplinary and conventional care model on disability, functionality, and QoL despite improvement in carer anxiety level following multidisciplinary care. However, the review of Li et al [ 14 ] only included 1 published article explicitly stating training in their intervention description with no inclusion of caregivers.…”

The use of the drug L-Carnitine Rompharm in patients with Parkinson's disease in the context of rational pharmacotherapy

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ВведениеБолезнь Паркинсона (БП) представляет второе по частоте, после болезни Альцгеймера (БА), нейродегенеративное заболевание, которым страдают 1-2% населения в возрасте старше 65 лет [1]. Согласно данным Всемирной организации здравоохранения БП страдают 6,1 млн человек, через 30 лет в связи с постарением населения число пациентов с БП может увеличиться до 12 млн человек [2]. В основе БП лежит дегенерация дофаминергических нейронов, определенную негативную роль играет дисбаланс ацетилхолина, глутамата, норадреналина и серотонина [3].

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