Physiotherapy versus placebo or no intervention in Parkinson's disease

Abstract

Background Despite medical therapies and surgical interventions for Parkinson's disease (PD), patients develop progressive disability. Physiotherapy aims to maximise functional ability and minimise secondary complications through movement rehabilitation within a context of education and support for the whole person. The overall aim is to optimise independence, safety, and well-being, thereby enhancing quality of life. Objectives To assess the e ectiveness of physiotherapy intervention compared with no intervention in patients with PD. Search methods We identified relevant trials by conducting electronic searches of numerous literature databases (e.g. MEDLINE, EMBASE) and trial registers, and by handsearching major journals, abstract books, conference proceedings, and reference lists of retrieved publications. The literature search included trials published up to the end of January 2012. Selection criteria Randomised controlled trials of physiotherapy intervention versus no physiotherapy intervention in patients with PD. Data collection and analysis Two review authors independently extracted data from each article. We used standard meta-analysis methods to assess the e ectiveness of physiotherapy intervention compared with no physiotherapy intervention. Trials were classified into the following intervention comparisons: general physiotherapy, exercise, treadmill training, cueing, dance, and martial arts. We used tests for heterogeneity to assess for di erences in treatment e ect across these di erent physiotherapy interventions. Main results We identified 39 trials with 1827 participants. We considered the trials to be at a mixed risk of bias as the result of unreported allocation concealment and probable detection bias. Compared with no intervention, physiotherapy significantly improved the gait outcomes of speed (mean di erence 0.04 m/s, 95% confidence interval (CI) 0.02 to 0.06, P = 0.0002); two-or six-minute walk test (13.37 m, 95% CI 0.55 to 26.20, P = 0.04) and Freezing of Gait questionnaire (-1.41, 95% CI-2.63 to-0.19, P = 0.02); functional mobility and balance outcomes of Timed Physiotherapy versus placebo or no intervention in Parkinson's disease (Review)

International Parkinson and movement disorder society evidence‐based medicine review: Update on treatments for the motor symptoms of Parkinson's disease

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