Physiotherapy versus placebo or no intervention in Parkinson's disease

Deane, Katherine; Jones, Diana; Playford, E Diane; Ben‐Shlomo, Yoav; Clarke, Carl E

doi:10.1002/14651858.cd002817

Cited by 177 publications

(229 citation statements)

References 96 publications

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“…9,73 In our study, quality of life improved across all groups, although the largest improvement was in the class. Reportedly, quality of life is correlated with depression and apathy, both which improved in the individual therapy group as well.…”

Section: Discussionmentioning

confidence: 46%

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Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease

King

Wilhelm

Chen

et al. 2015

Journal of Neurologic Physical Therapy

122

128

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Background and Purpose Comparative studies of exercise interventions for people with Parkinson Disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by 1) home exercise program, 2) individualized physical therapy, or 3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Methods Fifty-eight people (age 63.9 ± 8) with PD participated. People were randomized into: 1) home exercise program 2) individual physical therapy or 3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test (PPT). Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS motor and ADL scores were included. Results Only the individual group significantly improved in PPT. The individual exercise showed the most improvements in functional and balance measures, while the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. Discussion and Conclusions An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist. Video Abstract available for additional insights from the authors (See Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).

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Section: Discussionmentioning

confidence: 46%

“…14 A recent meta-analysis examined differences between types of exercise by sub-grouping studies according to intervention and found no difference but caution readers about the limited number of studies and the indirect comparison of interventions. 9 …”

Section: Introductionmentioning

confidence: 99%

Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease

King

Wilhelm

Chen

et al. 2015

Journal of Neurologic Physical Therapy

122

128

View full text Add to dashboard Cite

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“…17, 21 A recent Cochrane review reported on the short term effects of physical therapy in PD and concluded that physical therapy utilizing various exercise types can provide small but important changes in walking speed, balance, and clinician rated disability measured by the Unified Parkinson’s Disease Rating Scale (UPDRS). 22 One limitation noted by the review however was that the trials included were relatively small, usually comparing physical therapy to no physical therapy over short periods of time. It is not clear if exercise over long periods conveys continued improvements in patient function or whether the progressive nature of the disease overtakes the benefits of exercise in the long term.…”

Section: Introductionmentioning

confidence: 99%

Two-Year Exercise Program Improves Physical Function in Parkinson’s Disease

Prodoehl

Rafferty

David

et al. 2014

Neurorehabil Neural Repair

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Background The progressive resistance exercise (PRE) in Parkinson’s disease trial (PRET-PD) showed that PRE improved the motor signs of PD compared to a modified Fitness Counts (mFC) program. It is unclear how long-term exercise affects physical function in these individuals. Objective To examine the effects of long-term PRE and mFC on physical function outcome measures in individuals with PD. Methods A preplanned secondary analysis was conducted using data from the 38 patients with idiopathic PD who completed the PRET-PD trial. Participants were randomized into PRE or mFC groups and exercised 2 days/week up to 24 months. Blinded assessors obtained functional outcomes on and off medication at baseline, 6 and 24 months with the Modified Physical Performance Test (mPPT), five times sit to stand test (STS), Functional Reach Test (FRT), Timed Up and Go (TUG), Berg Balance Scale (BBS), 6 minute walk test (6MWT), and 50ft walking speed (walk speed). Results The groups did not differ on any physical function measure at 6 or 24 months (p’s > 0.1). Across time, all physical function measures improved from baseline to 24 months when tested on medication (p’s < .0001), except for 6MWT(p = .068). Off medication results were similar except that the 6MWT was now significant. Conclusions 24 months of supervised and structured exercise (either PRE or mFC) is effective at improving functional performance outcomes in individuals with moderate PD. Clinicians should strive to include structured and supervised exercise in the long-term plan of care for individuals with PD.

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“…5 Similarly, a recent systematic review of physiotherapy interventions encompassing general physiotherapy, exercise, treadmill training, cueing, dance, and martial arts found that physiotherapy improved mobility but not function over the short term (less than three months). 6 In contrast to these short term changes, van Nimwegen and colleagues' study demonstrated engagement in the exercise programme over two years. Their intervention had several key elements.…”

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confidence: 89%