Objective: To reinforce the importance of physical therapy in the management of Parkinson’s disease.

Background: Unsteadiness, falling, and tendency to fall are frequent symptoms of advancing PD, yet treatment options for gait improvement and fall prevention remain unmet. Physical therapy (PT) has been shown effective, but patient’s compliance and commitment with this are challenging. Management of PD symptoms require a multimodal approach to include traditional pharmacological medication, deep brain stimulation (DBS), and PT. At the 62nd (2010) and 64th (2012) AAN meetings, we presented the role of Nintendo Wii® and Kinect® in the treatment of gait and balance disorders in PD patients.

Methods: Case series. We compared the UPDRS III and Tinetti Gait and Balance (TGB) scores of all patients, pre- and post-medicine, medicine + DBS, medicine + DBS + PT. TGB assesses gait and balance in older adults. Besides giving information on maneuverability, it is also a good indicator of fall risk. Balance Score = 16, Gait Score = 12. Total TGB Score = 28: [25-28 = low fall risk, 19-24 = medium fall risk, < 19 = high fall risk].

Results: 21 patients volunteered in this observational study: 11M, 10F ages 57-87, all on PD medicine, 10 DBS: 5M, 5 F. TGB scores at day 1 ranged from 6-25. At day 28: 2 no improvement (+ PT,-DBS), 6 declined (average -2.2, +DBS, – PT), 13 improved (average +3.9, +PT, 3+DBS).

Conclusions: In this small observational study, we found that patients on medicine with or without DBS have better maneuverability after PT. PT should be considered integral in the management of Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/physical-therapy-a-third-wheel-in-the-management-of-parkinsons-disease/