Objective: To verify the effectiveness of neurofunctional physical therapy in sleep quality objectively and subjectively assess it among individuals with PD.

Background: Parkinson’s disease (PD) is a neurodegenerative and progressive disease, composed of motor and non-motor symptoms. Non-motor symptoms are highly prevalent, among them sleep disorders, which can affect 40 to 98% of these individuals, with a negative impact on their quality of life. Non-pharmacological strategies in the treatment of sleep disorders have become the target of current research, however, little is known about the effectiveness of physiotherapy in improving sleep disorders.

Method: A sample of individuals with PD was assessed before and after 32 physical therapy sessions and then three months later (follow-up). After information regarding when the diagnosis was disclosed, weight and height information was gathered along with Levodopa equivalent daily dose calculation, the patients were assessed using the following instruments: the Pittsburgh Sleep Quality Index (PSQI); Epworth Sleepiness Scale (ESS); Parkinson’s Disease Sleep Scale (PDSS); and actigraphy.

Results: Nineteen individuals aged 67.37 years old (±8.03) on average were included. No differences were found in any of the variables measured by the actigraphy or the ESS. Improvement was found from pre- to post-intervention when sleep was subjectively assessed in terms of nocturnal movements (p=0.04) and total score (p=0.03) obtained on the PDSS. Improvement was also found in the PDSS’ sleep onset/maintenance domain (p=0.001) between pre-intervention and follow-up. The participants’ total score obtained in the PSQI improved from the pre- to post-intervention (p=0.03). When only the poor sleepers subgroup (n=13) was considered, significant differences were found in the nighttime sleep and nocturnal movements variables and the PDSS’ total score between the pre- and post-intervention, while improvements in sleep onset/maintenance were found between pre-intervention and follow-up.

Conclusion: Neurofunctional physical therapy was effective in improving the subjective quality of the sleep of individuals with PD, especially of those who perceive themselves to be poor sleepers, without however, changing objective parameters of sleep assessed via actigraphy and daytime sleepiness.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-neurofunctional-physical-therapy-on-the-quality-of-sleep-of-individuals-with-parkinsons-disease-a-series-of-cases/