Objective: To evaluate all current evidence on the types, timing, frequency, duration, and outcomes of physical therapy (PT) regimens applied in Parkinson’s disease (PD).
Background: PD is a neurodegenerative syndrome that affects ~1% of the population above age 60, and a major goal of treatment is to preserve physical function through (PT). Although PT outcomes in PD have been well documented, aggregate information on the parameters of PT has not been previously explored.
Method: An electronic search of PubMed, Embase, Medline, and the Web of Science Core Collection. Eligible studies consisted of all peer-reviewed articles reporting PD randomized controlled trials published in English after 2000. We included comparisons of any PT PD intervention head-to-head with another intervention or when compared to ‘no’ intervention. All trials exclusively focused on exercise without a PT comparator were excluded.
Results: A total of 46 trials with 3,905 patients were identified and included for analysis. There were 10 trials (22%) comparing two different types of non-conventional PT interventions and 26 (56%) comparing one type of non-conventional PT to conventional PT or alternatively compared to general exercise. The remainder of trials (n=10, 22%) compared PT to no intervention (n=10, 22%). The most common non-conventional PT intervention uncovered was aquatic physiotherapy (n=5, 11%). PT regimen durations ranged from 2 to 12 weeks (n=38, 85%) and were most performed with frequencies of either twice or three times weekly (n=27, 58%). In most trials (n=39, 87%), PT session length ranged from 30 to 60 minutes. Across trials, PT revealed significant improvements: gait parameters (n=11, 24%.); balance variables (n=10, 22%); motor outcomes (n=5, 11%), quality of life (n=4, 9%) and cognition (n=1, 2.2%). Only one trials compared two different PT regimens using the same intervention. Approximately half of trials (n=22, 48%) documented some maintenance of benefit once the duration of the prescribed regimen was completed.
Conclusion: Overall, there was evidence that PT improved mobility features in PD. Though a wide range of PT types and PT regimens have been tested, comparative effectiveness of different regimens (durations, frequencies) and the long-term maintenance of their effects remain unknown.
To cite this abstract in AMA style:
M. El Hayek, J. Jofili Lopes, J. Lelaurin, A. Abi Nehme, K. Au, M. Okun, R. Salloum. A Systematic Review of the Type, Timing, Frequency and Durability of Effect in Parkinson’s Disease Physical Therapy [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/a-systematic-review-of-the-type-timing-frequency-and-durability-of-effect-in-parkinsons-disease-physical-therapy/. Accessed November 21, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-systematic-review-of-the-type-timing-frequency-and-durability-of-effect-in-parkinsons-disease-physical-therapy/