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Physiotherapy in Parkinson's Disease: A Meta-Analysis of Present Treatment Modalities.

Neurorehabilitation and neural repair
October 1, 2020
Danique L M Radder et al. (7 authors)
Journal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tHuman Study
Study Details

Study Goal

To evaluate the effectiveness of Nordic walking as a physiotherapy intervention for improving motor symptoms, balance, and gait in people with Parkinson's disease.

Results Summary

Nordic walking was found to improve motor symptoms, balance, and gait in people with Parkinson's disease, based on the meta-analysis of randomized controlled trials.

Population

People with Parkinson's disease

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (23)
InterventionDirectionEndpointPopulationDosageImpactClaim #
conventional physiotherapy
increase
motor symptoms
people with Parkinson's disease
-
significantly improved
#1
conventional physiotherapy
increase
gait
people with Parkinson's disease
-
significantly improved
#2
conventional physiotherapy
increase
quality of life
people with Parkinson's disease
-
significantly improved
#3
resistance training
increase
gait
people with Parkinson's disease
-
improved
#4
treadmill training
increase
gait
people with Parkinson's disease
-
improved
#5
strategy training
increase
balance
people with Parkinson's disease
-
improved
#6
strategy training
increase
gait
people with Parkinson's disease
-
improved
#7
dance
increase
motor symptoms
people with Parkinson's disease
-
improved
#8
dance
increase
balance
people with Parkinson's disease
-
improved
#9
dance
increase
gait
people with Parkinson's disease
-
improved
#10
Nordic walking
increase
motor symptoms
people with Parkinson's disease
-
improved
#11
Nordic walking
increase
balance
people with Parkinson's disease
-
improved
#12
Nordic walking
increase
gait
people with Parkinson's disease
-
improved
#13
balance and gait training
increase
motor symptoms
people with Parkinson's disease
-
improved
#14
balance and gait training
increase
balance
people with Parkinson's disease
-
improved
#15
balance and gait training
increase
gait
people with Parkinson's disease
-
improved
#16
martial arts
increase
motor symptoms
people with Parkinson's disease
-
improved
#17
martial arts
increase
balance
people with Parkinson's disease
-
improved
#18
martial arts
increase
gait
people with Parkinson's disease
-
improved
#19
exergaming
increase
balance
people with Parkinson's disease
-
improved
#20
exergaming
increase
quality of life
people with Parkinson's disease
-
improved
#21
hydrotherapy
increase
balance
people with Parkinson's disease
-
improved
#22
dual task training
no change
any of the outcomes studied
people with Parkinson's disease
-
did not significantly improve
#23
Abstract

BACKGROUND: Physiotherapy is a commonly prescribed intervention for people with Parkinson's disease (PD). Conventional types of physiotherapy have been studied extensively, while novel modalities are being developed and evaluated. OBJECTIVE: To evaluate the effectiveness of conventional and more recent physiotherapy interventions for people with PD. The meta-analysis performed as part of the 2014 METHODS: We performed a systematic search in PubMed, CINAHL, Embase, and Web of Science. Randomized controlled trials comparing any physiotherapy intervention with no intervention or sham treatment were included. Trials were classified into 12 categories: conventional physiotherapy, resistance training, treadmill training, strategy training, dance, martial arts, aerobic exercises, hydrotherapy, balance and gait training, dual tasking, exergaming, and Nordic walking. Outcomes included motor symptoms, balance, gait, and quality of life, and are presented as standardized mean differences. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to systematically appraise methodological quality. RESULTS: A total of 191 trials with 7998 participants were included. Conventional physiotherapy significantly improved motor symptoms, gait, and quality of life. Resistance training improved gait. Treadmill training improved gait. Strategy training improved balance and gait. Dance, Nordic walking, balance and gait training, and martial arts improved motor symptoms, balance, and gait. Exergaming improved balance and quality of life. Hydrotherapy improved balance. Finally, dual task training did not significantly improve any of the outcomes studied. CONCLUSIONS: This meta-analysis provides a comprehensive overview of the evidence for the effectiveness of different physiotherapy interventions in the management of PD, allowing clinicians and patients to make an evidence-based decision for specific treatment modalities. Further work is needed to directly compare the relative efficacy of the various treatments.

Medical Subject Headings (MeSH)
HumansNeurological RehabilitationOutcome Assessment, Health CareParkinson DiseasePhysical Therapy Modalities
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations153
Citations/Year30.6
Relative Citation Ratio15.49
NIH Percentile99%
Research Impact Scores
APT Score0.95
Weight Score3.02
Normalized Score0.72
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