Meta-AnalysisThe effects of physical therapy in Parkinson's Disease: A research synthesis☆,☆☆,★
Section snippets
Literature search
The database of articles published from 1966 to May 1999 was compiled by means of MEDLINE, CINAHL, and Cochrane register of controlled trials using combinations of the key words Parkinson's disease, exercise, exercise therapy, physical therapy, and group training. References presented in relevant publications were also examined. Only articles written in English, German, or Dutch were included.
Studies had to meet the following selection criteria: (1) patients with PD were included in the study,
Results
A total of 19 studies were initially found. Seven studies were classified as pre-experiments.11, 24, 25, 26, 27, 28, 29 These studies were excluded from further analysis because of a lack of experimental control. The remaining 12 studies were included in the meta-analysis. Group, patient, and treatment characteristics are shown in table 1.Reference (total n) E/C (n) Ind or Group (E/C) Mean Age (E/C) (yr) Duration of PD (E/C) (yr) Type
Discussion
On the basis of previous reviews, it was hypothesized that PT is an important adjunct to pharmacologic treatment in patients with PD, with regard to neurologic symptoms (eg, tremor, bradykinesia, rigidity), walking ability, ADLs, and QOL.
The results of our research synthesis support the hypothesis that patients with PD benefit from PT in terms of ADLs and walking ability (walking speed, stride length), but not in terms of neurologic signs. In only 18 of 12 studies the effect of PT on the QOL
Conclusion
Important limitations of the present research synthesis are the small amount of controlled intervention studies included, the poor methodologic quality of most of the intervention studies, selection-bias by unpublished papers, and studies published in foreign languages. However, the increasing number of well-controlled intervention studies published in the last 5 years holds an important promise for the future with regard to evidence-based PT.
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2018, ExploreCitation Excerpt :Many treatment approaches of PD have therefore attempted to slow down symptom progression or to improve the patients’ overall conditions. Rehabilitative treatment programs, including qigong, dancing, exercise, and physiotherapy, have been applied to PD patients, and trials have shown that these exercises could help PD patients.25–30 Despite the evidence, however, PD patients have difficulty following a general and routine exercise program due to their trouble with movement.
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Supported by the Parkinson Patiënten Vereniging and Prinses Beatrix Fonds (grant no. P00-03-11).
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or any organization with which the author(s) is/are associated.
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Reprint requests to Cees J.T. de Goede, PT, Dept of Physical Therapy, University Hospital Vrije Universiteit, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands, e-mail: [email protected].