Physical Therapy Improves Function in Parkinson’s Disease

1/26/2017

Each year, doctors diagnose 60,000 new cases of Parkinson’s disease (PD). Parkinson’s disease is a progressive neurodegenerative disorder challenging patients in gait, transfers, balance, and posture - among other challenges. As Parkinson’s disease progresses, patients face increased dependence, inactivity, and social isolation. With advances in pharmacology and surgery giving PD patients longer lives and increased motor function, interventions to maximize patient autonomy, prepare family caregivers, and otherwise improve quality of life become increasingly important. The evidence now demonstrates that a referral to physical therapy can add to the benefits achieved through usual care.

Claire Tomlinson and colleagues recently completed the largest review and meta-analysis of randomized controlled trials on physical therapy for Parkinson’s disease.¹

With 39 trials including 1,827 patients, they demonstrate that physical therapy for Parkinson’s disease creates statistically significant improvements in:

Gait speed (average improvement 0.04 m/s at three months)
Six-minute walking distance (average improvement 13.37 meters after three months)
Freezing of gait
Berg Balance Scale
Clinician-rated disability

The physical therapy interventions studied include: “general physical therapy,” exercise, cueing, and more. The last Cochrane review of this sort was published in 2001. That study covered only 280 patients. While most measures trended toward improvement, the study failed to demonstrate statistical significance for the difference between intervention and control. The higher number of participants in the more recent Cochrane review by Tomlinson and colleagues allowed some of those trends to become statistically significant. Now clinicians can have more confidence when making evidence-based plans of care and recommending physical therapy for management of Parkinson’s disease.

When patients are homebound and have demonstrated a recent change in condition, make Five Star Home Health part of your team for maximizing quality of life for these patients. With timely responses to physical therapy referrals, the availability of in-home speech and occupational therapy, and nurses experienced in PD management, Five Star can make an important difference in the lives of your patients. Our multi-disciplinary approach will be able to address the functional improvements noted in the recent Cochrane review while also addressing ability through activities modification, home safety, communication, swallowing, family training, and more. Parkinson’s disease is considered to exist in three stages: early, moderate, and advanced. Inasmuch as each stage represents different needs for therapy, education, and preparation, it is appropriate for doctors to order an episode of home health in the early stage and each time the doctor recognizes progression into the next stage.

Providing Both Interim and Long-Term Home Care

When patients have disabilities, dementia, or problematic mobility, refer to Five Star Home Health because we provide both Medicare-certified home health for short-term medical needs and personal care for long-term, largely non-medical services. We can provide the continuity of care your patients with disabilities may need to live safely at home long term.

References

Tomlinson C, Patel S, Meek C, et al. Physiotherapy versus placebo or no intervention in Parkinson’s disease (Review). The Cochrane Library. 2013.