Effects of Physiotherapy Interventions for adult patients with Parkinson’s Disease – A Systematic Review

Abstract

Background: Parkinson's Disease (PD) stands out as one of the most widespread neurological disorders resulting in physical disabilities and movement impairments. A multidisciplinary approach involving physical therapies alongside pharmacological and neurological treatments is recommended. We aimed to evaluate the effectiveness of physiotherapy interventions on balance, functional mobility, quality of life, and activities of daily living compared to medication in patients with Parkinson's disease (PD). Additionally, we sought to assess the differences in outcomes between physiotherapy interventions implemented in high-income and upper-middle-income countries versus those in low-income and lower-middle-income countries (LICs and LMICs). Methods: Electronic searches, supplemented with bibliographic searches, were done in MEDLINE (Ovid), Physiotherapy Evidence Database (PEDro), and the Cochrane Library. Two independent reviewers (FM and GM) conducted the search, focusing on published randomized controlled trials (RCTs). A narrative synthesis was performed to summarize the findings. Results: A total of 6 studies were selected from 583 articles. Four trials showed that there was a significant effect in improving quality of life after physiotherapy intervention. Four studies assessing activities of daily living showed significant improvement after physiotherapy intervention as compared to baseline. Positive outcomes were observed for balance and functional mobility following treadmill and conventional gait training. The lack of relevant data in the context of LICs and LMICs made it challenging to draw any conclusions about the effectiveness of interventions in these settings. Conclusion: This systematic review revealed significant improvements in balance, functional mobility, quality of life, and activities of daily living among patients with Parkinson's Disease who underwent physiotherapy interventions in compared with medication. This review necessitates for further research for these interventions, particularly in lower-income and lower-middle-income countries, to investigate any differences from high-income settings.