Physiotherapy versus placebo or no intervention in Parkinson’s disease
This review updated the 2001 Cochrane review1, assessing the effectiveness of physiotherapy intervention versus no intervention in patients with PD. The review now includes 39 randomised trials with 1827 participants. It also reports the comparison of the different types of physiotherapy interventions used in the treatment of PD, and thus provides a comprehensive assessment of physiotherapy. The review includes a more comprehensive range of outcome measures compared with previous reviews, and thus provides the most reliable summary available of the current published evidence.
The review showed that physiotherapy has short term benefits in Parkinson’s disease. There was significant benefit from physiotherapy for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed, Berg balance scale and scores on the unified Parkinson’s disease rating scale. A wide range of physiotherapy techniques are currently used to treat Parkinson’s disease, with little difference in treatment effects.
Large, well designed, randomised controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating Parkinson’s disease in the longer term.
This review was published in the Cochrane Database of Systematic Reviews in August 20122 and as a short paper in the BMJ in September 20123.
1) Deane K, Jones DE, Playford ED, Ben-Shlomo Y, Clarke CE. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database of Systematic Reviews 2001;(3):CD002817. http://www.ncbi.nlm.nih.gov/pubmed/11687029
2) Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley C, Deane KHO, Wheatley K, Ives N. Physiotherapy intervention in Parkinson’s disease: systematic review and meta-analysis. British Medical Journal 2012;345(7872). http://www.ncbi.nlm.nih.gov/pubmed/22867913
3) Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley C, Deane KHO, Herd CP, Wheatley K, Ives N. Physiotherapy versus placebo or no intervention in Parkinson’s disease. Cochrane Database of Systematic Reviews 2012;(8):CD002817. – Cochrane update with additional trials as published in the BMJ in press. http://www.ncbi.nlm.nih.gov/pubmed/22895932