Parkinsons patients may not benefit from physical therapy


BIRMINGHAM, England, Jan. 20 (UPI) -- People with mild to moderate Parkinson's disease do not benefit from physical therapy, researchers in England found in a new study. Researchers at the University of Birmingham said there were no clinical or lifestyle improvements as a result of physical and occupational therapy, suggesting better programs need to be created to benefit patients. Parkinson's disease affects about 7 million people around the world, and 4 percent of people over the age of 80. The study was focused on patients with mild to moderate Parkinson's, which some researchers say should be interpreted as narrowing who is referred for physical therapy but should not rule it out. Part of the motivation for the study, the researchers said, was to be sure funds in England's National Health Service are allocated for effective treatments. "This shows that there is an urgent requirement to review current guidelines for patients with Parkinson's disease," said Dr. Carl Clarke, a researcher at the University of Birmingham, in a press release. "The resource that is committed towards these therapies, that do not appear to be effective, could be better used in patients with more severe problems with their Parkinson's disease." For the study, published in JAMA Neurology, researchers recruited 762 people with mild to moderate Parkinson's disease, randomly enrolling 381 of them in physiotherapy and occupational therapy, while the other 381 received no therapy. Based on the Nottingham Extended Activities of Daily Living Scale and Parkinson Disease Questionnaire, the researchers reported little to no immediate or medium-term meaningful improvements to their condition or life. While the study led researchers to conclude low-dose, patient-centered, goal-directed physiotherapy and occupational therapy does not help early stage Parkinson's patients, a researcher from the Mayo Clinic argues patients should be referred to therapy when it appears it may help. "Certain Parkinson's disease-related symptoms should benefit from routine physical therapy strategies, including gait freezing, imbalance and fall risk, or immobilized limbs," writes Dr. Eric Ahlskog, of the Mayo Clinic, in an editorial published in JAMA Neurology alongside the study, noting at least one area that physical therapy practices lack for Parkinson's patients. "These conventional physical therapy practices take no advantage of what has now become increasingly apparent: ongoing aerobic exercise may slow the progression of Parkinson's." Clarke said more research is needed into the benefits of physical therapy for Parkinson's patients, adding that it can be difficult to change guidelines for things that appear beneficial to patients. He said, however, long-term physical activity must be worked into treatment programs to get more benefit from them. "It is likely that increasing physical activity is beneficial for patients with earlier Parkinson's, whether that be through dance classes or by using some of the emerging, interactive technologies that are being tested," Clarke said. "The big challenge is to embed that behaviour long term, and to encourage more exercise over a long period of time."Stephen Feller

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