Physiotherapy and occupational therapy do not produce improvements in quality of life for patients with mild to moderate Parkinson’s disease, according to a UK study.
The findings suggest resources are being wasted on these therapies, say Professor Carl Clarke from Birmingham University, UK, and his team.
The team analysed details of 762 patients undergoing rehabilitation treatment for mild to moderate Parkinson’s disease, recruited from 37 UK centres. They were followed for 15 months afterwards.
This showed that combined physiotherapy plus occupational therapy did not lead to improvements in activities of daily living during follow-up, compared with the group given neither treatment. The study was published in JAMA Neurology yesterday (19 January).
"At three months, there was no difference between groups in activities of daily living total score or Parkinson Disease Questionnaire," the authors report. They add: "There was no difference in adverse events."
The team concludes: "Physiotherapy and occupational therapy were not associated with immediate or medium-term clinically meaningful improvements in activities of daily living or quality of life in mild to moderate Parkinson’s disease. This evidence does not support the use of low-dose, patient-centred, goal-directed physiotherapy and occupational therapy in patients in the early stages of Parkinson’s disease."
However, they suggest that future research could explore the impact of more structured and intensive physical and occupational therapy programs.
Professor Clarke commented: "This shows that there is an urgent requirement to review current guidelines for patients with Parkinson’s disease.
“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. That said, it is likely that increasing physical activity is beneficial for patients with earlier Parkinson’s."
Clarke, C. E. et al. Physiotherapy and Occupational Therapy vs No Therapy in Mild to Moderate Parkinson Disease: A Randomized Clinical Trial. JAMA Neurology 19 January 2016 doi:10.1001/jamaneurol.2015.4452
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