Multidisciplinary rehabilitation for Parkinson’s disease is associated with reduced disability and better functional status and quality of life compared to conventional rehabilitation, according to a review study.
However, these differences did not reach statistical significance. This means that either of the two approaches offers equivalent benefits, or that the small number of trials and patients included, as well as the short duration of the interventions, prevented the detection of such differences, noted the authors. researchers.
Significant differences were observed for caregiver anxiety, with the multidisciplinary approach being superior to conventional rehabilitation in reducing anxiety.
Future studies, appropriately designed, with adequate numbers of patients, are needed to draw strong conclusions, the researchers noted.
The review study, “Multidisciplinary rehabilitation for people with Parkinson’s disease: a systematic review and meta-analysiswas published in the journal Parkinson’s disease.
People with Parkinson’s disease may experience not only characteristic motor problems, but also non-motor symptoms, such as cognitive impairment, depression, sleep disturbances, and gastrointestinal, urinary, and sexual difficulties.
Both motor and non-motor symptoms contribute to significant disability and negatively affect patients’ quality of life.
“Previous studies have highlighted that the integration of different healthcare professionals into a multidisciplinary care team is necessary to address the complexity and burden of PD. [Parkinson’s disease]“, wrote the researchers.
“This multidisciplinary team could include physical rehabilitation, psychological support, occupational therapy, speech, language, swallowing therapy and nutrition,” they added.
However, no study to date has provided clear evidence of the superiority of multidisciplinary rehabilitation over standard physical rehabilitation.
With this in mind, a team of researchers in Ethiopia and Turkey systematically reviewed studies published up to May 2021 that reported the results of randomized controlled trials and compared the multidisciplinary intervention to conventional physiotherapy.
From the initial 2,704 results, 34 studies were searched for eligibility, and six – covering 1,260 patients – were included in the meta-analysis. The publication date of the study ranged from 2012 to 2019, and the number of patients included ranged from 43 to 762.
In all studies, the multidisciplinary team included an occupational therapist, psychotherapist, movement disorder specialist, and social worker, among other healthcare providers.
The interventions, lasting an average of three months (range, four weeks to eight months), took place in health facilities and/or hospitalized patients in five studies, and at home in one study.
Details of the intervention, outcomes, and measures to assess these outcomes varied widely across studies. The most commonly reported outcomes included functional mobility, balance and falls, motor symptoms, and patient-rated quality of life.
The results showed that multidisciplinary rehabilitation was associated with a tendency to be superior to conventional physiotherapy in reducing disability (four studies, 243 patients) and improving functional abilities (four studies, 972 patients) and the quality of life (five studies, 1217 patients).
However, none of these intervention differences reached statistical significance.
Notably, data from two studies, involving a total of 143 patients, showed that multidisciplinary rehabilitation significantly reduced caregiver anxiety levels, compared to standard care.
These results suggest that “multidisciplinary rehabilitation may not show superiority over conventional rehabilitation in patients with PD,” the researchers wrote, adding that “these unexpected results may be secondary to the small size and short duration of the interventions in many included studies”.
In addition to their inherited limitations, the included studies were limited to those in English, and the method of quality assessment of each study did not take into account “timing of results or compliance with intervention, which are very relevant when considering physiotherapy interventions,” the team wrote.
As such, “further studies with better designs and adequate sample size will be needed” to draw “concrete conclusions,” they added.