Paramedical Therapies for Parkinson Disease: A Systematic Review
Background: Parkinson disease is associated with multiple disabilities and functional impairment in activities of daily living regarding gait, posture, falls, balance, and cognitive decline. The paramedical therapies have been proposed as an effective adjunctive intervention by exercising physiotherapy, speech and language therapy, occupational therapy, and maximizing independence and motor rehabilitation. Objectives: This systematic review explores the effectiveness of different paramedical therapies for Parkinson disease under variant treatment strategies. Methods: We searched online resources like PubMed, PubMed Central, Cochrane Library, and Google Scholar for randomized controlled trials on all types of paramedical interventions. We included human studies published in peer-reviewed journals in the English language in the last ten years. Results: After reviewing 600 initial studies, we excluded 250 duplicates and all irrelevant articles. We did a quality assessment for the remaining 17 studies using The Physiotherapy Evidence Database (www.pedro.org.au). Multidisciplinary physiotherapy trials and speech and language therapy for dysarthria trials had data supporting the beneficial outcome regarding the risk of fall, postural instability, gait speed, improvement in all motor aspects and quality of life. Due to heterogeneous methodology and outcomes, the data is insufficient regarding superiority of one physiotherapy modalities to the others. Conclusions: Rehabilitation interventions encompass a wide range of benefit to the patients who have Parkinson disease, as well as a wide range of techniques and modalities, which needs to be adjusted, measured in the array of intensity, duration, content, quantitative outcome measures in future large randomized clinical trials to improve specific treatment strategies and cost-effective designed interventions.