title: Evidence-based analysis of physical therapy in Parkinson's disease with recommendations for practice and research.
abstract: Physical therapy is often prescribed in Parkinson's disease. To facilitate the uniformity and efficacy of this intervention, we analyzed current evidence and developed practice recommendations. We carried out an evidence-based literature review. The results were supplemented with clinical expertise and patient values and translated into practice recommendations, developed according to international standards for guideline development. A systematic literature search yielded 6 systematic reviews and 23 randomized controlled trials of moderate methodological quality with sufficient data. Six specific core areas for physical therapy were identified: transfers, posture, reaching and grasping, balance, gait, and physical capacity. We extracted four specific treatment recommendations that were based on evidence from more than two controlled trials: cueing strategies to improve gait; cognitive movement strategies to improve transfers; exercises to improve balance; and training of joint mobility and muscle power to improve physical capacity. These practice recommendations provide a basis for current physical therapy in Parkinson's disease in everyday clinical practice, as well as for future research in this field.
authors.affiliation: Department of Physical Therapy, Leiden University Medical Center (LUMC), The Netherlands.
authors.forename: Samyra H J
authors.initials: SH
authors.lastname: Keus
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.forename: Erik J M
authors.initials: EJ
authors.lastname: Hendriks
authors.forename: Alexandra B
authors.initials: AB
authors.lastname: Bredero-Cohen
authors.forename: Marten
authors.initials: M
authors.lastname: Munneke
mesh_terms: D035843:Biomedical Research / Q000379:methods*; D006801:Humans; D010300:Parkinson Disease / Q000628:therapy*; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic / Q000592:standards*