Physiotherapy helps reduce Parkinson’s-related difficulties in daily activities

According to a recent study conducted by University of Tartu researchers, two-month group physiotherapy helps significantly reduce difficulties in the daily functional tasks of patients with Parkinson’s disease.

One of the authors of the study and Programme Director in Physiotherapy Kadri Medijainen said that earlier research on Parkinson’s disease has mostly focused on motor symptoms, and the patient-centred perspective has often been overlooked. In this study, 24 patients with Parkinson’s disease were randomly assigned to an intervention and a control group, and their performance was assessed twice, with a ten-week interval.

Participants in the study used the Modified Patients Specific Functional Scale (ModPSFS) to assess their performance of 24 daily activities. The performance of each activity was rated on an 11 point scale, with 0 indicating no difficulty and 10 marking a situation where the patient was unable to perform the activity independently. “To ensure that all respondents were comparable, only those activities that all respondents performed on a daily basis were used in the data analysis,” Medijainen said.
Members of the intervention group underwent one-hour physiotherapy sessions, in groups of three, twice a week for 8 consecutive weeks. The therapy sessions were assembled based on the recommendations of the European Physiotherapy Guideline for Parkinson’s Disease, and each session included exercises to improve gait, transfers (incl. in-bed), balance, physical capacity and manual dexterity.

Kadri Medijainen said that according to scientific literature, such inclusion of guideline recommendations into an integrated approach is uncommon. Intervention studies mostly concentrate on one treatment method, which is understandable from the research perspective. "Parkinson’s is a disease which manifests very differently in different people. When the treatment is complex, it is also difficult to draw conclusions. However, to help patients as much as possible, a multimodal yet Parkinson's-specific approach is needed," Medijainen said, confidently.

 The results of the study showed that two months of group physiotherapy significantly reduced the patient-perceived difficulties in the basic activities of daily living in patients with Parkinson’s disease. According to Medijainen, improvements also revealed in those aspects that most research articles focus on, such as freezing, impaired gait speed and joint mobility. "The focus of this study was the patient’s perspective on the effects of the physiotherapy intervention. Of course, the whole work of the interdisciplinary team is aimed at enhancing the patients’ well-being."

Medijainen admitted that although, patients are offered Parkinson’s-specific physiotherapy in some places in Estonia, it is still underused and the general awareness of the content and importance of physiotherapy at the different stages of Parkinson's disease is still poor. "Hopefully, this study helps improve the situation," she said.

The article "Structured guideline-based physiotherapy reduces difficulties in activities of daily living in Parkinson’s disease" was published in the journal NeuroRehabilitation.