Efficacy of a physical therapy program in patients with Parkinson’s disease: A randomized controlled trial

Abstract

Ellis T, de Goede CJ, Feldman RG, Wolters EC, Kwakkel G, Wagenaar RC. Efficacy of a physical therapy program in patients with Parkinson’s disease: a randomized controlled trial. Arch Phys Med Rehabil 2005;86:626-32. Objective To investigate the effects of a physical therapy (PT) program in groups of people with Parkinson’s disease (PD). Design Randomized controlled trial with a crossover design. Setting Two outpatient rehabilitation clinics in Boston and Amsterdam, respectively. Participants Sixty-eight subjects diagnosed with typical, idiopathic PD, Hoehn and Yahr stage II or III, and stable medication use. Intervention Group A received PT and medication therapy (MT) for the first 6 weeks, followed by MT only for the second 6 weeks. Group B received only MT for the first 6 weeks and PT and MT for the second 6 weeks. Main outcome measures The Sickness Impact Profile (SIP-68), the mobility portion of the SIP-68, the Unified Parkinson’s Disease Rating Scale (UPDRS), and comfortable walking speed (CWS) at baseline, 6-week, 12-week, and 3-month follow-up. Results At 6 weeks, differences between groups were significant for the SIP mobility ( P=.015; effect size [ES]=.55), for CWS ( P=.012; ES=.49), for the activities of daily living (ADL) section of the UPDRS ( P=.014; ES=.45), and for the total UPDRS ( P=.007; ES=.56). The total SIP and the mentation and motor sections of the UPDRS did not differ significantly between groups. Significant differences were found at 3 months compared with baseline for CWS, the UPDRS ADL, and total scores. Conclusions People with PD derive benefits in the short term from PT group treatment, in addition to their MT, for quality of life related to mobility, CWS, and ADLs; long-term benefits were found in CWS, UPDRS ADL, and total scores but varied between groups.